Sex: F
Vaccine: PPV, UNK
Symptoms: Antibody test negative, Blood immunoglobulin G decreased, Immunoglobulin therapy, Vaccination failure
Clinical narrative: severely impaired anti-body response to both 13-valent pneumococcal conjugate vaccine (PCV13) and pneumococcal polysaccharide vaccine (PPV23); severely impaired anti-body response to both 13-valent pneumococcal conjugate vaccine (PCV13) and pneumococcal polysaccharide vaccine (PPV23)/ poor response to pneumococcal vaccinations;   This literature marketed report had been received from the authors of a published article, titled as stated above, and referring to a female patient of unknown age. The patient's medical history included that she was hospitalized in the neonatal intensive care unit (NICU) for the first 4 months of life; intrauterine growth retardation (IUGR); compound heterozygous RNU4ATAC variants were identified, both specifically associated with MOPDI/III [1]: n.50G more than C and n.51G more than A; EGD and colonoscopy were performed at the age of 2 years for emesis and dyschezia; referal for immune evaluation after gastrointestinal biopsies revealed a paucity of plasma cells and lymphoid aggregates without well-formed germinal centers; infection history at that time included probable sepsis at age 3 months and 2 courses of antibiotics for upper respiratory infection; and at the age of 2.5 years demonstrated hypogammaglobulinemia, decreased numbers of CD19 + B cells and CD8 + T cells, and protective diphtheria and tetanus titers. The patient's concurrent conditions included spondyloepimetaphyseal dysplasia with extreme short stature, microcephaly, lissencephaly, agenesis of corpus callosum, arachnoid cyst, atrial septal defect, congestive heart failure, renal dysplasia, hypertension, feeding dysfunction, global developmental delay, and cortical visual impairment Immunizations were up to date, given on a catch-up schedule. Her concomitant medications were not reported.  On an unknown date, the patients were vaccinated with pneumococcal vaccine, polyvalent (23-valent) (PNEUMOVAX23) injection (reported as pneumococcal polysaccharide vaccine [PPV23]) and pneumococcal vaccine conj 13v (crm197) (reported as 13-valent pneumococcal conjugate vaccine [PCV13]), both administered for prophylaxis (doses, vaccination schemes, frequencies, routes of administration, anatomical sites of injection, lot numbers, and expiration dates were not reported).  On an unknown date, the patient experienced severely impaired antibody response to both 13-valent pneumococcal conjugate vaccine (PCV13) and pneumococcal vaccine, polyvalent (23-valent) (PNEUMOVAX23), therefore an immunoglobulin replacement therapy was initiated due to markedly low IgG and poor response to pneumococcal vaccinations (antibody test negative, vaccination failure). The outcome of these events was not reported.  The causal relationship between antibody test negative and vaccination failure regarding pneumococcal vaccine, polyvalent (23-valent) (PNEUMOVAX23) vaccination was determined as related.  This is one of two reports regarding the same article.  A copy of the published article is attached as further documentation of the patient's experience.