[Infection prevention following splenectomy: protective effect of a new 17-valent pneumococcal vaccine]

The antibody response to a new, 17-valent pneumococcal vaccine (Moniarix; Smith Kline-RIT) was tested in 43 splenectomised or functionally asplenic patients. The vaccine contained the following types of capsular antigens: 1, 2, 3, 4, 6A, 7F, 8, 9N, 11A, 12F, 14, 15F, 17F, 18C, 19F, 23F, 25 (Danish nomenclature). The vaccination was well tolerated. Local, reversible reddening and swelling was seen in 22 patients. The only systemic side effect was a rise of temperature in 13 patients. Serum titers of more than 300 ng/ml of specific antibodies were considered protective. A complete immunization of all patients was reached only with the capsular antigens 11A and 19F. The other antigens only induced protective serum concentrations in some of the patients. Considering the frequency of infections with the different types of antigens in Western Europe, percentage of asplenic patients at risk for infections with all pneumococcal types has been reduced by the vaccination to about 34%. It is proposed that the combination of pneumococcal vaccine and penicillin-prophylaxis provide effective protection for splenectomised patients against bacterial infections. The duration of penicillin-prophylaxis depends on the age of the patient at the time of splenectomy and the basic disease.