Pneumococcal vaccine adverse effects

Patients with AIDS have an impaired antibody response to pneumococcal vaccine. Adverse effects in symptomatic and asymptomatic HIV-infected vaccinees were not different from those in HIV-negative persons (7). 

Pneumococcal vaccines produced by different manufacturers are currently available, for example Pneumovax 23 produced by Merck Sharp Dohme and Pnu-Imune 23 produced by Lederle Laboratories. Each vaccine dose (0.5 ml) contains 25 pg of each polysaccharide antigen. Immunization is recommended for people who are at increased risk of developing pneumococcal disease because of underlying chronic health conditions and for older people. About 50% of vaccinees develop mild adverse effects, such as erythema and pain at the injection site. Fever, myalgia, and severe local reactions have been reported in under 1% of vaccinees. Severe systemic reactions, such as anaphylaxis have been rarely reported. 

The immunogenicity of 7-valent pneumococcal-conjugate vaccine plus 23-valent pneumococcal vaccine in 11 children has been compared with the immunogenicity of 23-valent vaccine alone in 12 children up to 2 years of age with sickle cell disease (9). IgG pneumococcal antibody concentrations were higher with combined administration, with no increase in adverse effects after immunization with 23-valent vaccine. 

Pneumococcal polysaccharide vaccine generally is considered safe based on clinical experience since 1977, when the pneumococcal polysaccharide vaccine was licensed in the United States. Mild, local side effects (e.g., pain at the injection site, erythema, and swelling) develop in approximately half of persons who receive pneumococcal vaccine. These reactions usually persist for less than 48 hours. Moderate systemic reactions (e.g., fever and myalgias) and more severe local reactions (e.g., local induration) are rare. Intradermal administration may cause severe local reactions and is inappropriate. Severe systemic adverse effects (e.g., anaphylactic reactions) rarely have been reported after administration of pneumococcal vaccine (34,37). Pneumococcal vaccination has not been causally associated with death or neurological illness (e.g., Guillain-Barre syndrome) among vaccine recipients. 

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