From the Research
For a 55-year-old woman with a history of splenectomy, I recommend the inactivated influenza vaccine (IIV4) or the recombinant influenza vaccine (RIV4), administered annually, as the most effective way to prevent influenza and its potential complications, given her increased susceptibility to severe infections following splenectomy 1. The standard dose is appropriate, though high-dose formulations are also acceptable.
- Live attenuated influenza vaccine (LAIV) should be avoided in this patient due to her asplenic status, which puts her at higher risk for complications from influenza.
- The vaccine should be administered before flu season begins, typically in September or October. This patient should receive the flu vaccine every year without fail due to her increased susceptibility to severe infections following splenectomy. The spleen plays a crucial role in filtering blood and helping the body fight certain bacteria, so its absence compromises immune function, particularly against encapsulated organisms. While influenza is viral, preventing flu infection helps avoid secondary bacterial infections that could be especially dangerous for this patient. Additionally, this patient should ensure she has received other recommended vaccines for asplenic individuals, including pneumococcal, meningococcal, and Haemophilus influenzae type b vaccines, as supported by studies such as 2 and 3. It is essential to prioritize these vaccinations to reduce the risk of overwhelming post-splenectomy infections, as highlighted in 4 and 5. Given the suboptimal immunization coverage for vaccines recommended for asplenic patients, as shown in 1, it is crucial to emphasize the importance of adherence to vaccination guidelines for this patient population.