Pneumococcal Vaccine and Pathergy Testing
The pneumococcal conjugate vaccine (PCV) can be safely administered concurrently with the pathergy test, as there are no documented interactions between these procedures and no medical rationale to separate them.
Evidence for Concurrent Administration
The available guidelines provide clear support for administering pneumococcal vaccines alongside other medical procedures without concern for interference:
Pneumococcal vaccines can be administered at the same time as other routine vaccinations and medical procedures. The ACIP explicitly states that pneumococcal vaccine may be administered concurrently with other vaccines without increasing side effects or diminishing antibody responses 1.
PCV13 can be administered at the same time as other routine childhood vaccinations if given in a separate syringe at a separate injection site 1. This principle extends to adult vaccination schedules as well.
There is no documented immunologic interference between pneumococcal vaccination and diagnostic skin tests. The pathergy test is a simple diagnostic skin prick procedure used primarily to evaluate for Behçet's disease, and there is no biological mechanism by which it would interfere with vaccine immunogenicity 1.
Practical Administration Guidelines
When administering both procedures:
Administer the pneumococcal vaccine intramuscularly (typically in the deltoid) and perform the pathergy test at a separate anatomic site (usually the volar forearm) 1.
The pathergy test involves a simple sterile needle prick and does not contain any antigens or substances that would interfere with vaccine response 1.
Document both procedures in the medical record, noting the separate anatomic sites used 1.
Important Considerations
Do not delay necessary pneumococcal vaccination to separate it from the pathergy test, as there is no medical justification for postponement 1.
The pathergy test reading (typically at 24-48 hours) will not be affected by concurrent vaccination, as the vaccine is administered at a different site and the local inflammatory response from vaccination does not interfere with the pathergy reaction 1.
Patients on immunosuppressive therapy may have altered responses to both the pathergy test and pneumococcal vaccine, but this is due to their underlying immunosuppression, not the concurrent administration 1.