A survey of vaccine coverage and antibiotic prophylaxis in splenectomised patients in Scotland.
OBJECTIVE
To determine the coverage of vaccine and antibiotic prophylaxis in splenectomised patients in Scotland.


METHODS
Patients who had undergone splenectomy between 1 January 1988 and 31 December 1998 were identified. A questionnaire was sent to general practitioners to validate vaccine and antibiotic status for these patients.


RESULTS
A total of 974 living splenectomised patients were identified during the study period. Information on vaccine and antibiotic status was available for 708 (73%) and 770 (79%) of living patients, respectively. Coverage of pneumococcal vaccine (88%) was higher than that of Haemophilus influenza type b (Hib) conjugate vaccine (70%) or meningococcal vaccine (51%). Only 47% of patients received all three vaccines. A higher coverage was also documented for pneumococcal vaccine (28%) than Hib (19%) and meningococcal vaccine (14%) before elective splenectomy. Only 13% received all three vaccines before splenectomy. Coverage of influenza vaccine increased significantly, from 76% in the 1997/1998 season to 96% in the 2000/2001 season. Antibiotic prophylaxis was received by 67% of all patients. The current recommendation, comprising pneumococcal and Hib vaccination and antibiotic prophylaxis, was received by only 52% of the patients. There was no association between the coverage of vaccine and socioeconomic status.


CONCLUSIONS
Further improvement in coverage of recommended vaccines and antibiotic prophylaxis is still needed to reduce the risk of serious infection in this high risk group.
Kyaw
M H
MH
Public Health Sciences, University of Edinburgh, Teviot Place, EH 8 9AG, UK. Moe.Kyaw@scieh.csa.scot.nhs.uk
Holmes
E M
EM
Chalmers
J
J
Jones
I G
IG
Campbell
H
H
D000328:Adult; D019072:Antibiotic Prophylaxis / Q000706:statistics & numerical data*; D016667:Bacterial Capsules; D002648:Child; D018073:Haemophilus Vaccines / Q000008:administration & dosage; D019538:Health Care Surveys; D006801:Humans; D016867:Immunocompromised Host; D022401:Meningococcal Vaccines / Q000008:administration & dosage; D022242:Pneumococcal Vaccines / Q000008:administration & dosage; D011135:Polysaccharides, Bacterial / Q000008:administration & dosage; D012606:Scotland; D012923:Social Class; D013156:Splenectomy / Q000009:adverse effects*; D014611:Vaccination / Q000706:statistics & numerical data*
D018073:Haemophilus Vaccines; C044237:Haemophilus influenzae type b polysaccharide vaccine; D022401:Meningococcal Vaccines; D022242:Pneumococcal Vaccines; D011135:Polysaccharides, Bacterial