Immunisation – splenectomy

Vaccinations for people without a spleen

If you don't have a spleen or it doesn't work well, you are at increased risk of infection. It's important that you have vaccinations to reduce your risk of infection.

What is the role of the spleen in your body?

The spleen is a small organ located in the upper left side of your abdomen, just under your rib cage. The spleen contains white blood cells that destroy bacteria and help your body fight infections when you are sick. It also helps remove, or filter, old red blood cells from circulation.

Some people are born without a spleen (this is called asplenia) or their spleen does not work properly (this is called splenic dysfunction).

Why do people have their spleen removed?

Some people have their spleen surgically removed. This operation is called a splenectomy. The most common reason for splenectomy is to treat a ruptured spleen, which is often caused by an injury to your abdomen (tummy area).

A splenectomy may also be used to treat other conditions, including removing an enlarged spleen that is causing discomfort (splenomegaly), some blood disorders, certain cancers, infection and noncancerous cysts or tumours.

Why do I need vaccinations before a splenectomy?

Vaccinations help reduce your risk of getting a life-threatening infection after splenectomy.

After spleen removal, you are more vulnerable to serious or life-threatening infections, including pneumonia, septicaemia (blood poisoning) and meningitis. Infections usually develop quickly and make you severely ill. The risk of a life-threatening infection after splenectomy is more than 50 times higher than the risk in the general population. 

To reduce your risk of getting life-threatening infections, it is recommended that you complete your vaccinations 2–4 weeks before a planned splenectomy. If you have an unplanned splenectomy, you should get them after you've recovered from the operation. You should also get them if you've been diagnosed with hyposplenism (when your spleen doesn't function as it should).  

Which vaccinations you need depends on what vaccinations you've had before and what your healthcare provider currently recommends. The vaccines are free, and you'll usually get them at your GP surgery. You may need to pay a consultation fee. 

You'll need boosters of some vaccinations to keep up your immunity (a booster is a repeat of a vaccination that you've had before). You should have a flu vaccination every year.

Recommended vaccines include:

References

  1. Immunisation of special groups: Functional asplenia, hyposplenia and pre-/post-splenectomy (Section 4.3.11) Immunisation Handbook 2020, NZ
  2. Immunisation for adults pre-/post-splenectomy or with functional asplenia Immunisation Advisory Centre, NZ

Image: HealthInfo, NZ, 2020

Reviewed by

Dr Helen Kenealy is a geriatrician and general physician working at Counties Manukau DHB. She has a broad range of interests and has worked in a variety of settings including inpatient rehabilitation, orthgeriatrics and community geriatrics.
Credits: Health Navigator Editorial Team. Reviewed By: Dr Helen Kenealy, geriatrician and general physician, Counties Manukau DHB Last reviewed: 22 Mar 2021