Vaccination coverage and awareness of infectious risks in patients with an absent or dysfunctional spleen in the Netherlands

ObjectiveTo evaluate the current practice to prevent infections in patients with an absent or dysfunctional spleen in a part of the Netherlands. To measure serum antibody levels against Streptococcus pneumoniae and Haemophilus influenzae type b.DesignObservational study of vaccination coverage by analysis of questionnaires and serum antibody levels.SettingPrimary care practices in the Utrecht area of the Netherlands, catchment area 750,000 inhabitants, period 2006–2007.ParticipantsOne hundred and thirty adult patients with an absent or dysfunctional spleen.Main outcome measuresPercentage of patients informed about infectious risks and aware of the timely use of antimicrobial prophylaxis. Vaccine coverage against S. pneumoniae, H. influenzae type b and Neisseria meningitidis. Levels of serum antibodies against S. pneumoniae and H. influenzae type b.ResultsFifty-six patients (43%) have not received up-to-date information about the infectious risks associated with their condition; 65 patients (50%) are not aware of the need to contact a physician immediately in case of high fever; 37 patients (28%) are keeping antimicrobial prophylaxis at home. Pneumococcal vaccination has been administered within the last 5 years to 103 of 130 patients, antibody levels above the threshold of ≥0.35 μg/mL are found in 83 of the 101 patients (data lacking in 2 patients). Complete coverage against S. pneumoniae is only 64% (83/130). A minority of patients (respectively 32% and 27%) has been vaccinated against H. influenzae type b and N. meningitidis.ConclusionsVaccination coverage and education about infectious risks in patients with an absent or dysfunctional spleen can be improved markedly in the Netherlands.