SHORT REPORT

A survey of vaccine coverage and antibiotic prophylaxis in splenectomised patients in Scotland

M H Kyaw¹, E M Holmes², J Chalmers³, I G Jones² and H Campbell¹

¹ Public Health Sciences, University of Edinburgh, Teviot Place, Edinburgh EH 8 9AG, UK
² Scottish Centre for Infection and Environmental Health, Clifton House, Clifton Place, Glasgow G3 7LN, UK
³ Information and Statistics Division of the Common Services Agency, Trinity Park House, South Trinity Road, Edinburgh EH5 3SQ, UK

Correspondence to:
Correspondence to:
Dr M H Kyaw, Scottish Centre for Infection and Environmental Health, Clifton House, Clifton Place, Glasgow G3 7LN, UK;
Moe.Kyaw{at}scieh.csa.scot.nhs.uk

Aims: To determine the coverage of vaccine and antibiotic prophylaxis in splenectomised patients in Scotland.

Methods: Patients who had undergone splenectomy between 1 January 1988 and 31 December 1998 were identified. A questionnaire was sent to general practitioners to validate vaccine and antibiotic status for these patients.

Results: A total of 974 living splenectomised patients were identified during the study period. Information on vaccine and antibiotic status was available for 708 (73%) and 770 (79%) of living patients, respectively. Coverage of pneumococcal vaccine (88%) was higher than that of Haemophilus influenza type b (Hib) conjugate vaccine (70%) or meningococcal vaccine (51%). Only 47% of patients received all three vaccines. A higher coverage was also documented for pneumococcal vaccine (28%) than Hib (19%) and meningococcal vaccine (14%) before elective splenectomy. Only 13% received all three vaccines before splenectomy. Coverage of influenza vaccine increased significantly, from 76% in the 1997/1998 season to 96% in the 2000/2001 season. Antibiotic prophylaxis was received by 67% of all patients. The current recommendation, comprising pneumococcal and Hib vaccination and antibiotic prophylaxis, was received by only 52% of the patients. There was no association between the coverage of vaccine and socioeconomic status.

Conclusion: Further improvement in coverage of recommended vaccines and antibiotic prophylaxis is still needed to reduce the risk of serious infection in this high risk group.

Keywords: splenectomy; antibiotic; vaccines, prophylaxis

Abbreviations: BCSH, British Committee for Standards in Haematology; DoH, Department of Health; Hib, Haemophilus influenza type b; SMR, Scottish Morbidity Record

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