splenectomy and pneumococcal vaccination

Last edited 05/2019

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
      • 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)