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
    • 4CMenB, two doses 4 weeks apart
  • Streptococcus pneumoniae: Pneu-C-13, one dose, followed in 8 weeks by Pneu-P-23, one dose
  • 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
Men-C-ACYW-135 4CMenB Pneu-C-13 Hib	Men-C-ACYW-135 4CMenB Pneu-P-23	splenectomy
influenza, if appropriate season