Reactions after 3 or More Doses of Pneumococcal Polysaccharide Vaccine in Adults in Alaska

Background. Following vaccination with 23-valent pneumococcal polysaccharide vaccine (PPV), pneumococcal antibody levels decline to prevaccination levels within 6–10 years. The Advisory Committee on Immunization Practices does not recommend routine revaccination because data on the safety and effectiveness of additional doses are insufficient. Methods. To determine whether medically attended adverse events occur more frequently after the third dose of PPV than after the first or second dose, we performed a retrospective review of medical records from a computer database for health care facilities that serve more than one-half of the Alaska Native population. All persons who had received ⩾3 PPV doses (n = 179) were included in the review, as were a randomly selected comparison group of 181 persons who had received 1 or 2 doses. Results. Only 1 (0.55%) of 179 persons who had received ⩾3 PPV doses and 4 (2.76%) of 181 persons in the comparison group had a medically attended adverse event, and no severe adverse events were recorded. Conclusion. We found no difference in the risk of medically attended adverse events following ⩾3 doses of PPV, compared with 1 or 2 doses.