Immunization of people with asplenia and hyposplenia

Can receive all routine vaccines, including live vaccines
Try to complete vaccines at least 2 weeks before splenectomy, or wait at least 2 weeks after vaccination to start
Vaccines specifically recommended in asplenia or hyposplenia:
- Haemophilus influenzae type b (Hib), one dose
- Neisseria meningitidis:
  - Quadrivalent Men-C-ACYW-135, two doses 8 weeks apart followed by a booster every 5 years
  - 4CMenB, two doses 4 weeks apart
- Streptococcus pneumoniae:
  - Pneu-C-13, one dose with a booster at 5 years. Must wait at least 1 year after Pneu-P-23.
  - Pneu-P-23, one dose. Must wait at least 8 weeks after Pneu-C-13.
- Influenza (annually)
- If transfusion-dependent: hepatitis A and B vaccines
Should also have pill-in-pocket broad-spectrum oral antibiotics to be taken in case of fever

Sample schedule for vaccination before planned splenectomy
Week -10	Week -2	Week 0	Ongoing
Men-C-ACYW-135	Men-C-ACYW-135	splenectomy	Men-C-ACYW-135 booster every 5 years
4CMenB	4CMenB
Pneu-C-13	Pneu-P-23		Pneu-C-13 booster at 5 years
Hib
influenza, if appropriate season			annual influenza vaccination

Further Reading