Table. Recommendations for vaccination in people who have received chemotherapy
These recommendations are based on the principle that, where possible, children and adults have completed an age-appropriate routine vaccination schedule prior to chemotherapy.
Vaccine category | Vaccine | Recommendation | Comments |
---|---|---|---|
Non-live vaccines | COVID-19 |
|
Number of primary and additional doses are based on the person’s age and presence of other risk factors for severe illness from COVID-19. |
Diphtheria-tetanus-pertussis- and polio-containing vaccinesa,b |
|
– | |
Haemophilus influenzae type ba,b | Aged <5 years: 1 booster dose | – | |
Hepatitis A | Use if indicated | – | |
Hepatitis Ba,b | 1 booster dose for seronegative people with specific at risk conditions | Check serology 4–8 weeks after vaccination. | |
Human papillomavirusa |
Aged ≥9 years: 3-dose primary schedule |
|
|
Influenza | 1 dose annually |
|
|
Japanese encephalitis (inactivated) |
Use if indicated |
See also Vaccination for international travellers. | |
Meningococcal (MenACWY and MenB)a | 1 booster dose of both MenACWY and MenB vaccines | Priority should be given to children (aged <2 years) and adolescents (aged 15–19 years). | |
Mpox (live, non-replicating) | Use if indicated or seek specialist advice on individual risks and benefits of vaccination | – | |
Pneumococcal (conjugate and polysaccharide vaccines)a |
|
|
|
Rabies | Use if indicated | See also Travellers who are immunocompromised. | |
Immunisation against respiratory syncytial virusa |
|
– | |
Zoster (herpes zoster, recombinant) | Aged ≥18 years if immunocompromised: a 2-dose primary schedule | – | |
Live vaccines | BCG | If benefit outweighs risk, give ≥4 weeks before chemotherapy | See also Travellers who are immunocompromised. |
Cholera (live) | Choose non-live vaccine option if indicated | See also Travellers who are immunocompromised. | |
Measles-mumps-rubella (MMR)a | A single dose of MMR-containing vaccine, and a 2nd dose for those not seroconverted (MMRV vaccine can be used as the 2nd dose in children aged <14 years) | Check measles and rubella serology 6–8 weeks after vaccination. | |
Q fever | Contraindicated or consult a specialist | Serological and skin tests are needed before vaccination. | |
Rotavirus | Complete routine schedule (≥4 weeks before chemotherapy, if possible) | Only indicated in infants within age limit (1st dose <15 weeks of age, 2nd dose <25 weeks of age) | |
Typhoid (live) |
Choose non-live vaccine option if indicated | – | |
Varicella (monovalent)a | Complete a 2-dose schedule, give ≥4 weeks before chemotherapy if seronegative (MMRV vaccine can be used as the 2nd dose in children aged <14 years) | Check varicella serology before vaccination if unvaccinated or unsure. | |
Yellow fever | If benefit outweighs risk, give ≥4 weeks before chemotherapy | See also Travellers who are immunocompromised. | |
Acronyms used:
Footnotes: |