[CIS PIDD] [cis-pidd] pneumococcal vaccine strategy in adolescents & adults with immune deficiency

[Laia Alsina Manrique de Lara]

OK,
So how bad would it be to administer first Pneumovax23 to complete diagnosis, and if no response is observed, administer Prevenar13 for prophylactic purposes +/- IGRT?

Laia Alsina
Allergy and Clinical Immunology Department,
Hospital Sant Joan de Deu, Barcelona.

El 04/12/2013, a las 21:13, "John Ziegler" <j.ziegler at unsw.edu.au<mailto:j.ziegler at unsw.edu.au>> escribió:

Stan

 PPV23 as primary vaccine is still popular in this setting among my colleagues but I think it's unethical not to give PCV13 first.

John


_________________________
Professor John B. Ziegler, AM
Department of Immunology & Infectious Diseases
Sydney Children's Hospital
High St., Randwick NSW 2031
Australia
T: (02) 93821515
F: + 61 + 2 93821580
E: j.ziegler at unsw.edu.au<mailto:j.ziegler at unsw.edu.au>

On 5 Dec 2013, at 8:06 am, "Stan Ress" <stan.ress at uct.ac.za<mailto:stan.ress at uct.ac.za>> wrote:

Hi all,

I have been referred a 15 year-old patient with extremely severe IgA deficiency, recurrent respiratory infections, & bronchiectasis on CT chest. Her baseline vaccine status revealed low IgG ELIZA antibodies against 4/5 antigens, including S. pneumonia & H. Influenza B. Our policy has been to vaccinate such patients with 23-valent pneumococcal polysaccharide vaccine. However, I saw a reference to ACIP recommendation that children & adults with immune compromising conditions or asplenia, should receive 13-valent conjugate vaccine 1st, followed 8 weeks later by unconjugated PPSV23.

Is this the general current practise?

Thanks.
--
Stanley Ress
Associate Professor of Medicine
Head: Division of Clinical Immunology
Department of Medicine
H47 Old Main Building-room 26
Groote Schuur Hospital and UCT
Observatory 7925
Cape Town
South Africa
TEL:INTERN. + 2721-4066201 or 4066197
FAX:   "    + 2721-(0)865173095
Cell: 0833115482
email: stan.ress at uct.ac.za<mailto:stan.ress at uct.ac.za>

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