Children Without Spleens
The spleen is an organ that has multiple functions. Aside from recycling old worn-out red blood cells in the body, the spleen is a crucial component of the overall immune system. The spleen filters the blood and constantly looks for the presence of bacteria in the circulating blood. If a germ is detected, it is immediately quarantined and neutralized.
While almost everyone is born with a working spleen, some children and adults end up losing their spleen for one reason or another. A common reason that children lose their spleen is if they have sickle cell anemia. Children with sickle cell anemia have abnormally shaped blood cells. These abnormally shaped cells do not circulate well through the spleen, so over the course of many years the spleen becomes so congested in these children that it eventually stops working. Another reason why children may lose their spleen is if they were involved in a serious accident that caused their spleen to rupture. Surgeons sometimes have no choice but to remove the spleen from these children because these children would otherwise bleed to death. Very few individuals are born without a spleen.
Since children without spleens can get sick so easily, many of them need to take antibiotics on a daily basis to protect their bodies from germ invasion. The routine vaccination for every child is even more crucial in these children without spleens.
Children without a spleen are significantly more prone to getting certain bacterial infections because they lack a crucial component of the immune system. Their bodies are unable to screen out germs from the blood, and bacteria can multiply in their bodies totally unhindered. Currently three vaccines are especially important for these children, including the pneumococcal conjugate vaccine, the Hib conjugate vaccine, and the meningococcal conjugate vaccine.
The Pneumococcal Vaccine
The pneumococcal vaccine is routinely administered to all children at age two months, four months, six months, and again at twelve months of age. For these children without a functional spleen, this vaccine is even more important. Consult Chapter 11 for a more in-depth discussion of the pneumococcal conjugate vaccine.
The Hib Vaccine
The Hib vaccine is already recommended for all healthy children, and children without spleens should receive this vaccine at the same schedule. Recently, there has been a nationwide shortage of the Hib vaccine, and most doctors are skipping some doses of this vaccine to conserve the existing vaccine supply for those who need it the most. If your child has no functional spleen, she must get the complete series of this vaccine. No skipping of doses should be permitted because the risk of life-threatening infection is so high. Please refer to Chapter 10 for more detailed discussion about the Hib conjugate vaccine.
The Meningococcal Vaccine
Meningococcus is a bacterium that can cause devastating infection. The infection caused by this bacterium is particularly aggressive, and it can spread so rapidly that the victim can die on the same day of the first sign of illness. Children without spleens are particularly defenseless against this bacterium, and early vaccination against this infection could be life saving.
The meningococcal conjugate vaccine is not usually recommended for healthy children until early adolescence. However, in children without spleens, this vaccine should be administered at age two years. More recently, there have been research studies that are looking into whether this vaccine could be given at an even earlier age. Please refer to Chapter 16 for more discussion on the meningococcal vaccine. Consult with your child's doctor for the latest recommendation.