Vaccination for Asplenia

Vaccination for Asplenia


Patients without a spleen are at risk for developing postsplenectomy infections

Due to the high mortality rates associated with these infections, it is imperative to ensure these patients receive the appropriate vaccinations at the appropriate time based on CDC recommendations


The vaccination schedule consists of 4 vaccines initially if patient has an unknown vaccination history

Day 1 of vaccination is dependent on whether the splenectomy is elective or emergent

  • To be administered 14 days prior to procedure if possible, if given within 14 days prior, doses are valid
  • To be administered 14 days post-splenectomy or as soon as patient has been stabilized after surgery prior to discharge, whichever comes first
  • Some data suggest suboptimal vaccine responses if administered within 14 days after splenectomy
  • If concerns of suboptimal response, revaccination can be considered. There is limited data regarding waiting until 14 days post-op, which can lead to missed vaccinations


All vaccinations can be administered at the same time on Day 1

Annual inactivated flu vaccine is recommended for every patient yearly during flu season

More Information

  1. Hammerquist R, Messerschmidt K, Pottebaum A et al. Vaccinations in asplenic adults. American Journal of Health-System Pharmacy. 73:9, e220-e228.
  2. “Adult Immunization Schedule by Vaccine and Age Group.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 5 Feb. 2019,
  3. “Vaccination of Adults with Asplenia.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 2 May 2016,
  4. Konradsen H, Rasmussen C, Ejstrud P et al. Antibody levels against Streptococcus pneumoniae and Haemophilus influenzae type b in a population of splenectomized individuals with varying vaccination status. Epidemiol Infect. 199 Oct; 119(2):167-174.
  5. Shatz DV, Schinsky MF, Pais LB. Immune responses of splenectomized trauma patients to the 23-valent pneumococcal polysaccharide vaccine at 1 versus 7 versus 14 days after splenectomy. J Trauma. 1998 May; 44(5): 760-5; discussion 765-6.
  6. Rubin LG, Schaffner W. Clinical Practice, Care of the asplenic patient. N Engl J Med. 2014 Jul 24;31(4):429-56.
  7. Di Sabatino A, Carsetti R, Corazza GR. Post-splenectomy and hyposplenic states. Lancet. 2011 July 2; 378(9785):86-97.
  8. Immunization Action Coalition Express, Issue 1194: July 15, 2015.