Table 7. Vaccination of Persons With Asplenia or a Sickle
Cell Disease, Cochlear Implants, or CSF Leak
Recommendation
(Strength, Evidence Quality)
Vaccine
Asplenia or a Sickle Cell
Disease
Cochlear Implants
a
or
CSF Leak
H influenzae type b
conjugate
U: age <5 y (SR-M)
R: age ≥5 y (WR-L)
U (SR-M)
Hepatitis A U (SR-M) U (SR-M)
Hepatitis B U (SR-M) U (SR-M)
DTaP, Td, Tdap U (SR-M) U (SR-M)
HPV U (SR-M) U (SR-M)
Influenza, inactivated U (SR-M) U (SR-M)
Influenza, live attenuated X (WR-VL) U (SR-M)
MMR, live U (SR-M) U (SR-M)
MMRV, live U (SR-M) U (SR-M)
Meningococcal conjugate R: age 2-55 y
b
(SR-L) U (SR-M)
Meningococcal
polysaccharide
R: age >55 y
b
(SR-L) U (SR-M)
Pneumococcal conjugate
(PCV13)
U: age <6 y
c
(SR-M)
R: age ≥6 y
d
(SR-VL)
U: age <6 y
c
(SR-M)
R: age ≥6 y
d
(SR-L)
Pneumococcal
polysaccharide (PPSV23)
R: age ≥2 y
e
(SR-L) R: age ≥2 y
e
(SR-M)
Poliovirus, inactivated U (SR-M) U (SR-M)
Rotavirus, live U (SR-M) U (SR-M)
Varicella, live U (SR-M) U (SR-M)
Zoster, live U (SR-M) U (SR-M)
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.
a
Includes patients with profound hearing loss who are scheduled to receive a cochlear implant or have
inner ear-cerebrospinal fluid communication.
b
A 2-dose primary series should be administered and an additional dose every 5 years.
c
Two doses of PCV13 for children 2 through 5 years of age who have not previously received doses of
PCV or received <3 doses of PCV7.
d
If PCV13 has not previously been administered. For patients ≥19 years who have previously received
PPSV23, PCV13 should be administered aer an interval of ≥1 year aer the last PPSV23 dose
(WR-L).
e
Administer 8 or more weeks aer indicated dose(s) of PCV13 and a single revaccination with
PPSV23 5 years aer the initial dose (SR-M).
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