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Published on: December 20, 2024
A survey of vaccine coverage and antibiotic prophylaxis in splenectomised patients in Scotland
M H Kyaw1, E M Holmes, J Chalmers
1Public Health Sciences, University of Edinburgh, Teviot Place, EH 8 9AG, UK. Moe.Kyaw@scieh.csa.scot.nhs.uk
Aims:
To determine the coverage of vaccine and antibiotic prophylaxis in splenectomised patients in Scotland.
Methods:
Patients who had undergone splenectomy between 1 January 1988 and 31 December 1998 were identified. A questionnaire was sent to general practitioners to validate vaccine and antibiotic status for these patients.
Results:
A total of 974 living splenectomised patients were identified during the study period. Information on vaccine and antibiotic status was available for 708 (73%) and 770 (79%) of living patients, respectively. Coverage of pneumococcal vaccine (88%) was higher than that of Haemophilus influenza type b (Hib) conjugate vaccine (70%) or meningococcal vaccine (51%). Only 47% of patients received all three vaccines. A higher coverage was also documented for pneumococcal vaccine (28%) than Hib (19%) and meningococcal vaccine (14%) before elective splenectomy. Only 13% received all three vaccines before splenectomy. Coverage of influenza vaccine increased significantly, from 76% in the 1997/1998 season to 96% in the 2000/2001 season. Antibiotic prophylaxis was received by 67% of all patients. The current recommendation, comprising pneumococcal and Hib vaccination and antibiotic prophylaxis, was received by only 52% of the patients. There was no association between the coverage of vaccine and socioeconomic status.
Conclusion:
Further improvement in coverage of recommended vaccines and antibiotic prophylaxis is still needed to reduce the risk of serious infection in this high risk group.
