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Your vaccine and antibiotic plan after spleen removal | CION Cancer Clinics
After a splenectomy you need vaccines against pneumococcus, meningococcus and Hib, plus a flu vaccine every year. Ideally they begin at least two weeks before planned surgery, or from two weeks after an emergency operation. Many people also take antibiotics, daily or as a supply at home. This page explains the usual order, why the timing matters, and what to ask if you are unsure what you have missed. At CION Cancer Clinics, our haematologist reviews abnormal blood reports with you, orders only the tests that answer your question and explains each result plainly.
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Medically reviewed by Dr. Basudev PokhrelConsultant Haematologist · last reviewed September 2026, next review due September 2027
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On this page
- Which vaccines do you need after a splenectomy?
- What does each vaccine protect you from?
- When is each vaccine usually given?
- How does planned surgery differ from emergency surgery?
- Why are antibiotics given as well as vaccines?
- What do people often get wrong about these vaccines?
- What do the words on your vaccine record mean?
- Common questions about vaccines after splenectomy
The short answer
Which vaccines do you need after a splenectomy?
You need protection against pneumococcus, meningococcus and Hib, plus a flu vaccine every year. Ideally they start at least two weeks before a planned splenectomy (surgery to remove the spleen), or from two weeks after an emergency one.
Why these particular vaccines
The spleen is the organ that filters out germs wrapped in a slippery outer coat. Without it, those germs can cause a very fast, severe blood infection. Pneumococcus, meningococcus and Hib are the main coated germs, so the vaccines are aimed at them. Flu is added because it often opens the way to a pneumonia.
Why the timing matters
A vaccine works by teaching the immune system to make antibodies, and the spleen helps with that job. Given before surgery, while the spleen is still there, the vaccines tend to work more strongly. After an emergency operation, waiting a short while lets the body recover from surgery so the response is better.
The exact vaccines, brands and gaps between doses vary by country and by your age. Your haematologist or physician sets your schedule. This page explains the pattern, not your personal plan.Vaccine by vaccine
What does each vaccine protect you from?
These are the names you will see on your vaccine card or prescription. Most people need all of them.
Pneumococcal vaccines
Protect against the germ behind most serious infections after spleen removal. There are two kinds, usually given one after the other with a gap between them.
On your card
- PCV, the conjugate vaccine
- PPSV23 or PPV23, the polysaccharide vaccine
Meningococcal vaccines
Protect against meningitis and a fast blood infection. One vaccine covers the A, C, W and Y strains. A separate vaccine covers strain B. Both are usually recommended.
Hib vaccine
Protects against Haemophilus influenzae type b. Children usually had it in their routine schedule. Adults who did not may be given a catch-up dose, sometimes combined with a meningococcal vaccine.
Flu vaccine
Given every year, ideally before the flu season. The virus changes, so last year's dose does not cover this year. Family members living with you can get it too.
Not sure whether this applies to you?
Ask an oncologistThe usual order
When is each vaccine usually given?
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Before surgery, if it is planned
The first doses are given at least two weeks before the operation. This is common when the spleen is removed for a low platelet count, a blood disorder or lymphoma.
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After surgery, if it was an emergency
After an accident or sudden bleeding there is no time beforehand. The first doses are then usually given from two weeks after surgery, often before you go home or at the first follow-up.
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The second round
Some vaccines need a second dose or a second type after a gap of several weeks. Your doctor will give you the date. Missing it leaves protection incomplete.
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Every year
The flu vaccine, each season, for life.
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Boosters later on
Some people are advised a later pneumococcal or meningococcal booster. Advice on this differs between guidelines, so ask your doctor to note on your card whether one is due and when.
Side by side
How does planned surgery differ from emergency surgery?
Planned splenectomy
Emergency splenectomy
Vaccines start before the operation
Vaccines start after you recover from surgery
Plan is discussed at the pre-surgery visit
Plan is often made at discharge, so ask for it
Antibiotic plan agreed in advance
Antibiotics usually started while you are still in hospital
Easy to miss nothing, if you keep the record
Easy to miss doses, so check your card at follow-up
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The other half of protection
Why are antibiotics given as well as vaccines?
Vaccines do not cover every strain or every germ, so antibiotics act as a second layer. There are two common approaches, and your doctor may use one or both.
Daily antibiotics
A low daily antibiotic, commonly penicillin-type medicines such as phenoxymethylpenicillin or amoxicillin, or another choice if you are allergic. Some people take it for a period after surgery, some for longer. Children and people with lowered immunity are more often advised to continue. The length is set by your team.
An emergency supply at home
Many people are also given a supply of antibiotics to keep at home, with written instructions on when to take them if a fever starts. Taking it does not replace going to hospital. It buys time on the way.
Who this plan may not suit as written
If you are allergic to penicillin, on other medicines that interact, or pregnant, the choice changes. Tell your doctor. Never start, stop or swap antibiotics on your own, and do not use leftover tablets from someone else.
Commonly believed
What do people often get wrong about these vaccines?
"The surgery was years ago. It is too late for vaccines now."
It is not too late. Many people in India were never offered the full set at the time. Vaccines given years later still lower your risk. Take your discharge summary to your doctor and ask what is missing.
"Once I have had the vaccines, a fever is nothing to worry about."
Vaccines reduce the risk a great deal, but not completely. A fever without a spleen still means going to the emergency department the same day, or calling 108, and saying you have no spleen.
"The flu shot is optional. It is only a cold."
Flu can lead to a bacterial pneumonia, which is exactly the kind of infection you are trying to prevent. The yearly flu vaccine is part of the plan, not an extra.
"Antibiotics every day will make them stop working."
This is a fair worry, and your doctor weighs it. For people at higher risk, the protection usually outweighs the concern. If you are unsure, discuss it rather than stopping the tablets.
On your card
What do the words on your vaccine record mean?
- Asplenia
- Having no spleen, or a spleen that does not work. Hyposplenism means the spleen works only partly.
- Conjugate vaccine
- A vaccine joined to a protein so the immune system responds more strongly and for longer.
- Booster
- A later dose that tops up protection that has faded.
- OPSI
- Overwhelming post-splenectomy infection. The rare, fast, severe infection these vaccines and antibiotics are meant to prevent.
- Standby or rescue antibiotics
- A supply kept at home, used only as your written plan says.
Questions we are asked
Common questions about vaccines after splenectomy
Are these vaccines available in India?
Most of them are available through private clinics and hospitals, though not every brand is stocked everywhere, and some are not part of the free government schedule for adults. Ask your doctor to write the vaccine names clearly so a pharmacy or vaccination centre can source them. Check the current cost with the centre before you go.
Can all the vaccines be given on the same day?
Several can, usually in different arms. Some must be spaced apart, particularly the two types of pneumococcal vaccine, which work better in a set order with a gap. Your doctor plans the order. Do not rearrange it yourself to save a visit without asking first.
I had my spleen removed in an accident. Did I miss the window?
No. After emergency surgery, vaccines are simply given afterwards rather than before. If you left hospital without them, or are not sure, take your discharge summary to your doctor now. It is common for doses to be missed in the rush after an accident, and they can still be given.
Are there side effects?
Most people get a sore arm, and some feel tired or slightly feverish for a day or so. Serious reactions are rare. Tell the person giving the vaccine about any past allergic reaction. If you get a high fever afterwards, do not assume it is the vaccine. Get checked the same day.
Does my child need a different schedule?
Often yes. Children's vaccine choices and gaps depend on their age and which routine vaccines they have already had. Young children are also more vulnerable, so daily antibiotics are more often advised. Your child's paediatrician or haematologist will set a plan, and the school should know about it.
I am on chemotherapy. Can I still have these vaccines?
Usually yes, because these are not live vaccines. Timing matters, though, since chemotherapy can weaken the response. Your haematology team decides when to give them around your cycles, and may repeat some later. Live vaccines are a different matter, so always check before any vaccine.
Should my family also be vaccinated?
A yearly flu vaccine for the people you live with is sensible, because it reduces the chance of flu coming into the house. Their other vaccines follow their own routine schedule. Good hand washing at home also helps more than most people expect.
Who can check which vaccines I am still missing?
Your haematologist or physician. At CION, Dr. Basudev Pokhrel and the haematology team review your discharge summary and vaccine record, list what is missing and coordinate with your surgeon or family doctor. Bring every paper you have, including old prescriptions.
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Sources
- NHS — Spleen problems and spleen removal
- UK Health Security Agency — Immunisation of individuals with underlying medical conditions: the Green Book, chapter 7
- National Cancer Institute — Definition of splenectomy
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
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