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Post-Splenectomy Vaccination — RACP Adult Medicine MCQ

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ModerateInfectious DiseasesPost-Splenectomy VaccinationRACP Adult Medicine

A 60-year-old man post-splenectomy for ITP 6 months ago did not receive pre-splenectomy vaccines. He has not been vaccinated against encapsulated organisms. What vaccines should he receive now?

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Correct answer: E — Pneumococcal, meningococcal, and Haemophilus influenzae type b vaccines

Post-splenectomy patients require vaccination against encapsulated organisms: pneumococcal (13-valent conjugate + 23-valent polysaccharide), meningococcal (ACWY conjugate + B), and Hib (conjugate). Ideally given ≥2 weeks before elective splenectomy. If missed, give ≥2 weeks post-surgery. Annual influenza vaccine is also recommended. Lifelong prophylactic antibiotics (amoxicillin or phenoxymethylpenicillin) should be considered.

Reference: ATAGI – 2024 – Australian Immunisation Handbook; Spleen Australia 2024