Asplenia and hyposplenia

^¥ doses as per NIP at 6 weeks, 4 months, 6 months (additional dose for those with a special risk condition) and routinely at 12 months of age.
^β booster doses are given at ≥ 12 months of age/8 weeks since previous dose (whichever is later).
^§ if not up to date with NIP recommendations refer to the Australian Immunisation Handbook for catch up advice.
^{^} ideally Prevenar 13® is administered first, followed by Pneumovax 23® at ≥ 4 years of age/minimum of 8 weeks later (whichever is later). If Pneumovax 23® is inadvertently administered first, a minimum of 12 months should elapse before administering Prevenar 13®.
^Ω to be given a minimum of 8 weeks following any previous doses.
^€ maximum of 2 doses of Pneumovax 23® in a lifetime.
N/A- not recommended.

^ booster doses are given at ≥ 12 months of age/8 weeks since the previous dose (whichever is later).
^# a single dose of Nimenrix® is funded on the NIP at 12 months and for year 10 students and adolescents aged 15-19 years who missed receiving the vaccine at school.
^¥ administration of prophylactic paracetamol is recommended for those < 4 years of age (15mg/kg per dose) 30 minutes prior to vaccination (or as soon as possible after), as well as 2 subsequent doses (4-6 hours apart) to reduce the likelihood and severity of fever.
^† Menveo® may be used interchangeably as an alternate brand to Nimenrix®. Where possible completing a course with the same brand is preferred.
^§ Bexsero® is registered for use from 6 weeks of age. Trumenba® is an alternate meningococcal B vaccine available as a 3 dose course for individuals asplenia/hyposplenia aged 10 years or older. Meningococcal B vaccines are not interchangeable.

^{^} if < 5 years of age and not up to date with NIP refer to the Australian Immunisation Handbook for catch up recommendations.
^§ a single dose is recommended for those aged 5 years or over who have not previously completed a primary course.

N/A- not recommended in this age group.
^£  immunisation of family members recommended.
^€  2 doses, given 4 weeks apart is recommended for those < 9 years of age in the 1st year of receiving the vaccine.

^β please note that pneumococcal vaccination for adults is recommended and funded under the NIP. In instances where doses have already been given they do not need to be repeated following a new diagnosis of asplenia/hyposplenia.
^§ dose only required if patient has never received a dose of Prevenar 13® before.
^¥ ideally Prevenar 13® is administered first, followed by Pneumovax 23® a minimum of 8 weeks later. If Pneumovax 23® is inadvertently administered first, a minimum of 12 months should elapse before administering Prevenar 13®.
^ individuals who previously received Synflorix® or Prevenar 7® are recommended to receive a single dose of Prevenar 13® at diagnosis.
^† maximum of 2 doses only of Pneumovax 23® in a lifetime.
N/A- not recommended.

^ß in instances where a primary course has previously been given there is no need to repeat the course.
^† Menveo® may be used interchangeably as an alternate brand to Nimenrix®. Where possible completing a course with the same brand is preferred.
^ individuals who previously received meningococcal C only vaccines (eg NeisVac-C®, Menjugate® or Meningitec®) should be re-immunised with meningococcal ACWY as recommended in these guidelines. There should be a minimum interval of at least 8 weeks between meningococcal vaccine doses.
^§ individuals who previously received polysaccharide meningococcal ACWY vaccines (Menomume®or Mencevax®) should be re-immunised with conjugate meningococcal ACWY as recommended in these guidelines. There should be a minimum of 6 months elapse before administering a conjugate meningococcal ACWY vaccine.
^¥ there is no maximum number or doses in a lifetime.
^Ω Trumenba® is an alternate meningococcal vaccine available as a 3 dose course for individuals asplenia/hyposplenia aged 10 years or older. Meningococcal B vaccines are not interchangeable for primary courses or booster doses.

^ dose only required if patient did not previously complete their primary course.

^§ immunisation of family members is recommended.
^ people who have received a solid organ transplant/HSCT should be given 2 doses of influenza vaccine, 4 weeks apart in the first year of being vaccinated following their transplant.