Which statement about asplenic patients and vaccination is true?

Which statement about asplenic patients and vaccination is true?

• A. Annual influenza vaccination is not necessary
• B. PPSV23 should be given only once
• C. PPSV23 is contraindicated in asplenia
• D. PPSV23 should be given twice, with the second dose after five years

Answer: (D)

Asplenia markedly increases the risk of severe infection from encapsulated bacteria, especially pneumococcus. To reduce this risk, vaccination includes annual influenza plus pneumococcal protection with PPSV23 given in two doses. PPSV23 covers many pneumococcal serotypes, but antibody protection wanes over time, so a second dose is recommended at least five years after the first. If the first PPSV23 was given before age 65, a booster is also recommended at age 65 or later, to maintain protection. This is why the statement that PPSV23 should be given twice, with the second dose after five years, is true. Annual influenza vaccination is still recommended for asplenic patients. A single PPSV23 dose is not sufficient for long-term protection in this high-risk group, and PPSV23 is not contraindicated in asplenia.

Asplenia markedly increases the risk of severe infection from encapsulated bacteria, especially pneumococcus. To reduce this risk, vaccination includes annual influenza plus pneumococcal protection with PPSV23 given in two doses. PPSV23 covers many pneumococcal serotypes, but antibody protection wanes over time, so a second dose is recommended at least five years after the first. If the first PPSV23 was given before age 65, a booster is also recommended at age 65 or later, to maintain protection. This is why the statement that PPSV23 should be given twice, with the second dose after five years, is true.

Annual influenza vaccination is still recommended for asplenic patients. A single PPSV23 dose is not sufficient for long-term protection in this high-risk group, and PPSV23 is not contraindicated in asplenia.