[Pneumococcal vaccination of splenectomized patients. Recommendations based on a 10-year experience]

In 1978, pneumococcal vaccination in splenectomized patients over the age of two years was introduced in Denmark. Since then, no cases of pneumococcal bacteraemia or meningitis have occurred in splenectomized children. Prior to introduction of vaccination, infections of this nature occurred with an incidence of approximately 4%. We have investigated the duration of the vaccine-induced increase in antibodies in splenectomized children and adults and, on this basis, we recommend that all children vaccinated in the age group 2-14 years should have pneumococcal antibodies measured five years after vaccination because the antibodies in a number of the children will have decreased to such an extent that revaccination is necessary. All patients who were over 14 years on vaccination should, until further notice, have the pneumococcal antibodies measured after ten years although we have found that 2, 5, 7 and 10 years after vaccination, the antibody level had only decreased to 71, 69, 70 and 63% of the antibody concentrations obtained by pneumococcal vaccination.