In which case pneumococcal vaccine is most effective:

Ans is 'a' ie When given preoperatively "Timing of vaccination generally is accepted as a minimum of 2 weeks before planned elective splenectomy and within 7 to 10 days after unplanned or emergent splenectomy, although data supporting this practice are lacking." -- Schwartz 9/e "Pneumococcal vaccine should be administered to all patients 2 weeks before elective splenectomy. Harrison 17/eIf the spleen is removed in emergency (eg. following trauma), vaccination should be given as soon as possible following surgery.Booster injection of pneumococcal vaccine should be given every 5 to 6 years.Other vaccines advisable in splenectomy pts: vaccines to Neisseria meningitides, Haemophilus influenza type b