Vaccination of asplenic or hyposplenic adults

Background: Sepsis is a feared complication in patients with an absent or dysfunctioning spleen.

Methods: A literature search was undertaken to identify recommendations for vaccination in asplenic or hyposplenic adults, and published data regarding the effectiveness of the vaccines in reducing the incidence of infections, and vaccine failures.

Results: Various committees and organizations recommend that the pneumococcal, meningococcal and Haemophilus influenza vaccine, plus booster doses, should be administered to patients with an absent or dysfunctional spleen. However, adherence to such recommendations varies. Furthermore, vaccine failures still occur in a subset of properly immunized individuals. Immunocompromised individuals, in particular, have a greater risk of inadequate antibody response.

Conclusion: Immunization is partially responsible for the observed reduction in sepsis after splenectomy.