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Splenectomy and pneumococcal vaccination

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Children and adults requiring splenectomy or commencing immunosuppressive treatment should be vaccinated according to the age-specific advice outlined above for risk groups

  • ideally, pneumococcal vaccine should be given four to six weeks before elective splenectomy or initiation of treatment such as chemotherapy or radiotherapy
    • if this is not possible, it can be given up to two weeks before treatment
    • if it is not possible to vaccinate beforehand, splenectomy, chemotherapy or radiotherapy should never be delayed
      • if it is not practicable to vaccinate two weeks before splenectomy, immunisation should be delayed until at least two weeks after the operation
        • this is because there is evidence that functional antibody responses may be better from this time
      • if it is not practicable to vaccinate two weeks before the initiation of chemotherapy and/or radiotherapy
        • immunisation can be delayed until at least three months after completion of therapy in order to maximise the response to the vaccine
        • immunisation of these patients should not be delayed if this is likely to result in a failure to vaccinate

Advise prophylactic antibiotic for splenectomy should be continued despite vaccination.

Reference:

  • The Green Book. Chapter 25 - Pneumococcal (April 2019)

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