Vaccination of persons with asplenia or sickle cell disease

R: recommended—administer if not previously administered or not current; such patients may be at increased risk for this vaccine-preventable infection; U: usual—administer if patient not current with recommendations for dose(s) of vaccine for immunocompetent persons in risk and age categories; X: contraindicated.
* Only the quadrivalent meningococcal polysaccharide vaccine (Menomune, MPSV4) has been approved by the US Food and Drug Administration for individuals ≥56 years of age; however, this vaccine was discontinued in 2017. In addition, a quadrivalent meningococcal conjugate vaccine (Menactra or Menveo) is preferred by the United States Advisory Committee on Immunization Practices (ACIP) for individuals in this age group who are expected to require revaccination since limited data demonstrate a higher antibody response after a subsequent dose of a quadrivalent meningococcal conjugate vaccine compared with a subsequent dose of the quadrivalent meningococcal polysaccharide vaccine.
¶ A two-dose primary series should be administered with an additional dose every five years.
Δ A meningococcal serogroup B vaccine should be administered as either a two-dose series of Bexsero or a three-dose series of Trumenba.
◊ Two doses of PCV13 for children aged two to five years who have not received doses of PCV or received <3 doses of PCV7.
§ If PCV13 has not been administered. For patients aged ≥19 years who have received PPSV23, PCV13 should be administered after an interval of ≥1 year after the last PPSV23 dose (weak, low).
¥ Administer eight or more weeks after indicated dose(s) of PCV13 with a single revaccination with PPSV23 five years after the initial dose (strong, moderate).