Recommended Vaccinations After Splenectomy

Core Vaccinations Required

The World Health Organization recommends that patients who have undergone splenectomy should receive immunization against encapsulated bacteria, including Streptococcus pneumoniae, Haemophilus influenzae type B, and Neisseria meningitidis, to prevent life-threatening overwhelming post-splenectomy infection (OPSI) 1
Patients over 6 months of age should receive an annual influenza vaccine, as recommended by the World Health Organization 1, 2

The World Health Organization suggests that ideally, vaccinations should be administered at least 2 weeks before splenectomy if the procedure is planned, to allow for optimal antibody response 1, 3
For emergency splenectomy or trauma cases, vaccination should be started no sooner than 14 days after splenectomy, as antibody response is suboptimal before this time, according to the World Health Organization 1, 4

The World Health Organization states that OPSI presents as fulminant sepsis, meningitis, or pneumonia primarily caused by encapsulated bacteria, with a mortality rate ranging from 30-70% 1
Children under 5 years have a greater overall risk of OPSI with increased mortality compared to adults, as reported by the World Health Organization 1

The World Health Organization strongly recommends malaria prophylaxis for travelers to endemic areas, as well as providing patients with emergency antibiotics for use in case of sudden onset of fever, malaise, chills, or other constitutional symptoms 1, 2, 5
The Centers for Disease Control and Prevention recommend that primary care providers should be informed of the patient's asplenic status, to ensure proper care and management 1, 2

The American Academy of Pediatrics recommends that children under age 5 have higher risk of OPSI and require careful attention to vaccination status, as well as education about their lifelong increased risk of infection 1
The World Health Organization notes that current vaccines do not provide complete coverage against all serotypes, highlighting the need for ongoing vigilance and monitoring 1

The British Medical Journal recommends annual influenza vaccine to reduce the risk of secondary bacterial infections in patients after splenectomy 6
For elective splenectomy, vaccinations should be administered at least 2 weeks before surgery to ensure optimal antibody response, as recommended by the British Medical Journal 6
Reimmunization schedule: Pneumococcal vaccine should be considered for reimmunization after 2 years, especially in children under 2 years of age, according to the British Medical Journal 6
Reimmunization for asplenic patients is generally recommended every 5-10 years, as stated by the British Medical Journal 6

The risk of serious infection is highest in the first two years after splenectomy, but up to one-third of infections occur at least five years later, as reported by the British Medical Journal 6
The risk of dying from serious infection is clinically significant and almost certainly lifelong, according to the British Medical Journal 6

Lifelong prophylactic antibiotics should be offered in all cases, especially in the first two years after splenectomy, as recommended by the British Medical Journal 6
Patients should keep a supply of antibiotics at home to use immediately if symptoms of infection develop, as advised by the British Medical Journal 6
Asplenic patients are particularly susceptible to infection by Capnocytophaga canimorsus from dog bites and should receive a five-day course of co-amoxiclav, as recommended by the British Medical Journal 6