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A survey of vaccine coverage and antibiotic prophylaxis in splenectomised patients in Scotland
  1. M H Kyaw1,
  2. E M Holmes2,
  3. J Chalmers3,
  4. I G Jones2,
  5. H Campbell1
  1. 1Public Health Sciences, University of Edinburgh, Teviot Place, Edinburgh EH 8 9AG, UK
  2. 2Scottish Centre for Infection and Environmental Health, Clifton House, Clifton Place, Glasgow G3 7LN, UK
  3. 3Information and Statistics Division of the Common Services Agency, Trinity Park House, South Trinity Road, Edinburgh EH5 3SQ, UK
  1. 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

Abstract

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.

  • splenectomy
  • antibiotic
  • vaccines, prophylaxis
  • BCSH, British Committee for Standards in Haematology
  • DoH, Department of Health
  • Hib, Haemophilus influenza type b
  • SMR, Scottish Morbidity Record

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