Yildirium et al reported risk factors for 13-valent conjugated pneumococcal vaccine failure in pediatric patients. The authors are from the Georgia Institute of Technology, Boston Medical Center, Boston University and Emory University.
Patient selection: pediatric patient who received the 13-valent pneumococcal vaccine
Vaccine failure: diagnosis of invasive pneumococcal disease (IPD) due to a vaccine serotype in a child who is fully vaccinated (more than 14 days after completing the vaccination protocol)
Incomplete vaccination is associated with IPD.
Risk factors for vaccine failure:
(1) age > 60 months of age
(2) underlying comorbidity (sickle cell disease, prematurity, immunodeficiency, immunosuppression, malignancy, Down syndrome, neutropenia, developmental delay, asplenia, cochlear implant, congenital heart disease, nephrotic syndrome, neuromuscular disorder, asthma, chronic lung disease)
Bacteremia and pneumonia were the most common types of IPD.
Serotypes causing the majority of vaccine failures: 3, 7F and 19A.
If no comorbidity is found and if there was no problem in the vaccination process, then an investigation for an occult immunodeficiency should be considered.
