Table. Recommendations for vaccination in people with functional or anatomical asplenia

Hib (Haemophilus influenzae type b) vaccine

6 weeks to <5 years

• Give the recommended course of Hib-containing vaccine, or catch-up vaccination, according to Table. Catch-up schedule for Haemophilus influenzae type b (Hib) vaccination for children <5 years of age.
• The child does not need extra or repeat doses.

≥5 years

• If the person has never received a Hib vaccine dose, give a single dose of Hib-containing vaccine.
• If the person has not completed their primary course of Hib vaccine, give a single dose of Hib-containing vaccine.
• If the person has completed their Hib vaccination course , they do not need extra or repeat doses.

Influenza vaccine

6 months to <3 years

• Give 2  doses (0.25 mL each), 4 weeks apart, in the 1st year of vaccination.
• Give 1  dose (0.25 mL) in subsequent years.

3 to <9 years

• Give 2  doses (0.5 mL each), 4 weeks apart, in the 1st year of vaccination.
• Give 1  dose (0.5 mL) in subsequent years.

≥9 years

• Give 1  dose (0.5 mL) every year.
• If people with asplenia have had a solid organ or haematopoietic stem cell transplant, they need 2 doses of influenza vaccine during their 1st year of influenza vaccination after transplantation.

Meningococcal vaccines

≥2 months

• MenACWY vaccine is recommended according to the age at which the vaccine course started (see Table. Recommendations for MenACWY vaccine for people with a specified medical condition that increases their risk of invasive meningococcal disease in Meningococcal disease).
• MenB vaccine is recommended according to the age at which the vaccine course started (see Table. Recommendations for MenB vaccine for people with a specified medical condition that increases their risk of invasive meningococcal disease in Meningococcal disease).
• Infants can receive MenB vaccine from 6 weeks of age to align with the schedule for other routine infant vaccines. People who are at increased risk of meningococcal disease can receive MenB and MenACWY vaccines together. (See also Meningococcal disease.)

Pneumococcal vaccines

• Give a 3-dose primary course of 13vPCV, with a 4th dose of 13vPCV at age 12 months. 
• Give a single dose of 23vPPV at age 4 years and another dose of 23vPPV, at least 5 years later.

• If the condition is pre-existing and the child has not received a complete primary course (as above) follow Table. Catch-up schedule for 13vPCV for Aboriginal and Torres Strait Islander children living in NT, Qld, SA or WA ONLY, and all children with any medical condition(s) associated with an increased risk of invasive pneumococcal disease, aged <5 years for catch-up schedules.
• If newly diagnosed follow Table. Catch-up schedule for 13vPCV for Aboriginal and Torres Strait Islander children living in NT, Qld, SA or WA ONLY, and all children with any medical condition(s) associated with an increased risk of invasive pneumococcal disease, aged <5 years, to determine the number of 13vPCV now required based on the number of doses already received and the age at presentation.
• The above doses of 13vPCV should be followed with two doses of 23vPPV. The first dose of 23vPPV should be given 12 months after the last 13vPCV dose or at 4 years of age, whichever is later. The second dose of 23vPPV should be given 5 years after the previous 23vPPV dose.

• If the condition is newly diagnosed or the person has never received a dose of 13vPCV due to the presence of the risk condition, give a single dose of 13vPCV,  followed by 2 doses of 23vPPV (as below).
• The recommended interval between a 13vPCV dose and a subsequent 23vPPV dose is 12 months (an interval of 2–12 months acceptable). The recommended minimum interval between any two 23vPPV doses is 5 years.
• There is a maximum limit of 2 doses of 23vPPV.  Therefore, if the person has already received at least 2 doses of 23vPPV, no further 23vPPV doses are required. 
• If the person has received 1 dose of 23vPPV previously, give the 13vPCV at least 12 months after the previous 23vPPV dose. Give the 2nd 23vPPV dose 12 months after the 13vPCV dose, and at least 5 years after the previous 23vPPV dose, whichever is later.  
• For Aboriginal and Torres Strait Islander adults aged ≥50 years, these vaccine doses are covered in the routine recommendation and do not need to be repeated.
• For non-Indigenous adults aged ≥70 years, a dose of 13vPCV is part of the routine recommendation and does not need to be repeated.