Check immunisation history with patient, administer vaccinations appropriately (see table 2 below) and inform patient's GP.
Procedure | Time schedule for vaccinations |
Planned splenectomy | *4-6 weeks pre-operatively. If this is not possible, then 2 weeks pre-operatively. |
Unplanned splenectomy | 2 weeks post-operatively (antibody response may be better). |
Completion of radio- or chemotherapy | Delay vaccination for at least 3 months. |
Bone marrow transplant | 9-12 months post transplant. |
*For further information see the Green Book (Immunisation against Infectious Diseases) via https://www.gov.uk/government/organisations/department-of-health or British Committee for Standards in Haematology (www.bcshguidelines.com) or contact the immunology department. |
Vaccinations | Notes / Comments |
Haemophilus influenzae type b (Hib) |
Adults who have been fully immunised with Hib /MenC as part of routine vaccination programme give: combined Hib/MenC vaccine and Meningococcal B vaccine. After 4 weeks give the MenACWY conjugate vaccine and a second dose of the Meningcoccal B vaccine. |
Meningococcal group B (Bexsero®) | |
Meningococcal Group C conjugate (MenC) | |
Influenza vaccine | Recommended yearly to all adult patients. |
Pneumococcal vaccine | Give at same time as Hib/MenC vaccine. For all patients re-immunisation is recommended every 5 years |
If immunisation unknown / cannot be clarified or for further information see the Green Book (Immunisation against Infectious Diseases) via https://www.gov.uk/government/organisations/department-of-health or British Committee for Standards in Haematology (www.bcshguidelines.com) or contact the immunology department. |
Amoxicillin oral 500mg every 24 hours.
If true penicillin / beta-lactam allergy:
Erythromycin oral 500mg every 24 hours.
All patients with an absent or dysfunctional spleen should receive prophylactic antibiotics for at least 2 years, but ideally for life. Prophylactic antibiotics should be started immediately post surgery.
Last reviewed February 2018