Vaccination and splenectomy in Olmsted County

Area of Science:

• Infectious Diseases
• Immunology
• Surgical Outcomes

Background:

• Splenectomy increases the risk of severe infections due to impaired immune function.
• Vaccination is recommended to prevent encapsulated bacterial infections in asplenic individuals.

Purpose of the Study:

• To evaluate the long-term impact of vaccination on postoperative infection rates in adults following splenectomy.
• To assess the association between vaccination status and the incidence and timing of post-splenectomy infections.

Main Methods:

• A population-based cohort study identified 724 adults who underwent splenectomy between 1965 and 2011.
• Descriptive statistics, Kaplan-Meier estimates, and Cox proportional hazard ratios were used to analyze infection risk and vaccination status.

Main Results:

• Overall vaccination rates were 62%, with 36% of patients developing post-splenectomy infections, primarily sepsis, pneumonia, and bloodstream infections.
• Patients who did not receive complete vaccination had a significantly shorter median time to infection compared to vaccinated patients (1.5 vs. 3.3 years).
• Lack of complete vaccination was linked to increased bloodstream infection rates within 5 years post-splenectomy.

Conclusions:

• Complete vaccination is associated with a reduced risk and delayed onset of infections after splenectomy.
• Improved vaccination protocols decreased infectious complication risks, except for malignancy-related indications.
• Booster vaccinations are recommended for adults who have undergone splenectomy to maintain protection.