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The 23 valent pneumococcal polysaccharide vaccine PPSV23 induces an adequate serological response independent of the time of vaccination at disease onset, on high dose steroid therapy or during remission 45; unfortunately, it does not effectively stimulate long lasting immunity in children younger than 2 years of age 46, 47, in which a protective response follows the administration of the 7 valent pneumococcal conjugated vaccine PCV7 buy priligy reddit