Pneumovax vaccine

My nine-month-old, 17 pound daughter was given the pneumovax 23 vaccine in error. The nurse should have given her the hep B shot, but pulled the wrong vial of vaccination. Should I be concerned about possible interference with developing her own immunities, side effects or her ability to fight off infection? I have read that there are not many, or any studies done for children under the age of two that have been given this vaccine. I would appreciate any insight you could give me.

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Robert Steele

Robert W. Steele, MD, is a board certified pediatrician at St. John's Regional Health Center in Springfield, MO. He graduated from medical... Read more

The Pneumovax 23 vaccine is one of two licensed vaccines given to protect against infection with the bacteria, Streptococcus pneumoniae. This bacteria is responsible for most of the cases of bacterial pneumonia in adults and children; it is the bacteria most often found in ear and sinus infections and is the most common cause of bacterial meningitis in children. But with the possibility of preventing all these diseases, why don't all children receive this vaccine? The answer lies in the details:

It has not been proven to prevent ear infections

Although Streptococcus pneumoniae is the most common bacteria found in ear infections, those children who received the vaccine have not been found to get fewer of them. How can this be? Well, it was soon realized that although this vaccine did prevent the number of ear infections caused by this particular bacteria, the total number of ear infections did not change. In other words, these children simply got ear infections caused by other bacteria.

There are many types of these bacteria

Notice that the name of the vaccine is Pneumovax 23. The twenty-three comes from the fact this vaccine contains material to vaccinate against 23 of the most common types of Streptococcus pneumoniae. However, there are at least ninety different types that have currently been identified. So, while the Pneumovax 23 vaccine is effective against 95% of the types that cause disease, there are others that may cause infection because they are not included in the vaccine. All types cannot be included because the cost of doing so would make it prohibitive. In addition, the effectiveness of the vaccine is lowered with increasing inclusion of different types.

It is usually ineffective in children under age two

The immune system of a child under age two is immature when it comes to having the ability to respond to certain vaccines. While the Pneumovax vaccine works very well in adults (giving excellent immunity for about 5-10 years), only about 30% of children under two years are able to develop immunity after this shot. The reason for this is due to the way the vaccine is manufactured. Fortunately, a lot of research has been done to look for different ways to make this vaccine so that it will be effective in young children. And in fact, preliminary studies have suggested that this new vaccine will not only be effective in preventing serious disease like meningitis but may also have a large impact against ear infections.

I am sorry to hear your child was accidentally given the incorrect injection. However, it shouldn't cause any significant problems. This vaccine has been used since 1977 and has been found to be quite safe. The most common side effects of the Pneumovax vaccine are swelling and pain at the injection site. It does not adversely affect the immune system, and in fact, there is a chance (admittedly small) that for the next year or so your daughter will be immune to the bacteria that most commonly cause life threatening infections. Within the next several years, it is very likely the new Pneumovax vaccine will be found to be effective in small children and become one of the routine immunizations for all infants.

I hope this helps.

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