PDQ Cancer Information Summaries [Internet].
Bethesda (MD): National Cancer Institute (US); 2002-.
NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.
Table 2. Vaccination Schedule for Hematopoietic Stem Cell Transplant (HSCT) Recipientsa
| Autologous HSCT | 6 Mob | 8 Mob | 12 Mob | 24 Mob |
|---|---|---|---|---|
| Allogeneic HSCT (if not immunized before 12 mo post-HSCT; start regardless of GVHD status or immunosuppression) | 12 mob (sooner if off immunosuppression) | 14 mob (or 2 mo after first dose) | 18 mob (or 6 mo after first dose) | 24 mob |
| Inactivated Vaccines | ||||
| Diphtheria, tetanus, acellular pertussis (DTap) | Xc | Xc | Xc,d | |
| Haemophilus influenzae (Hib) | X | X | Xd | |
| Hepatitis B (HepB) | X | X | Xd | |
| Inactive polio (IPV) | X | X | Xd | |
| Influenza—seasonal injection (IM) | Xe | |||
| Pneumococcal conjugate (PCV 7, PCV 13) | Xf | X | Xd,f,g | |
| Pneumococcal polysaccharide (PPV 23) | Xd,f,g | |||
| Live Attenuated Vaccines (contraindicated in patients with active GVHD or on immunosuppression) | ||||
| Measles, mumps, rubella | Xd,h | |||
| Optional Inactivated Vaccines | ||||
| Hepatitis A | Optional | |||
| Meningococcal | Xd (for high-risk patients) | |||
| Optional Live Vaccines (contraindicated in patients with active GVHD or on immunosuppression) | ||||
| Chicken pox (varicella vaccine) | Optional | |||
| Rabies | May be considered at 12–24 mo if exposed | |||
| Yellow fever, tick-borne encephalitis (TBE), Japanese B encephalitis | For travel in endemic areas | |||
| Contraindicated Vaccines | ||||
| Intranasal influenza (trivalent live-attenuated influenza vaccine)—household contacts and caregivers should not receive within 2 weeks before contact with HSCT recipient; shingles; bacillus Calmette-Guerin (BCG); oral polio vaccine (OPV); cholera; typhoid vaccine (PO, IM); rotavirus. | ||||
GVHD = graft-versus-host disease; IM = intramuscular; PO = orally.
bTimes indicated are times posttransplant (day 0).
cUse of Tdap is acceptable if DTap is not available.
dTiters may be considered for pediatric patients and patients with GVHD who received immunizations while on immune suppression (minimum 6–8 weeks after last vaccination).
eMay start as soon as 4 months post-HSCT or sooner for patients with CD4 counts >200/mcL or at any time during an epidemic. If given <6 months after HSCT, may require second dose. Children younger than 9 years require second dose, separated by 1 month.
fConsider pre- or postvaccine (at least 6–8 weeks after) titers.
gPCV 7 at 24 months only for patients with GVHD; all other patients can get PPV 23.
hPediatric patients should receive two doses at least 1 month apart.