Asplenia and Vaccines

Asplenia is a medical classification reserved for individuals without functional spleens. In most cases, people with compromised spleen activity or hyposplenia, undergo spleen removal to prevent additional complications that often lead to poor health outcomes, such as immune thrombocytopenic purpura (ITP), autoinfarction sickle cell disease, etc. Asplenia is also a common anatomical and functional birth defect. Regardless of the type or cause, it is a common condition that millions of Americans live with every day.

The Correlation Between Vaccines and Asplenia

The spleen filters blood cells and prevents infection from bacteria, viruses, and other pathogens. It also breaks down and removes old red blood cells and acts as a storehouse for blood cells and platelets. Individuals with asplenia are exceptionally vulnerable to infections stemming from encapsulated bacteria because their immune systems are impaired or weakener than those with minimal or normal spleen function. This vulnerability means they tend to develop more severe symptoms and complications when exposed to pathogens that do not occur in individuals with normal spleen and immune system activity. Having a spleen may seem disadvantageous health-wise, but vaccinations, antibiotic prophylaxis, and therapeutic and lifestyle strategies are highly effective at shoring up the immune system’s response and defenses.

Many spleen removal patients are not aware of how beneficial vaccines are and avoid vaccines due to misinformation or fear. Not having a spleen means there is far less protection to ward off disease. In high-risk environments, it is typically a matter of time before immunocompromised become sick. Whereas those who have normal spleen function, with or without underlying conditions do not. In high-risk patients, especially those with chronic conditions or asplenia, vaccine-induced immunity offers stronger, more effective, and longer-lasting protection than natural immunity. Vaccines can trigger a strong immune system response in a small percentage of healthy and asplenia people as their bodies develop robust protections necessary to evade disease. These symptoms are temporary and much less severe than those who develop immunity naturally.

Infection Risks for Spleen Dysfunction and Removal Patients

Infection and disease vulnerability is highest during the first few years after spleen removal, the onset of spleen dysfunction, and in children under the age of five. Immunodeficiencies stemming from other conditions besides asplenia also elevate infection risks. Moreover, asplenic and hyposplenism individuals are extremely susceptible to tissue and organ impairment and damage or sepsis in addition to secondary disease development. Vaccines, along with antibiotics and proper education can help patients reduce their risk of frequent and serious infections and health conditions.

Currently, Dr. Abtin Khosravi, MD recommends for current, future, and post-operative Orange County Robotic General Surgery spleen removal surgery patients and those with impaired spleen function follow their physician’s guidance on vaccinations to reduce their immunodeficiency against Haemophilus influenzae type b, Neisseria meningitidis, Streptococcus pneumoniae, and other conditions to avoid secondary viral and bacterial infections and life-threatening complications.

Pre-Splenectomy and Post Splenectomy Vaccine Recommendations

Patients awaiting spleen removal should complete their vaccines at least two weeks before their splenectomy procedures. Anyone unable to complete their immunizations in a timely manner should talk with their medical care team or surgeon for alternative immunization schedule guidance. In most cases, outstanding vaccinations can be resumed a week or two after surgery. Individuals with decreased spleen function, also known as functional asplenia and are considering spleen removal surgery should complete their vaccinations as soon as they learn of their conditions, without delay.

• Influenza vaccine is an annual booster that helps prevent flu/influenza infections.
• Tdap vaccine protects against tetanus, diphtheria, and whooping cough infections.
• Hib vaccine protects against Haemophilus influenzae type b (Hib) and is necessary for those with weakened immune systems and without prior Hib vaccination history.
• Pneumococcal vaccines help prevent pneumonia and other serious pneumococcal diseases, especially in those who are high-risk or without spleens.
• Meningococcal vaccines offer protection against meningitis and other meningococcal diseases.
• Zoster vaccine is offered to individuals 50 years or older as additional protection against shingles, an extremely painful and potentially chronic condition.
• HPV vaccine is available as a series and beneficial for women, 26 years old or younger and men under the age of 21.
• MMR offers protection against measles, mumps, and rubella. Anyone born after 1956 may lack sufficient immunity against these conditions. MMR vaccination is recommended for anyone without previous measles, mumps or rubella infection or immunization history.
• Varicella vaccine is available as a two-dose immunization. It is recommended for anyone born in or after 1980 and currently lacking natural immunity or missing a dose.
• COVID-19 vaccines are given as a series and boosters. Asplenia patients and those with weak immune systems are very susceptible to the severe and, in some cases, life-threatening effects of COVID infections. COVID-19 vaccines and boosters minimize disease activity and symptom and secondary infection development leading to better outcomes.

Vaccinations are necessary to strengthen the body’s long-term defenses against germs, bacteria, and other toxins and pathogens. They boost the response time and production of infection-fighting antibodies that help lessen the severity and progression of any illnesses that develop. Just like natural immunity, immunizations can become less effective over time and require timely boosters for continuous protection.

Asplenia and Vaccine Considerations

Because the risk of infection and disease is life-threatening for people with asplenia, especially after exposure to infectious pathogens, ongoing self-care and routine medical supervision are critical. Seek immediate and aggressive medical intervention at the first sign of fever, malaise, or suspected infection.

Contact Us

If you do not have a spleen or your spleen does not work well or and you are considering spleen removal surgery, call (714)-541-4996 to schedule an appointment at Orange County Robotic General Surgery to discuss your vaccine or asplenia-related concerns with Dr. Khosravi, MD, FACS.