Recommended vaccines after allogeneic HCT
| Vaccine . | Recommendation . | Comments . |
|---|---|---|
| Nonlive vaccines | ||
| Tetanus toxoid + diphtheria toxoid | Yes | Three doses (DT) starting 6 mo after transplantation |
| Inactive influenza | Yes | Seasonal, beginning 4-6 mo after transplantation depending on season |
| Inactivated poliovirus | Yes | Three doses starting 6 (-12) mo after transplantation |
| Conjugated Hib | Yes | Three doses starting 6 (-12) mo after transplantation |
| Pneumococcal conjugate | Yes | Three doses starting 3 (-6) mo after transplantation; booster at 12 mo in patients with chronic GVHD |
| Pneumococcal polysaccharide | Yes | Booster at 12 mo in patients without GVHD no earlier than 8 weeks after conjugate |
| Acellular pertussis | Yes | Children <7 starting 6 (-12) mo after transplantation |
| Hepatitis B virus | Yes | In countries where it is recommended to the general population, starting 6 (-12) mo after transplantation |
| Papillomavirus | Yes | As in the general population, starting earliest 6-12 mo after transplantation; three doses |
| Meningococcal conjugate | Yes | As in the general population, starting 6 mo after transplantation; two doses |
| Recombinant zoster vaccine | Can be considered | Limited data after stem cell transplantation |
| Vaccines against COVID-19 | Yes | Limited data but risk/benefit favors vaccination |
| Live vaccines | ||
| MMR | Individual consideration | Children and seronegative adults, not before 24 mo after HCT; not to be given to patients with GVHD |
| Varicella | Individual consideration | Seronegative patients, not before 24 mo after BMT; not to be given in patients with GVHD |
| Live zoster | Not recommended |
| Vaccine . | Recommendation . | Comments . |
|---|---|---|
| Nonlive vaccines | ||
| Tetanus toxoid + diphtheria toxoid | Yes | Three doses (DT) starting 6 mo after transplantation |
| Inactive influenza | Yes | Seasonal, beginning 4-6 mo after transplantation depending on season |
| Inactivated poliovirus | Yes | Three doses starting 6 (-12) mo after transplantation |
| Conjugated Hib | Yes | Three doses starting 6 (-12) mo after transplantation |
| Pneumococcal conjugate | Yes | Three doses starting 3 (-6) mo after transplantation; booster at 12 mo in patients with chronic GVHD |
| Pneumococcal polysaccharide | Yes | Booster at 12 mo in patients without GVHD no earlier than 8 weeks after conjugate |
| Acellular pertussis | Yes | Children <7 starting 6 (-12) mo after transplantation |
| Hepatitis B virus | Yes | In countries where it is recommended to the general population, starting 6 (-12) mo after transplantation |
| Papillomavirus | Yes | As in the general population, starting earliest 6-12 mo after transplantation; three doses |
| Meningococcal conjugate | Yes | As in the general population, starting 6 mo after transplantation; two doses |
| Recombinant zoster vaccine | Can be considered | Limited data after stem cell transplantation |
| Vaccines against COVID-19 | Yes | Limited data but risk/benefit favors vaccination |
| Live vaccines | ||
| MMR | Individual consideration | Children and seronegative adults, not before 24 mo after HCT; not to be given to patients with GVHD |
| Varicella | Individual consideration | Seronegative patients, not before 24 mo after BMT; not to be given in patients with GVHD |
| Live zoster | Not recommended |
DT, diphtheria and tetanus toxoids; MMR, measles, mumps, and rubella. Adapted from Cordonnier et al.10