A child receives a dose of live attenuated MMR vaccine. Two weeks later the child requires an emergency splenectomy. The next dose of MMR vaccine should ideally be scheduled:

• A Immediately after surgical recovery, as asplenic children need vaccines urgently
• B The dose already received within the last 4 weeks provides immunity; no interval concern ✓
• C At least 3 months after the splenectomy to allow immune reconstitution
• D At least 2 weeks after splenectomy, same as standard immunocompromised wait time

Explanation

Live vaccines like MMR administered 4 weeks or less before an immunosuppressive procedure or condition are considered immune responses that may be impaired by the subsequent immunosuppression. However, since the MMR was given 2 weeks before the splenectomy, immunity from this dose may be suboptimal. The standard recommendation is that live vaccines given <4 weeks before the onset of immunosuppression should be repeated ≥3 months after immunosuppressive condition resolves or is stabilized. Splenectomy itself does not create T-cell immunosuppression, but the child may have reduced IgM responses to encapsulated organisms — timing of repeat vaccination should follow standard immunization guidance.

Reference: Ghai Essential Pediatrics, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.