title: Recommended vaccinations for asplenic and hyposplenic adult patients.
abstract: Asplenic or hyposplenic (AH) individuals are particularly vulnerable to invasive infections caused by encapsulated bacteria. Such infections have often a sudden onset and a fulminant course. Infectious diseases (IDs) incidence in AH subjects can be reduced by preventive measures such as vaccination. The aim of our work is to provide updated recommendations on prevention of infectious diseases in AH adult patients, and to supply a useful and practical tool to healthcare workers for the management of these subjects, in hospital setting and in outpatients consultation. A systematic literature review on evidence based measures for the prevention of IDs in adult AH patients was performed in 2015. Updated recommendations on available vaccines were consequently provided. Vaccinations against S. pneumoniae, N. meningitidis, H. influenzae type b and influenza virus are strongly recommended and should be administered at least 2 weeks before surgery in elective cases or at least 2 weeks after the surgical intervention in emergency cases. In subjects without evidence of immunity, 2 doses of live attenuated vaccines against measles-mumps-rubella and varicella should be administered 4-8 weeks apart from each other; a booster dose of tetanus, diphtheria and pertussis vaccine should be administered also to subjects fully vaccinated, and a 3-dose primary vaccination series is recommended in AH subjects with unknown or incomplete vaccination series (as in healthy people). Evidence based prevention data support the above recommendations to reduce the risk of infection in AH individuals.
authors.affiliation: a Department of Health Sciences , University of Florence , Florence , Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Bonanni
authors.affiliation: b Specialization Medical School of Hygiene and Preventive Medicine, University of Florence , Florence , Italy.
authors.forename: Maddalena
authors.initials: M
authors.lastname: Grazzini
authors.affiliation: b Specialization Medical School of Hygiene and Preventive Medicine, University of Florence , Florence , Italy.
authors.forename: Giuditta
authors.initials: G
authors.lastname: Niccolai
authors.affiliation: b Specialization Medical School of Hygiene and Preventive Medicine, University of Florence , Florence , Italy.
authors.forename: Diana
authors.initials: D
authors.lastname: Paolini
authors.affiliation: b Specialization Medical School of Hygiene and Preventive Medicine, University of Florence , Florence , Italy.
authors.forename: Ornella
authors.initials: O
authors.lastname: Varone
authors.affiliation: c Department of Experimental and Clinical Medicine , University of Florence, Italy and Infectious and Tropical Diseases Unit, Careggi University Hospital , Florence , Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Bartoloni
authors.affiliation: c Department of Experimental and Clinical Medicine , University of Florence, Italy and Infectious and Tropical Diseases Unit, Careggi University Hospital , Florence , Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Bartalesi
authors.affiliation: d Operative Unit of Hygiene and Public Health, Local Health Unit of Florence, Regional Health Service , Florence , Italy.
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Santini
authors.affiliation: d Operative Unit of Hygiene and Public Health, Local Health Unit of Florence, Regional Health Service , Florence , Italy.
authors.forename: Simonetta
authors.initials: S
authors.lastname: Baretti
authors.affiliation: d Operative Unit of Hygiene and Public Health, Local Health Unit of Florence, Regional Health Service , Florence , Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Bonito
authors.affiliation: d Operative Unit of Hygiene and Public Health, Local Health Unit of Florence, Regional Health Service , Florence , Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Zini
authors.affiliation: e Tuscany Region, Rights of Citizenship and Social Cohesion , Florence , Italy.
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Mechi
authors.affiliation: f Health Direction, Careggi University Hospital , Florence , Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Niccolini
authors.affiliation: f Health Direction, Careggi University Hospital , Florence , Italy.
authors.forename: Lea
authors.initials: L
authors.lastname: Magistri
authors.affiliation: f Health Direction, Careggi University Hospital , Florence , Italy.
authors.forename: Maria Beatrice
authors.initials: MB
authors.lastname: Pulci
authors.affiliation: a Department of Health Sciences , University of Florence , Florence , Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Boccalini
authors.affiliation: a Department of Health Sciences , University of Florence , Florence , Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Bechini
mesh_terms: D000328:Adult; D018562:Disease Transmission, Infectious / Q000517:prevention & control*; D006801:Humans; D007153:Immunologic Deficiency Syndromes / Q000150:complications*; D009975:Orthomyxoviridae; D013158:Splenic Diseases / Q000150:complications*; D014611:Vaccination / Q000706:statistics & numerical data*; D014612:Vaccines / Q000008:administration & dosage* / Q000276:immunology*
chemical_list: D014612:Vaccines
keywords: asplenic; hyposplenic; infectious diseases; prevention; recommendations; splenectomy; vaccinations