Post-splenectomy patients are at risk of rapidly-progressing sepsis due to IgG-coated bacteria and encapsulated organisms. Although relatively rare, this rapidly-progressing sepsis is associated with a high mortality rate. The above recommended vaccines specifically target such causative organisms.

Non-elective splenectomy patients should be vaccinated 14 days post-splenectomy or at the time of hospital discharge, whichever comes first. Asplenic patients should be revaccinated at the appropriate time interval for each vaccine (Table 1).

Vaccines Post Emergent Splenectomy± Based on CDC Adult Immunization Schedule Recommendations from 2022 Chart Updated May 2022 The table below represents the most common scenario (e.g. no prior Pneumococcal vaccination).

• Post embolization of spleen – vaccination at discretion of provider Immunizations to be given 14 days post injury or prior to discharge from the hospital, whichever comes first, unless patient remains in the ICU.

Eight weeks after doses given prior to discharge, patient will need a second set of vaccinations: one dose of MenACWY (Menquadfi/Menveo) and one dose of serogroup B meningococcal (Bexsero). Additionally, revaccination of Menquadfi/Menveo is recommended every 5 years.

All splenectomy patients should receive an educational handout that with the post-splenectomy vaccine schedule. This is the same schedule providers use. WakeMed will ensure vaccinations are administered from time zero to the second round of splenectomy vaccines at 8-weeks. Long-term vaccination follow-up is the responsibility of the patient

Vaccinations should be administered the day prior to discharge, 14 days after splenectomy, or last day of ICU care (prior to floor/progressive transfer) – whichever comes first. 1,2

When to give vaccines? Elective splenectomy: immunise at least TWO weeks before (ideally four to six weeks) before surgery. Emergency splenectomy: immunise at least TWO weeks post surgery or when the patient is feeling sufficiently well. This requires co-ordination between hospital clinicians and GPs to ensure all the vaccines are given.

What vaccinations will I need after a splenectomy? Three bacteria for which you will be or have been vaccinated for that cause the most severe infections. 1. Pneumococcus vaccine (Pneumovax) is used to prevent infection caused by the pneumococcal bacteria.

Timing of vaccination relative to splenectomy: 1. Should be given at least 14 days before splenectomy, if possible. Doses given during the 2 weeks (14 days) before surgery can be counted as valid. 2. If the doses cannot be given prior to the splenectomy, they should be given at least 14 days after surgery or prior to discharge, whichever is ...