MVEC special risk guidelines

These guidelines have been prepared by immunisation staff at the Royal Children’s Hospital and Monash Health and endorsed at a monthly immunisation meeting. Attendees at this meeting include paediatricians, infectious disease physicians, nurse immunisation specialists, infection control team members and a representative from the Immunisation Section of the Victorian Department of Health.

These guidelines are based on the latest available evidence and aim to align with recommendations in the Australian Immunisation Handbook.

Vaccine funding

Some of the recommendations in these guidelines are outside the scope of the National Immunisation Program (NIP). Different jurisdictions and individual hospitals have varying approaches to non-NIP vaccines, which should be clarified with the local health service.

We welcome any feedback on the guidelines, please email: info.mvec@mcri.edu.au

Asplenia/Hyposplenia

  • Children and adults without a functional spleen are at increased risk of infection with encapsulated bacteria, most importantly Streptococcus pneumoniae (pneumococcus), the cause of invasive pneumococcal disease (IPD) which includes: meningitis (brain infection); septicaemia (blood infection) and pneumonia (chest infection)
  • Infections with other bacteria, such as Neisseria meningitidis (meningococcus) and Capnocytophaga canimorsus (after dog or cat bite) also occur at an increased rate in asplenia patients
  • Some of these infections are vaccine preventable diseases and protection can be optimised by appropriate and timely immunisation
  • Immunisation status should be reviewed every 5 years.
  • Annual influenza vaccination is recommended.
  • Children with congenital asplenia, cancer related asplenia and those with sickle cell anaemia are at greater risk of infection than those who have had splenectomy for trauma
  • The first 2-years following splenectomy are considered the highest risk for infection, although several reports indicate that the risk is lifelong
  • MVEC have worked with the Spleen Australia team to develop comprehensive vaccination guidelines

Resources

Reviewed by: Nigel Crawford (Director, SAEFVIC, Murdoch Children’s Research Institute), Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children’s Research Institute)

Date: September 2018

Materials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.

You should not consider the information in this site to be specific, professional medical advice for your personal health or for your family’s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.