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 splenectomy 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

• Canadian Immunization Guide: Asplenia or hyposplenia