I asked Dr Charlotte Cunningham-Rundles for a response. She stated that if the patient has been ill and requiring a lot of antibiotic use, it might be helpful to proceed with Pneumovax to increase her antibody titers during the pregnancy. The immunization would also allow transfer of maternal antibodies to the fetus later in the pregnancy. She indicated that if the obstetrician preferred that Pneumovax no be administered to the patient, then she would abide by the obstetrician's preference.
I hope this answer is helpful to you.
Jacqueline A. Pongracic, MD, FAAAAI