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

6 weeks to <2 years

• Give a 3-dose primary course of 13vPCV, with a 4th dose of 13vPCV at age ≥12 months.
• See Table. Catch-up schedule for 13vPCV for Aboriginal and Torres Strait Islander children living in NSW, Vic, Tas or ACT, and all children who do not have medical condition(s) associated with an increased risk of invasive pneumococcal disease, aged <5 years for catch-up schedules.

2–5 years

• If the child has received an incomplete primary course of pneumococcal polysaccharide vaccine, give 1  or 2 doses of 13vPCV as per 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.
• If the child did not receive the recommended 13vPCV dose at age ≥12 months, give 1  or 2 doses of 13vPCV as per 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.
• Give a single dose of 23vPPV at age 4–5 years.
• Whenever possible, give the 13vPCV dose(s) before the recommended 23vPPV dose(s). If 13vPCV is given after 23vPPV, wait at least 12 months between 13vPCV and the last 23vPPV dose. The recommended minimum interval between a 13vPCV dose and a subsequent 23vPPV dose is 2 months. The recommended minimum interval between any two 23vPPV doses is 5 years.

>5 to <18 years

• If the child has never received a 13vPCV dose, give a single dose of 13vPCV, preferably before 23vPPV.
• If the child received a dose of 23vPPV at 4–5 years of age, give another dose of 23vPPV 5 years later (at age 9–10 years).
• If asplenia is newly diagnosed, give 2 doses of 23vPPV, 5 years apart (after 13vPCV).
• Whenever possible, give the 13vPCV dose(s) before the recommended 23vPPV dose(s). If 13vPCV is given after 23vPPV, wait at least 12 months between 13vPCV and the last 23vPPV dose. The recommended minimum interval between a 13vPCV dose and a subsequent 23vPPV dose is 2 months. The recommended minimum interval between any two 23vPPV doses is 5 years.

≥18 years

• If the person has never received a dose of 13vPCV, give a single dose of 13vPCV, preferably before 23vPPV.
• There is a maximum limit of 3  doses of 23vPPV during adulthood (age ≥18 years). Give the 1st adult dose at diagnosis (after 13vPCV — see above) or at least 5 years after the last 23vPPV dose, whichever is later.
• Whenever possible, give the 13vPCV dose(s) before the recommended 23vPPV dose(s). If 13vPCV is given after 23vPPV, wait at least 12 months between 13vPCV and the last 23vPPV dose. The recommended minimum interval between a 13vPCV dose and a subsequent 23vPPV dose is 2 months. The recommended minimum interval between any two 23vPPV doses is 5 years.
• If asplenia is diagnosed at age ≥65 years (age ≥50 years for Aboriginal or Torres Strait Islander adults), only a single revaccination dose of 23vPPV is recommended.