title: Pneumococcal polysaccharide vaccination administered early after neurotrauma or neurosurgery.
abstract: Pneumococcal vaccination is recommended to lower the risk of posttraumatic meningitis, and early vaccination may be of importance. After both trauma and central nervous system injury, immune-suppression may occur, which could affect T-cell function and the response to T-cell dependent vaccines. We therefore aimed to investigate the response to early vaccination with a T-cell independent pneumococcal polysaccharide vaccine (PPSV).
  
  
  
  Thirty-three patients with basilar skull fracture and 23 patients undergoing transsphenoidal pituitary gland surgery were vaccinated with PPSV within 10days after neurotrauma or neurosurgery. Twenty-nine neurosurgical patients vaccinated ⩾3weeks after neurotrauma or neurosurgery served as controls. Serotype-specific anti-polysaccharide binding IgG antibody levels to serotypes 4, 6B, 9V, 14, 18C, 19F and 23F were determined by enzyme immunoassay.
  
  
  
  The vaccination was safe and a highly significant antibody response was found against all serotypes in all groups (p<0.001 for each of the serotypes). There were no differences between groups or in the group by time interaction in any of the serotypes. After early and late vaccination, protective levels were found in >80% for serotypes 9V, 14, 18C, 19F and 23F and in 70% and 50% for serotypes 6B and 4, respectively.
  
  
  
  Patients vaccinated with PPSV within 10days after neurotrauma or neurosurgery respond similarly to those vaccinated after ⩾3weeks, indicating that PPSV can be administered early after neurotrauma or neurosurgery.
  
  
  
  NCT02806284.
authors.affiliation: Dept of Medical Sciences, Section of Infectious Diseases, Uppsala University, Sweden. Electronic address: anna.ljunghill_hedberg@medsci.uu.se.
authors.forename: Anna Ljunghill
authors.initials: AL
authors.lastname: Hedberg
authors.affiliation: Dept of Medical Sciences, Section of Infectious Diseases, Uppsala University, Sweden.
authors.forename: Karlis
authors.initials: K
authors.lastname: Pauksens
authors.affiliation: Dept of Neuroscience, Section of Neurosurgery, Uppsala University, Sweden.
authors.forename: Per
authors.initials: P
authors.lastname: Enblad
authors.affiliation: Dept of Medical Sciences, Section of Infectious Diseases, Uppsala University, Sweden(1).
authors.forename: Jessika
authors.initials: J
authors.lastname: Söderberg
authors.affiliation: Dept of Neuroscience, Section of Rehabilitation Medicine, Uppsala University, Sweden.
authors.forename: Björn
authors.initials: B
authors.lastname: Johansson
authors.affiliation: National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Helena
authors.initials: H
authors.lastname: Käyhty
authors.affiliation: Dept of Medical Sciences, Section of Infectious Diseases, Uppsala University, Sweden.
authors.forename: Jan
authors.initials: J
authors.lastname: Sjölin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000907:Antibodies, Bacterial / Q000096:biosynthesis*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007115:Immunization Schedule; D007074:Immunoglobulin G / Q000096:biosynthesis; D008297:Male; D008875:Middle Aged; D010902:Pituitary Gland / Q000276:immunology* / Q000473:pathology / Q000601:surgery; D022242:Pneumococcal Vaccines / Q000008:administration & dosage*; D011018:Pneumonia, Pneumococcal / Q000276:immunology / Q000382:microbiology / Q000517:prevention & control*; D011135:Polysaccharides, Bacterial / Q000737:chemistry / Q000276:immunology; D065288:Serogroup; D020205:Skull Fracture, Basilar / Q000276:immunology* / Q000473:pathology / Q000601:surgery; D013100:Sphenoid Bone / Q000276:immunology / Q000601:surgery; D013296:Streptococcus pneumoniae / Q000276:immunology; D013997:Time Factors; D014611:Vaccination
chemical_list: D000907:Antibodies, Bacterial; D007074:Immunoglobulin G; D022242:Pneumococcal Vaccines; D011135:Polysaccharides, Bacterial
keywords: Neurosurgery; Neurotrauma; Pneumococcal polysaccharide vaccine