Background

The spleen plays an important role in preventing infection by removing bacteria (particularly encapsulated bacteria) from the blood stream. Individuals with anatomical asplenia (absent spleen) or functional asplenia/hyposplenia (no function or decreased function) are therefore at an increased risk of infections and are recommended to receive additional vaccines (outlined below).

The reason for asplenia or hyposplenia may be congenital or due to surgical removal (eg. in the case of trauma). Children with congenital asplenia, cancer related asplenia and those with sickle cell anaemia have a higher risk of infection than those who have had splenectomy for trauma.

Scheduling additional vaccines can be complicated by the cause of asplenia or hyposplenia. Where possible people having a planned splenectomy should ideally receive all additional vaccines at least 2 weeks prior to surgery. This is to ensure optimal protection prior to spleen removal. Those who undergo an unplanned or emergency splenectomy should defer vaccines for at least 7 days following surgery to allow time for recovery.

Individuals with asplenia/hyposplenia have a lifelong risk of infection. In addition to vaccination, patients are also recommended to receive prophylactic antibiotics.

Additional vaccine recommendations for children (<18 years)

  • Pneumococcal

  • Meningococcal

  • Haemophilus influenzae type B (HIB)

  • Influenza

  • COVID-19

Additional vaccine recommendations for adults (≥ 18 years)

  • Pneumococcal

  • Meningococcal

  • Haemophilus influenzae type B (HIB)

  • Influenza

  • COVID-19

Vaccine funding

Some of the recommendations in these guidelines are outside the scope of the National Immunisation Program (NIP). Different jurisdictions and individual hospitals have varying approaches to non-NIP vaccines, which should be clarified with the local health service.

Resources

Authors: Rachael McGuire (MVEC Education Nurse Coordinator) and Nigel Crawford (Director SAEFVIC, Murdoch Children’s Research Institute)

Reviewed by: Rachael McGuire (MVEC Education Nurse Coordinator) and Nigel Crawford (Director SAEFVIC, Murdoch Children’s Research Institute)

Date: May 5, 2022

Materials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.

You should not consider the information in this site to be specific, professional medical advice for your personal health or for your family’s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.