Vaccinations in asplenic adults.
OBJECTIVE
The recommended immunizations for adult asplenic patients are reviewed.


CONCLUSIONS
Patients without a spleen are at risk of developing overwhelming postsplenectomy infections due to encapsulated organisms, mainly pneumococcal, meningococcal, and Haemophilus influenzae type b (Hib). Due to the high mortality rates associated with these infections, vaccinations are recommended as a preventive measure. It is challenging to ensure optimal immunizations in these high-risk patients due to the number of recommended vaccines, the availability of multiple formulations, and the inability to administer specific formulations at the same time, as well as differences in subsequent vaccine administration schedules. Pharmacists play a key role in recommending specific vaccines and timing for these patients in order to achieve the most robust immune response. This article reviews the specific recommendations for pneumococcal, meningococcal, Hib, and influenza vaccinations in asplenic patients.


CONCLUSIONS
In order to prevent potentially life-threatening infections, asplenic individuals should be vaccinated against S. pneumoniae, N. meningitidis, Hib, and influenza. The optimal timing of vaccination in relation to splenectomy depends on the nature of the splenectomy.
Sanford USD Medical Center, Sioux Falls, SD. rhonda.hammerquist@sanfordhealth.org.
Rhonda J
RJ
Hammerquist
Department of Pharmacy Practice, South Dakota State University College of Pharmacy, Brookings, SD, and Sanford USD Medical Center, Sioux Falls, SD.
Kimberly A
KA
Messerschmidt
Barnes-Jewish Hospital, St. Louis, MO.
April A
AA
Pottebaum
Department of Pharmacy Practice, South Dakota State University College of Pharmacy, Brookings, SD, and Sanford USD Medical Center, Sioux Falls, SD.
Thaddaus R
TR
Hellwig
D000328:Adult; D003141:Communicable Diseases / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D007252:Influenza Vaccines / Q000627:therapeutic use*; D022401:Meningococcal Vaccines / Q000627:therapeutic use*; D022242:Pneumococcal Vaccines / Q000627:therapeutic use*; D013156:Splenectomy / Q000009:adverse effects* / Q000639:trends; D014611:Vaccination / Q000379:methods* / Q000639:trends
D007252:Influenza Vaccines; D022401:Meningococcal Vaccines; D022242:Pneumococcal Vaccines