Peer-reviewed article
Vaccination coverage, immune responses, and clinical characteristics in children with PFAPA syndrome: a monocentric prospective study.
Emilie Sallansonnet, Renato Gualtieri, Henri Margot, Manel Mejbri, Klara Posfay-Barbe et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined vaccination coverage and immune responses in 41 children with PFAPA syndrome, a common periodic fever condition. Children with PFAPA received most routine vaccinations on schedule and developed protective antibody levels for most vaccines, suggesting immunization is safe in this group. However, only 40% achieved protective levels against pneumococcal disease, and meningococcal vaccination was less commonly given on time. The findings support continued routine immunization of children with PFAPA while highlighting the need for monitoring of certain vaccine responses.
Key points
- 90–95% of patients received the primary DTaP-IPV-Hib-HBV series on time
- Serological testing confirmed protective antibody levels for diphtheria, tetanus, and measles
- Only 40% achieved protective pneumococcal antibody titers despite vaccination
- Meningococcal vaccination was administered on time in only 58% of patients
- None had received varicella vaccine, which was only introduced in Switzerland in 2023
Limitations
This is a small, single-center prospective study of 41 patients with no comparison group of children without PFAPA, so it cannot determine whether vaccine coverage or immune responses differ from the general pediatric population. The study does not assess vaccine reactogenicity or whether vaccination triggers febrile episodes in PFAPA.
Abstract
BACKGROUND: PFAPA syndrome (Periodic Fever, Aphthous Stomatitis, Pharyngitis, and Adenitis) is the most common periodic fever condition in children. Vaccination in this population can be challenging due to concerns about immune hyperreactivity, the potential to trigger febrile episodes, and uncertainty regarding vaccine efficacy. Data on immunization coverage and vaccine response in PFAPA remain limited. This study aimed to describe the clinical characteristics of children with PFAPA, with a particular focus on vaccination coverage and serological responses. METHODS: We conducted a prospective study of children with PFAPA followed at Geneva University Hospitals between February 2022 and April 2025. Clinical, laboratory, and genetic data were collected, along with vaccination status according to the Swiss national immunization schedule and serological results for major vaccine antigens. RESULTS: Forty-one patients were included. All exhibited elevated inflammatory markers during febrile episodes, and none had a monogenic cause identified. Vaccination coverage was high, with 90–95% of patients receiving the primary DTaP-IPV-Hib-HBV series on time. Minor delays were observed for the third pneumococcal and second MMR doses. Meningococcal (MenC/MenACWY) vaccination was administered on time in 58% of patients. Serological testing confirmed protective antibody levels for most antigens, including diphtheria, tetanus, and measles, but only 40% achieved protective pneumococcal titers. Only 65% showed varicella immunity because of past infection, as none had received the vaccine, which was only introduced in Switzerland in 2023. CONCLUSION: Children with PFAPA demonstrate high adherence to vaccination schedules and adequate immune responses, supporting the safety and effectiveness of routine immunization in this group. The reduced pneumococcal seroprotection suggests that monitoring antibody levels and considering booster doses may be warranted. Larger controlled studies are needed to assess vaccine immunogenicity and reactogenicity, particularly for highly reactogenic vaccines such as meningococcal B.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
Problem
Uncertainty about vaccination safety, efficacy, and immune responses in children with PFAPA syndrome
- Intervention
- Routine immunization according to Swiss national immunization schedule, with serological monitoring of vaccine response
- Population
- 41 children with PFAPA syndrome followed at Geneva University Hospitals
Key finding
90–95% of patients received primary DTaP-IPV-Hib-HBV series on time
Sallansonnet et al. · PubMed (US National Library of Medicine) · 24 Nov 2025