Patients without a Spleen Need Additional Doses of the Pneumococcal Vaccine
Pneumococcal disease is a serious, yet common, condition that affects many Americans each year. Very young children, the elderly and people with certain medical conditions, including those who have had their spleen removed are at the greatest risk of developing this serious condition and suffering from complications.
How Serious is Pneumococcal Disease?
According the Centers for Disease Control and Prevention (CDC) pneumococcal disease is a very serious disease and is responsible for the death of more people every year than all of the other vaccine preventable diseases combined. If left untreated pneumococcal disease can lead to pneumonia, blood infections and meningitis. When pneumococcal disease is allowed to progress to these complicated conditions then the death rate if relatively high. One in twenty people who develop pneumonia will die. Two in ten people who develop a blood infection will die and three in ten, or 30%, of people who develop meningitis will die. Those percentages are even higher if a patient’s ability to fight infections is compromised because of his or her age, medical condition, or previous removal of an organ such as the spleen.
People with certain types of medical conditions, including those who have had their spleen removed, are at an even greater risk of suffering from the serious complications of pneumococcal disease. The spleen is an important part of the body’s system of preventing infections. Once it is removed, the patient is considered to be at high risk of developing an infection for the rest of his or her life. Therefore, the patient’s physicians should take special precautions to prevent the patient from developing pneumococcal disease.
The Pneumococcal Vaccine
The pneumococcal vaccine is routinely given to prevent complications from pneumococcal disease. The vaccine is highly effective in preventing infection in healthy adults. The vaccine specifically protects against the 23 strands of bacteria that are most often responsible for the development of bacterial pneumococcal disease. Prevention is very important since antibiotics are no longer as effective at treating these types of infections as they were in the past.
Since the risk of developing pneumonia, blood infections or meningitis, and dying from these complications, is elevated for people without a spleen, they need a more aggressive vaccination schedule than the general population. Healthy patients typically receive one dose of the vaccine and develop full immunity. However, people who no longer have their spleens need two doses of the vaccine with additional booster shots of the vaccine every three to five years. This is because one dose of the vaccine may be less likely to work on a patient whose immune system is compromised by the lack of a spleen and preventing pneumococcal disease and its complications is even more important to their overall health.
While the vaccine is part of the early childhood standard of care and is routinely provided to the elderly, not all adults typically receive the vaccination. Therefore, it is possible that an older child or adult who has his or her spleen removed may be at risk of not receiving the vaccination and the effects of the missed vaccination can be catastrophic. Since the bacteria is now more resistant to antibiotics than it was in the past and since the patient’s body lacks the spleen necessary to fight the infection, the bacteria can quickly develop into a pneumonia, blood infection or meningitis that is very aggressive and difficult to treat. A patient’s changes of escaping these types of serious illnesses and the potential death that could result from the illnesses can be dramatically decreased if the patient receives the appropriate number of pneumococcal vaccinations that are necessary given the patient’s condition.