Table 3.

Summary of deficient response phenotypes to the 23-valent pneumococcal polysaccharide vaccine (PPSV23), with permission from Ref. (35)^*.

Phenotypea	Response to PPSV23, age >6 years	Response to PPSV23, age <6 years	Notes
Severe	≤2 protective titers (≥1.3 μg/mL)	≤2 protective titers (≥1.3 μg/mL)	Protective titers present are low
Moderate	<70% of serotypes are protective (≥1.3 μg/mL)	<50% of serotypes are protective (≥1.3 μg/mL)	Protective titers present to ≥3 serotypes
Mild	Failure to generate protective titers to multiple serotypes or failure of a twofold increase in 70% of serotypes	Failure to generate protective titers to multiple serotypes or failure of a twofold increase in 50% of serotypes	Twofold increases assume a pre-vaccination titer of <4.4–10.3 μg/mL, depending on the pneumococcal serotype
Memory	Loss of response within 6 months	Loss of response within 6 months	Adequate initial response to ≥50% of serotypes in children <6 years of age and ≥70% in those >6 years of age

^aAll phenotypes assume a history of infection.

*Reprinted from J Allergy Clin Immunol, 130, Orange J, Ballow M, Stiehm ER, et al. Use and interpretation of diagnostic vaccination in primary immunodeficiency: A working group report of the Basic and Clinical Immunology Interest Section of the American Academy of Allergy, Asthma & Immunology, S1-24, Copyright (2012), with permission from Elsevier.