Archie is a smiling, 9-month-old male, who waved his arms vi…
Archie is a smiling, 9-month-old male, who waved his arms vigorously, making happy baby noises. He was an active and alert boy. His temperature was 37.9 C and his other vital signs were normal. His right ear exam showed the tympanic membrane to be erythematous with fluid behind the membrane and poor movement. His left tympanic membrane revealed normal landmarks, but had slightly decreased movement. His nose exam showed minor mild erythema with clear to yellow nasal discharge. The rest of his physical examination was normal. The most likely cause of this disease is a gram-positive bacterium for which there are over 90 polysaccharide capsule antigenic types, and antibodies to the capsule are protective. How do we deal with vaccination in light of this problem in currently used vaccines?