Peri-splenectomy vaccination at tertiary-care facilities in Hamilton, Ontario
Bibliographic record
Abstract
Objective: The Canadian Immunization Guide recommends vaccinations against Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae type b (Hib) either at least 2 weeks before elective splenectomy or within 2 weeks following emergent splenectomy. This study aimed to assess compliance with these national recommendations. Recommended peri-splenectomy vaccines at the time of the study included the 23-valent pneumococcal polysaccharide vaccine (PPSV23), a quadrivalent meningococcal vaccine, and a Hib vaccine. Methods: Data for all adult elective and emergent splenectomy patients between March 2009 and November 2012 at an academic institution in Hamilton, Canada, were retrospectively reviewed. Data collection included indication for and date of splenectomy, vaccine formulation ordered and administered, and date of vaccine administration. Results: The vaccination rates of 125 patients were 55.2% for pneumococcus, 58.4% for meningococcus, and 59.2% for Hib; 66 patients (52.8%) received vaccinations against all three pathogens. Emergent splenectomy patients were significantly more likely than elective splenectomy patients to have documented vaccination against all three pathogens (62.9% versus 42.9%; p=0.003). Only 6 of 73 patients (8.2%) received a recommended quadrivalent meningococcal vaccine, while 49 of 69 pneumococcal-vaccinated patients (62.3%) received the recommended PPSV23. Conclusions: Peri-splenectomy vaccination patterns did not consistently meet national recommendations. Vaccines against S. pneumoniae, N. meningitidis, and Hib were administered in <60% of patients, which highlights a need for strategies to improve peri-operative vaccination rates in this population. Administration of vaccine formulations inconsistent with national guidelines demonstrates a need to improve awareness of the current vaccination recommendations for asplenic patients.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".