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 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 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