Emergent Splenectomy Vaccine Compliance

Document Type

Conference Proceeding

Publication Date

1-8-2025

Publication Title

Am J Health Syst Pharm

Abstract

Purpose: With a mortality rate up to 70%, overwhelming post-splenectomy infection (OPSI) by encapsulated organisms (Haemophilus influenzae type b, Neisseria meningitidis, and Streptococcus pneumoniae) is a rare but fatal complication of loss of splenic tissue. To mitigate this, vaccinations are crucial against these common causative organisms. However, initial vaccination compliance is challenging following an emergent splenectomy, as vaccines are recommended to be given two weeks post-splenectomy to ensure optimal therapeutic response. The purpose of this study was to describe current vaccination practices within a multicenter hospital system in order to identify potential opportunities to increase post emergent splenectomy vaccine compliance. Methods: This IRB-approved, retrospective, multi-center, observational study included 100 adult patients 18 years of age and older who received an emergent splenectomy between January 1st, 2014 and September 1st, 2024. Patients who received a splenectomy at an outside hospital, had a severe allergic reaction after a previous vaccine dose or to a vaccine component, received an emergent splenectomy at the time of a solid organ transplant or stem cell transplant, or were pregnant, incarcerated, or cognitively impaired were excluded. The primary endpoint was the proportion of patients who received the recommended vaccinations post emergent splenectomy. This was defined as receipt of the four recommended vaccinations (pneumococcal conjugate/polysaccharide vaccine, Haemophilus influenzae type b vaccine, meningococcal serogroups A, C, W, Y vaccine, and meningococcal serotype B vaccine) at least 14 days after the emergency splenectomy or prior to discharge, whichever was earliest. Secondary outcomes included timing of vaccination and patient-specific barriers to receiving the immunizations within the recommended timeframe. Data was extracted from electronic health records (EHR) using Structured Query Language (SQL). Patients were randomized using a random number generator until a total of 100 patients were obtained, with 10% of the extracted data evaluated for accuracy. Categorical data was described using simple frequencies and descriptive statistics for numerical data. Ordinal and continuous data were described using measures of central tendency.

Volume

82

First Page

S622

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