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Limb swelling in a pediatric sickle cell patient after revaccination with pneumococcal vaccine

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Abstract

Case (description) This report describes an incident of limb swelling after revaccination with the 23-valent pneumococcal polysaccharide vaccine (PPSV23). A 5-year old female with sickle cell disease experienced severe arm swelling with edema to the extent that it was difficult to put a shirt over the arm. The day prior, she received PPSV23 concomitantly with the meningococcal vaccine. She had received the PPSV23 vaccine 2.5 years prior to the event. The patient was managed with analgesics, antiemetics, and antibiotic prophylaxis and the arm swelling resolved 24 h later. A decreased length of time between revaccination and concurrent administration with the meningococcal vaccine could have contributed. Conclusion Although rare, limb swelling after revaccination could be a concern in special at-risk populations where repeated vaccination is necessary for pneumococcal protection.

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References

  1. Updated Recommendations for Prevention of Invasive Pneumococcal Disease Among Adults Using the 23-Valent Pneumococcal Polysaccharide Vaccine (PPSV23). MMWR Recomm Rep. 2012;61:816–9.

  2. Nuorti JP, Whitney CG. Prevention of pneumococcal disease among infants and children-use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine-recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2010;59:1–18.

    PubMed  Google Scholar 

  3. Vernacchio L, Neufeld EJ, MacDonald K, et al. Combined schedule of 7-valent pneumococcal conjugate vaccine followed by 23-valent pneumococcal vaccine in children and young adults with sickle cell disease. J Pediatr. 1998;133:275–8.

    Article  CAS  PubMed  Google Scholar 

  4. Nelson K, Goldman JA, Perlino CA. Severe local reactions to pneumococcal vaccine. South Med J. 1980;73:264–5.

    Article  CAS  PubMed  Google Scholar 

  5. Fine MJ, Smith MA, Carson CA, et al. Efficacy of pneumococcal vaccination in adults. A meta-analysis of randomized controlled trials. Arch Intern Med. 1994;154:2666–77.

    Article  CAS  PubMed  Google Scholar 

  6. Jackson LA, Benson P, Sneller VP, et al. Safety of revaccination with pneumococcal polysaccharide vaccine. JAMA. 1999;281:243–8.

    Article  CAS  PubMed  Google Scholar 

  7. Jackson LA, Nelson JC, Whitney CG, et al. Assessment of the safety of a third dose of pneumococcal polysaccharide vaccine in the vaccine safety datalink population. Vaccine. 2006;24:151–6.

    Article  CAS  PubMed  Google Scholar 

  8. Overturf GD, Rigau-Perez JG, Selzer J, et al. Pneumococcal polysaccharide immunization of children with sickle cell disease. I. Clinical reactions to immunization and relationship to preimmunization antibody. Am J Pediatr Hematol Oncol. 1982;4:19–23.

    CAS  PubMed  Google Scholar 

  9. Rigau-Perez JG, Overturf GD, Chan LS, Weiss J, Powars D. Reactions to booster pneumococcal vaccination in patients with sickle cell disease. Pediatr Infect Dis. 1983;2:199–202.

    Article  CAS  PubMed  Google Scholar 

  10. Kohl KS, Walop W, Gidudu J, et al. Swelling at or near injection site: case definition and guidelines for collection, analysis and presentation of immunization safety data. Vaccine. 2007;25:5858–74.

    Article  CAS  PubMed  Google Scholar 

  11. Naranjo CA, Busto U, Sellers EM, et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther. 1981;30:239–45.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Katie J. Suda.

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Daniels, C.C., Shelton, C.M., Bass, P.J. et al. Limb swelling in a pediatric sickle cell patient after revaccination with pneumococcal vaccine. Int J Clin Pharm 36, 261–263 (2014). https://doi.org/10.1007/s11096-013-9888-3

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  • DOI: https://doi.org/10.1007/s11096-013-9888-3

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