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 special 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?

Also, some people have their spleen surgically removed. This operation is called a splenectomy. The most common reason for a splenectomy is to treat a ruptured spleen, which is often caused by an injury to your abdomen (tummy area). A splenectomy may be used to treat other conditions, including an enlarged spleen that is causing discomfort (splenomegaly), some blood disorders, certain cancers, infection and noncancerous cysts or tumors.

Why do I need vaccinations before a splenectomy?

After spleen removal, you are more likely to get serious or life-threatening infections, including pneumonia, septicameia (blood poisoning) and meningitis. Infections usually develop quickly and make you severely ill. The risk of overwhelming 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.  

Which vaccinations you need depends on what vaccinations you've had before and what healthcare providers currently recommend. 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. Functional asplenia, hyposplenia and pre-/post-splenectomy National Immunisation Handbook, NZ, 2020
  2. Immunisation for adults pre-/post-splenectomy or with functional asplenia Immunisation Advisory Centre, NZ

Image: HealthInfo, NZ, 2020

Credits: Health Navigator Editorial Team.