Table. Recommendations for vaccination in people with asplenia or hyposplenia by age at the time of asplenia or hyposplenia diagnosis

• A complete age-appropriate course and booster doses of MenACWY vaccine are recommended. The number of doses depends on the vaccine brand and the person’s age when they start the vaccine course. See Table. Recommendations for MenACWY vaccine for people with a specified medical condition that increases their risk of invasive meningococcal disease.
• A complete age-appropriate course and booster doses of MenB vaccine are recommended. See Table. Recommendations for MenB vaccine for people with a specified medical condition that increases their risk of invasive meningococcal disease.

• 4 doses of PCV, with doses at 2, 4, 6 and 12 months of age. The dose at 6 months is an additional dose to the routine PCV schedule.

• 2 doses of MenACWY vaccine are recommended. See Table. Recommendations for MenACWY vaccine for people with a specified medical condition that increases their risk of invasive meningococcal disease.
• A complete age-appropriate course of MenB vaccine is recommended, with a single booster dose 3 years later. See Table. Recommendations for MenB vaccine for people with a specified medical condition that increases their risk of invasive meningococcal disease.

• Children who have received either a routine course of 3 doses of any PCV or 4 doses of 13vPCV or 15vPCV, are recommended to receive 1 dose of 20vPCV at least 8 weeks after any previous doses of PCV.
• Children who received a routine course of 4 doses of 20vPCV (i.e. Aboriginal and Torres Strait Islander children) have already received the recommended number of doses of pneumococcal vaccine and do not require any additional doses.
• For children who have not received a full routine infant course of pneumococcal vaccination, see Catch-up schedule for 20vPCV for children aged <5 years who are either Aboriginal and Torres Strait Islander (including those living in ACT, NSW, Tas or Vic born on or after 1 March 2025), or have a risk condition(s) for pneumococcal disease 

• 2 doses of MenACWY vaccine are recommended, with a booster dose at 3 or 5 years after the primary course (depending on age), and ongoing booster doses every 5 years after that. See Table. Recommendations for MenACWY vaccine for people with a specified medical condition that increases their risk of invasive meningococcal disease.
• A complete age-appropriate course of MenB vaccine is recommended, with a single booster dose 3 or 5 years after the primary course, depending on age. The number of doses depends on the vaccine brand. See Table. Recommendations for MenB vaccine for people with a specified medical condition that increases their risk of invasive meningococcal disease.

Aged <18 years: 

• Children who have received either a routine course of 3 doses of any PCV, or 4 doses of 13vPCV or 15vPCV, or 4 doses of any PCV plus 1 dose of PPV, are recommended to receive 1 dose of 20vPCV at least 8 weeks after any previous doses of PCV.
• Children who received either a routine course of 4 doses of 20vPCV or 4 doses of any PCV plus 2 doses of PPV (i.e. Aboriginal and Torres Strait Islander children) have already received the recommended number of doses of pneumococcal vaccine and do not require any additional doses.

Aged ≥18 years the following doses are recommended:

• 1 dose of PCV
• 1 dose of PPV 2–12 months after the last dose of PCV
• A 2nd dose of PPV at least 5 years after the 1st dose of PPV
  
  If the person has previously received a dose of PPV, the PCV dose should be given at least 12 months after the previous PPV dose. The 2nd dose of PPV should be given 12 months after the PCV dose or 5 years after the previous PPV dose, whichever is later.

There is a lifetime limit of 2 doses of 23vPPV. If they have previously received any doses of 23vPPV, these should be counted as part of this schedule.

Acronyms used: 

• Hib = Haemophilus influenzae type b
• MenACWY = meningococcal ACWY
• MenB = meningococcal B
• PCV = pneumococcal conjugate vaccine
• PPV = pneumococcal polysaccharide vaccine

Footnotes:
^a Recommended but not funded under the National Immunisation Program