The first week after my splenectomy, I realized recovery wasn’t just about wound care—it was about rewiring how I think about germs. I kept catching myself asking small questions that felt huge: When should I get my next shot? Is this mild fever an emergency, or am I overreacting? I started sketching a plan that would fit into real life, not just a clinic visit. Along the way, I learned that the “what” of vaccines is only half the story; the “when” and “what-if” steps for daily living matter just as much. So here are the notes I wish someone had handed me on day one—part diary, part field guide, all practical.
Why losing a spleen changes the infection playbook
The spleen is like a quiet proofreader for your immune system. It helps you recognize and clear specific bacteria—especially ones with slippery coats (encapsulated organisms). Without it, your risk of rapid, severe infection from bugs like Streptococcus pneumoniae (pneumococcus), Neisseria meningitidis (meningococcus), and Haemophilus influenzae type b (Hib) goes up. That’s the backstory for the vaccine focus you’ll hear about in every clinic visit. But I also learned there are other, less “headline-y” risks worth naming: dog or cat bites (because of Capnocytophaga), and certain tick-borne infections such as babesiosis. Knowing the terrain helped me swap vague anxiety for clear to-dos.
- Your infection risk is lifelong, with the first two years after surgery being especially important for staying current on vaccines and seeking care promptly for fevers.
- Fast action beats perfect action: if a fever hits, the plan you can follow within minutes is better than the “ideal” plan you can’t access at 2 a.m.
- Vaccines + habits + backup plan is the trio that gave me confidence—not just one piece alone.
For quick background check-ins, I bookmarked: the CDC’s adult schedule notes for special situations like asplenia here, the pneumococcal timing job aid here, and the meningococcal page here. For daily-life risks I kept the CDC pages on dog/cat bite bacteria here and babesiosis prevention here.
The vaccine map I sketched out
When I sat down with my calendar, I realized the map is actually simple once you sort by “core” vs “supporting” vaccines. The CDC’s adult schedule notes cover the special case of anatomic or functional asplenia, including timing around surgery and booster needs. I used that as my foundation and then customized with my clinician.
- Pneumococcal — Two good options for adults with asplenia:
- One-and-done conjugate: a single dose of PCV20 or PCV21 (Capvaxive). No PPSV23 needed after that per current CDC guidance.
- Two-step option: PCV15 followed by PPSV23. The usual interval is 1 year; a minimum 8-week interval can be used in immunocompromising conditions (asplenia qualifies) when accelerated protection is important. If PCV15 is used, complete with one PPSV23; additional PPSV23 doses are generally not recommended now.
I liked the clarity of the CDC’s timing job aid—it shows how to finish the series if you’ve already had one of these in the past.
- Meningococcal — This is actually two families of vaccines:
- MenACWY: For asplenia, do a 2-dose primary series 8 weeks apart, then a booster every 5 years while risk persists.
- MenB: Finish a brand-specific primary series (2 or 3 doses depending on product). Then get a booster 1 year later, and every 2–3 years after that while risk continues.
- Hib (Haemophilus influenzae type b) — If you never received Hib as a child, get one dose. For an elective splenectomy, the CDC prefers giving it at least 14 days before surgery; if not possible, discuss timing after surgery with your team.
- Seasonal vaccines — Influenza annually and keep COVID-19 up to date. These don’t specifically “fix” asplenia risk, but they reduce the background of serious respiratory infections that could complicate recovery.
- Routine adult vaccines — Stay current on Tdap/Td (a Tdap once, then Td/Tdap every 10 years), consider Hepatitis B (now broadly recommended through age 59, and at ≥60 based on risk), and Shingles (zoster) at ≥50. If you lack immunity to MMR or varicella, talk with your clinician—some live vaccines are contraindicated in certain immunocompromised states, but asplenia alone is not the same as immunosuppression from chemotherapy or high-dose steroids, so your context matters.
Working backward from the surgery date made the timing click
Here’s the timeline that made sense to me. It’s not medical advice, just the way I turned guidelines into a calendar I could live with.
- If your splenectomy is planned:
- At least 14 days before surgery: Try to receive Hib (if not previously vaccinated), and consider starting your meningococcal series (MenACWY dose 1; MenB dose 1 if time allows). If your team recommends pneumococcal before surgery, a single PCV20/PCV21 or PCV15 could be scheduled here, depending on your plan.
- Closer than 14 days: Don’t panic if the window is tight. Your team may defer some doses to after surgery to optimize responses and logistics.
- If surgery was urgent or already done:
- About 14 days after surgery (or at discharge if that timing works): This is a common point to start or continue the asplenia vaccines if you didn’t receive them pre-op. Discuss any fevers or antibiotics you’ve been on; your clinician may adjust timing.
- Set automatic reminders for MenACWY (dose 2 in 8 weeks) and MenB (brand-specific intervals), plus future boosters (5 years for MenACWY; 1 year then every 2–3 years for MenB).
- If you had splenectomy years ago:
- It’s not “too late.” Your clinician can review what you’ve already had and finish the series with today’s options (for example, a single dose of PCV20/PCV21 may complete pneumococcal needs even if you had PPSV23 in the past).
When details got fuzzy, I double-checked against the CDC adult notes here, the meningococcal page here, and the pneumococcal timing guide here.
Daily habits that lowered my risk without shrinking my life
This part surprised me: once the vaccines were scheduled, small routines made the biggest difference to my peace of mind. Here’s what stuck.
- Fever plan on the fridge — I wrote: “If temperature ≥ 101°F (38.3°C) or shaking chills, call clinic or go to urgent care/ER now.” My clinician and I also discussed if I should have a standby antibiotic at home for nighttime/weekend starts (not everyone needs this; it depends on your situation and your team’s protocol).
- Animal bite rule — If bitten or a wound is licked by a dog or cat, I clean it thoroughly and call the clinic immediately. The CDC notes that people at higher risk (like those without a spleen) may be advised to start antibiotics promptly because of Capnocytophaga. I keep that link handy here.
- Tick season strategy — I learned that babesiosis can be more severe without a spleen. In warm months or when I’m hiking in endemic areas, I use repellent, do full-body checks, and shower soon after being outdoors. The CDC’s prevention tips are concise here.
- Travel buffer — I try to schedule vaccines and check my booster status at least a month before international trips. A travel clinic can also advise on malaria prevention and meningococcal requirements if I’m heading to high-risk areas.
- Everyday hygiene still matters — Handwashing, staying home when sick, and prompt care for cuts are boring but effective. I keep a small kit stocked with bandages and antiseptic and refresh it with my prescription meds list.
- Medical ID and records — I wear a bracelet that says “asplenia” and carry an updated vaccine card. It’s not dramatic; it’s practical.
My lightweight checklist for clinic visits
- Bring a current vaccine list (photos on your phone are fine) and ask: “What’s next and when?”
- Confirm meningococcal booster dates (MenACWY every 5 years; MenB 1 year after series, then every 2–3 years while risk persists).
- Review pneumococcal status (PCV20/PCV21 typically completes needs; PCV15 requires PPSV23; prior PPSV23 may change the sequence).
- Ask about a standby antibiotic plan and when to use it (fever threshold, travel to remote areas, clinic hours vs after-hours).
- Discuss bite and tick protocols based on where you live and what you do outdoors.
Signals that tell me to slow down and call
These are my personal red flags—clear but not alarmist. I wrote them out so I wouldn’t second-guess myself in the moment.
- Fever ≥101°F (38.3°C), shaking chills, or feeling “suddenly very sick”
- Severe headache, stiff neck, confusion, or a new purple rash
- Shortness of breath or chest pain
- Rapidly spreading skin redness around a cut, bite, or wound
- After a bite: any signs of infection (increasing pain, redness, swelling, drainage) or if you’re unsure whether prophylactic antibiotics were started
My action steps: check my temperature, take the first dose of the standby antibiotic only if my clinician told me to do that, and seek urgent care. I also bring my vaccine record; it helps clinicians focus fast.
Things I decided to stop stressing about
I used to react to every sniffle as if it were a siren. Over time, these mindset shifts helped:
- Not every cold is an emergency. The point is not to panic at minor symptoms, but to act quickly when the pattern looks worrisome (fever, shakes, rapidly worsening).
- Antibiotics aren’t magic shields. They’re lifesaving when needed, but they don’t replace vaccines or basic prevention.
- Perfection isn’t required. If I miss a dose or get off schedule, we simply update the plan at the next visit. The CDC tools make catch-up feasible.
Putting it all together in one page
Here’s the summary I keep in my notes app:
- Core vaccines: PCV20 or PCV21 (or PCV15 then PPSV23); MenACWY 2 doses 8 weeks apart + booster every 5 years; MenB complete series + booster at 1 year then every 2–3 years; Hib one dose if not given before (preferably ≥14 days before elective splenectomy); flu annually; stay current on COVID-19.
- Routine adult vaccines: Tdap/Td every 10 years, zoster at ≥50, HepB as indicated, others per status (MMR/varicella with clinician guidance).
- Everyday rules: fever plan (≥101°F/38.3°C), animal bite protocol (call promptly; consider prophylaxis), tick precautions in endemic areas, medical ID, travel clinic check-ins.
FAQ
1) Do I need antibiotics every day for the rest of my life?
Answer: Not necessarily. Some clinicians prescribe daily prophylaxis for certain higher-risk people (for example, early after surgery or with additional risk factors), while others focus on a fast “fever plan” and standby antibiotics. This is individualized—ask your team to tailor a plan that fits your history and location.
2) I already had PPSV23 years ago. What happens now with the newer vaccines?
Answer: CDC guidance allows a single conjugate dose (PCV15, PCV20, or PCV21) at least one year after the last PPSV23 to complete protection; if PCV15 is used, no additional PPSV23 is generally recommended now. Your clinician can confirm the best finishing step using the CDC timing job aid.
3) If my splenectomy was an emergency, when should I start vaccinations?
Answer: Many teams start or resume asplenia vaccines around two weeks post-op (or at discharge if that timing lines up). If you’re still recovering or recently had a fever/antibiotics, your clinician may adjust the exact day—don’t worry if you need to space things out.
4) What should I do if I get a dog or cat bite?
Answer: Wash the wound thoroughly and contact your clinician right away. Because of Capnocytophaga risk, people without a spleen may be advised to start antibiotics promptly. Don’t wait for redness or swelling to “prove” infection.
5) How worried should I be about ticks and babesiosis?
Answer: Awareness and prevention go a long way. Use repellent, do tick checks, and shower soon after outdoor activities in endemic areas. If you develop fever or fatigue after a tick bite or travel to high-risk regions, seek care—make sure to mention asplenia so testing and treatment aren’t delayed.
Sources & References
- CDC — Adult Immunization Schedule Notes (2025)
- CDC — Pneumococcal Vaccine Timing Job Aid (2025)
- CDC — Meningococcal Vaccine Recommendations (2025)
- CDC — About Capnocytophaga and Bite Advice (2025)
- CDC — Babesiosis Prevention (2024)
This blog is a personal journal and for general information only. It is not a substitute for professional medical advice, diagnosis, or treatment, and it does not create a doctor–patient relationship. Always seek the advice of a licensed clinician for questions about your health. If you may be experiencing an emergency, call your local emergency number immediately (e.g., 911 [US], 119).