Pneumococcal vaccine

In posttraumatic meningitis treatment: for adults (age ≥ 19 years) with cerebrospinal fluid fistula who have not received any pneumococcal vaccines, or for those with unknown vaccination history, the CDC recommends 1 dose of PCV13 and 1 or 2 doses of PPSV23 as follows ¹⁾ (Note: these recommendations are specific for adults with CSF leaks and differ from general vaccination recommendations):

● 1 dose of pneumococcal conjugate vaccine (pneumococcal PCV13) (e.g. Prevnar 13)

● 1 dose of pneumococcal polysaccharide vaccine (PPSV23) (e.g. Pneumovax, Merck) at least 8 weeks later

● for patients ≥ 65 years: PPSV23 ≥ 8 weeks after PCV13 and ≥ 5 years after any PPSV23 at < 65 years

In skull base fracture, if there is a CSF leak, pneumococcal vaccine is recommended for adults age 2–65 years ²⁾.