What vaccines are indicated for someone with a splenectomy and is there concern that a person with a splenectomy may have a less than optimum response to vaccines?
Persons who do not have a functioning spleen or who have had a splenectomy do not handle encapsulated bacteria well and, therefore, are at increased risk for infection with encapsulated bacteria, especially Neisseria meningitidis and Streptococcus pneumoniae. They should be vaccinated with age-appropriate pneumococcal vaccine and meningococcal vaccine. Persons two years of age and older should receive two doses of pneumococcal polysaccharide vaccine separated by 3-5 years, depending on the age at time of revaccination. One dose of meningococcal vaccine should be administered. The recommendation for a booster dose is somewhat vague because polysaccharides aren’t the best antigens and don’t boost antibody titers very much with subsequent doses. However, high-risk people, including those without a functioning spleen can receive a one-time revaccination 3-5 years after the first dose. Certainly no more than a total of two doses should be given. Some providers also choose to administer one
