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)