There are some situations in which it is very important to think about vaccines before your child has surgery.
“Pneumococcal conjugate vaccine (PCV13, Prevnar 13, Pfizer), Haemophilus influenzae type b vaccine (Hib), meningococcal conjugate vaccine (MenACWY), and meningococcal B vaccine should be given 14 days before splenectomy, if possible.”
Ask the Experts about Scheduling Vaccines
A splenectomy leaves your child at extra risk for many vaccine-preventable diseases, so it is a good idea to get vaccinated and protected well in advance of a planned splenectomy, if possible.
This doesn’t mean that these vaccines won’t work after the surgery, but just that you don’t want your child to be unprotected while he remains unvaccinated.
Is Surgery a Contraindication to Getting Vaccinated?
What about other surgeries?
Some kids are put on an aspirin regimen after cardiac surgery and it should be noted that taking aspirin is a contraindication for getting FluMist, the nasal spray flu vaccine, and is considered a precaution for getting the chicken pox vaccine.
“(j)No adverse events associated with the use of aspirin or aspirin-containing products after varicella vaccination have been reported; however, the vaccine manufacturer recommends that vaccine recipients avoid using aspirin or aspirin-containing products for 6 weeks after receiving varicella vaccines because of the association between aspirin use and Reye syndrome after varicella. Vaccination with subsequent close monitoring should be considered for children who have rheumatoid arthritis or other conditions requiring therapeutic aspirin. The risk for serious complications associated with aspirin is likely to be greater in children in whom natural varicella develops than it is in children who receive the vaccine containing attenuated VZV. No association has been documented between Reye syndrome and analgesics or antipyretics that do not contain aspirin.”
Vaccine Recommendations and Guidelines of the ACIP
In most other situations, not only is surgery not considered a contraindication to getting vaccinated, but “hospitalization should be used as an opportunity to provide recommended vaccinations.”
“Most studies that have explored the effect of surgery or anesthesia on the immune system were observational, included only infants and children, and were small and indirect, in that they did not look at the immune effect on the response to vaccination specifically. They do not provide convincing evidence that recent anesthesia or surgery significantly affect response to vaccines. Current, recent, or upcoming anesthesia/surgery/hospitalization is not a contraindication to vaccination. Efforts should be made to ensure vaccine administration during the hospitalization or at discharge.”
Vaccine Recommendations and Guidelines of the ACIP
The one possible argument that makes sense to delay a vaccine in few days or weeks before a planned surgery is that if your child has a reaction to the vaccine, even if it is a mild reaction, like a fever or irritability, then it might cause them to delay the surgery.
And you could make the same argument about delaying vaccines in the days or weeks after having surgery. Could mild reactions to a vaccine be confused with complications from the surgery?
Otherwise, your anesthesiologist’s preferences aside, a recent or upcoming surgery is not a true contraindication to getting vaccinated, especially if it is a vaccine that your child is already past due for or needs because of a local outbreak, etc.
What happens if you delay getting your child vaccinated because of a planned surgery and they get exposed to someone with measles or chicken pox?
Fortunately, this isn’t usually an issue unless your child is already behind on their vaccines and needs to catch up. After all, there is a lot of flexibility built into the immunization schedule, so that your child could get all of their vaccines on time, even with a planned or unexpected surgery.
I’ve had the occasional family hesitate to vaccinate soon before a surgery because they worry that their child will develop a fever and be at risk of needing to postpone the surgery. Do you know if anyone’s looked at the risk of needing to delay surgery due to a potential fever associated with a vaccine?