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

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.

Although rare, limb swelling after revaccination could be a concern in special at-risk populations where repeated vaccination is necessary for pneumococcal protection.