PPSV23 polysaccharide response interpretation

Given the number of serotypes tested and the number reaching a protective titer, apply the age-specific proportion rule (≥70% adults / ≥50% young children).

Evidence tier: Guideline-derived.

Formula / logic

Adequate if (serotypes responding / serotypes measured) ≥ 0.70 for ages ≥6 years and adults, or ≥ 0.50 for children 2-6 years. When fewer than ~4 serotypes are interpretable, the proportion rule is unreliable.

Interpretation

A "responder" is a serotype reaching the protective titer (commonly serotype-specific IgG ≥1.3 µg/mL, with or without a ≥2-4 fold rise). Combine with clinical phenotype.

Evidence & citations

  1. Orange JS, et al. 2025 Inborn errors of immunity practice parameter (JTFPP/AAAAI/ACAAI/CIS). Ann Allergy Asthma Immunol. 2026;136(4):426-493.e1. PMID 41936423
  2. Perez EE, Orange JS, Bonilla F, et al. Update on the use of immunoglobulin in human disease: A review of evidence. J Allergy Clin Immunol. 2017;139(3S):S1-S46. PMID 28041678

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