Polysaccharide pneumococcal vaccine should be given to a patient with which disease?

• A. Asthma
• B. Sickle cell disease
• C. Acute renal failure
• D. Osteoarthritis

Answer: (B)

Sickle cell disease creates functional asplenia, meaning the spleen isn’t able to filter encapsulated bacteria effectively. This dramatically raises the risk of invasive pneumococcal disease from Streptococcus pneumoniae. The polysaccharide pneumococcal vaccine covers many pneumococcal serotypes and is specifically recommended for people with conditions that compromise splenic function or are otherwise at high risk for invasive pneumococcal infections. So, among the options, this disease best warrants PPSV23 vaccination. Asthma carries some risk, but it’s not as strong a stand-alone indication as asplenia from sickle cell disease. Acute renal failure and osteoarthritis do not by themselves mandate PPSV23.