What vaccination strategy is important for individuals without a spleen (asplenia)?

• A. Pneumococcal vaccines (PCV13 and PPSV23), meningococcal vaccines (MCV4 and MenB), and annual influenza.
• B. Only influenza vaccine annually.
• C. Live vaccines only.
• D. No vaccines needed.

Answer: (A)

When the spleen is absent, the body’s ability to clear encapsulated bacteria is reduced, so preventing infections from these organisms is essential. The main targets are pneumococcus and meningococcus, plus protection against influenza to lower the risk of viral illness that can lead to complications like bacterial pneumonia.

Vaccinating against Streptococcus pneumoniae with both PCV13 and PPSV23 broadens protection across many serotypes. PCV13 covers 13 serotypes, and PPSV23 covers 23 more, with the recommended order usually PCV13 first followed by PPSV23 after a short interval to maximize the immune response. For meningococcal coverage, vaccines against serogroups A, C, W, and Y (MCV4) along with protection against serogroup B (MenB) are advised because Neisseria meningitidis poses a high risk in asplenia. Adding an annual influenza vaccine helps reduce flu infections and the chance of flu-related complications, including secondary bacterial pneumonia.

So, the strategy of giving pneumococcal vaccines, meningococcal vaccines, and influenza vaccination best protects individuals without a spleen.