Brief Answer:
Hi this could be due to primary immundeficiency problem

Detailed Answer:
Hi I did review your concern.
Typically such results are seen in primary immunodeficiency problems.

Did your child have multiple ear, nose, lung or bowel infections in the past?

Poor antibody response to vaccines, especially the PCV13 vaccine is indicative of this problem and it contains many subentities which need to be diagnosed to determine further course of action.

The problem can be developing poor response to protein antigen or to carbohydrate antigen and it can be determined by certain lab test.

I would like to recommend you to consult a immunologist or a pediatrician specialized in dealing with immunological conditions near your place to evaluate this condition as it is relatively uncommon.
The first investigations needed would be
1)antibody titers to other vaccines, that the child has been vaccinated with in the past like diphtheria, tetanus, hemophilus influenza B.
2)Then we require Immunoglobulin titers for IgG,IgM,IgA,IgD and IgE. IgG subclass levels.
3)Complete blood report with WBC count and T and B cell levels based on flow cytometric analysis.

From this and other clinical data we can reach hopefully to a specific diagnosis and then can start treating the kid with prophylactic antibiotics, intravenous immunoglobulins at regular periods and so on. But first correct diagnosis is important.
So all in all,
These findings are suggestive of a primary immunodeficiency problem especially in a setting of previous frequent infections if she had them and proper evaluation by tests as I mentioned above is needed. Depending on proper diagnosis and treatment, most of these kids do as good as normal kids with some necessary precautions.

I hope this helps.
let me know if you have any more questions or concerns. i will try my best to help you out.
Wish your family all the best.
sincerely,
Dr Parth Desai

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