Pneumococcal revaccination of splenectomized children

Forty-three Danish splenectomized children received a single subcutaneous dose of a 14-valent pneumococcal vaccine (Pneumovax 23; Merck). Blood samples were taken before, 4 weeks after and 5 years after vaccination. Total pneumococcal antibody concentrations as well as antibodies against each of the 14 pneumococcal capsular polysaccharide antigens were measured by the enzyme-linked immunosorbent assay method. Depending on the pneumococcal antibody status 5 years after primary vaccination, the children were either revaccinated with a new 23-valent pneumococcal vaccine or scheduled for reexamination later. The antibody concentrations found 5 years after vaccination showed a strong correlation with the prevaccination antibody concentrations. Revaccination of children with low antibody concentrations 5 years after primary vaccination is safe, is without significant side effects and leads to a satisfactory antibody response.