<prompt> In which case pneumococcal vaccine is most effective:When given preoperativelyWhen given post operativelyAgainst all strains of bacteriaAgainst gram negative bacteria  <response>: 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 9e Pneumococcal vaccine should be administered to all patients 2 weeks before elective splenectomy. Harrison 17eIf 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 