TABLE 1.

Recommended vaccines and timing post‐hematopoietic cell transplant (HCT) from established international guidelines.

Vaccine‐preventable infection and vaccine(s)	Recommendations
	ECIL‐7 (2017) 32	DGHO (2018) 141	IDSA (2013) 33	International (2009) 35	UK (2023) 36	ACIP (2023) 142	AIH (2023) 143
Pneumococcal: PCV13, PCV15, PCV20 PPSV23	Three doses of PCV 1 month apart from 3–6 months after HCT, followed by a fourth dose of PCV if GvHD or PPSV23 6 months later 32				Three doses of PCV 1 month apart, from 3 to 6 months after HCT Booster dose given at 18 months post‐HCT with PCV if GvHD or PPSV23 if no GvHD	Three doses of PCV 1–2 months apart, from 3 to 6 months after HCT, with PPSV23 8 weeks after last dose of PCV or at 12 months post‐HCT. PCV as fourth dose if GvHD. New proposal to substitute fourth dose of PPSV23 with PCV20 144	Three doses of PCV from 6 months after HCT at 6, 8, and 12 months post‐HCT PPSV23 starting at 24 months post‐HCT then >5 years later
Hemophilus type B: Hib conjugate vaccine	Three doses of Hib vaccine at 1‐month intervals, from 3 months after HCT OR Three doses of combined diphtheria–tetanus–pertussis–Hib vaccine from 6 months after HCT	Three doses of Hib vaccine, from 6 to 12 months post‐HCT		Three doses of HiB at 2‐month intervals, from 6 to 12 months post‐HCT	Similar to DGHO/IDSA	Three doses of Hib vaccine, at least 1‐month interval, at 6 months post‐HCT	Three doses of Hib vaccine at 6, 8, and 12 months after HCT
Neisseria meningitidis: Quadrivalent (ACYW135) Conjugate (MCV‐4) Monovalent C conjugate (MCV‐C) Anti‐B vaccines MenB‐MC MenB‐fHBP	Recommended in accordance with local guidelines Two doses of vaccine against serotypes B and C, 6 months post‐HCT	1–2 doses of conjugate tetravalent vaccine, 6–12 months post‐HCT	Two doses of MCV‐4 6–12 months post‐HCT for 11– 18 years	Follow country guidelines, one dose, 6–12 months post‐HCT	Two doses of MCV‐4, 8 and 10 months post‐HCT Two doses of a MenB vaccine at a 2‐month interval, at 6 months post‐HCT	MCV‐4 for individuals 11–18 years or at high risk from 6 months post‐HCT Serogroup B meningococcal vaccine for individuals 16–23 years of age or at high risk, at 6 months post‐HCT	Two doses of any MCV‐4 vaccine at 2‐month intervals, from 6 months post‐HCT MenB: Two doses of Bexsero, at 2 month intervals, from 6 months post‐HCT OR Three doses of Trumenba at 1 and 5‐month intervals, from 6 months post‐HCT
Diphtheria and tetanus a : DT (full dose diphtheria) Td (reduced dose diphtheria) DTaP (higher dose of tetanus, diphtheria, pertussis toxoid) Tdap (lower dose formulation) Bordetella pertussis a : Acellular pertussis vaccine—ap (pertussis toxoid)	Three doses of diphtheria–tetanus vaccine at 1–2‐month interval, from 6 months after HCT for all ages 145 Full dose diphtheria (DT) vaccine preferred over reduced dose antigen formulation diphtheria toxoid (Td) to achieve adequate seroprotection Three doses (for pertussis) given in combination with each dose of the diphtheria–tetanus vaccine from 6 months after HCT					Three doses of DTaP for patients <7 years, 1–2‐month intervals, at 6 months post‐HCT For patients ≥7 years, options include: three doses of DTaP OR one dose of Tdap and two doses of DT OR one dose of Tdap and two doses of Td at 1–2‐month intervals, from 6 months post‐HCT	Three doses of diphtheria‐tetanus vaccine at 1–2 months interval, from 6 months after HCT DTPa for children <10 years dTpa for ≥10 years of age for first dose then two doses of dT. If unavailable, then complete with dTpa
Polio virus a : IPV DTPa‐IPV dTpa‐IPV	Three doses of IPV administered at 1–2‐month intervals, 6–12 months after HCT						Three doses of IPV administered at 1–2‐month intervals 6–12 months after HCT Can be given in combination with diphtheria, tetanus, pertussis vaccines
HPV: 4vHPV or 9vHPV	Follow local guidelines for general population and start 6–12 months post‐HCT				Three‐dose schedule is recommended for all HCT recipients aged 12 and over ACIP currently advises vaccination with either 4vHPV or 9vHPV in immunocompromised persons age 9–26 years		Three doses of 9vHPV at 0, 2, 6 months, starting at 8 months post‐HCT If >25 years of age, conduct risk assessment to determine their need for HPV vaccination
HBV: HBV vaccine Engerix	Three doses at 0, 1, and 6 months apart, 6–12 months post‐HCT in those non‐immune to HBV		Three doses at 0, 1, and 6 months apart at 6–12 months post‐HCT	Follow general population recommendations in their country of residence	Three doses at 0, 1, and 6 months, from 6 months post‐HCT	Three doses at 0, 1, and 6 months apart, from 6 months post‐HCT	Three doses (high‐dose formulation is preferred) at 6, 8, and 12 months post‐HCT
Influenza virus: IIV Live intranasal influenza vaccine is contraindicated	One dose of IIV, annually, at the beginning of influenza season Second dose at 3–4 weeks later could be considered in patients expected to have impaired immune response, or during outbreaks in patients vaccinated <6 months post‐HCT	One dose of IIV, annually, at 3–6 months post‐HCT Second dose should be considered in patients who have had early vaccination	One dose of IIV annually, starting 6 months post‐HCT or 4 months post‐HCT if there is a community outbreak	One dose of IIV annually Consider second dose if the vaccine is given <6 months post‐HCT	One dose of IIV annually, from 6 months post‐HCT Consider commencing at 3 months post‐HCT if a peak influenza transmission period	One dose of IIV, annually from 6 months post‐HCT Second dose if first dose is given <4 months after HCT	Two doses of IIV in the first year post‐HCT and then one dose annually thereafter. Adjuvant IIV recommended for those ≥65 years of age 143
SARS‐CoV‐2	Predated SARS‐CoV‐2				Three doses of COVID‐19 (preferably mRNA) vaccine starting 3–6 months post‐HCT as primary course Further booster vaccine doses recommended as per local guidelines, and at least 3–6 months after the last dose of vaccine 36 , 75 , 79 , 146
Varicella zoster virus: LAVV	LAVV can be administered at ≥24 months post‐HCT in varicella‐seronegative HCT recipients who do not have active GvHD, are not receiving any immunosuppression (some recommend for >12 months) and are 8–11 months after the last dose of IVIg (UK guidelines suggest 3 months post‐IVIg) 24 , 33 , 48 , 49 , 50 A second dose could be administered 4 weeks after the first					LAVV at 24 months post‐HCT and no GvHD and the patient is considered immunocompetent	Two doses of LAVV, 4 weeks apart at 24 months post‐HCT if there is evidence of immune reconstitution
Herpes zoster virus: aRZV, adjuvanted recombinant zoster virus vaccine (inactivated), Shingrix	Predated aRZV vaccine				Two doses aRZV at least 2 months apart, commencing at 6 months following HCT	Two doses of aRZV 6–12 months post‐allogeneic SCT and 3–12 months post‐autologous SCT	Two doses of aRZV at 6 and 8 months post‐HCT
MMR: MMR live virus vaccine	One dose of MMR vaccine to seronegative HCT recipients >24 months post‐transplantation; no GvHD, no immunosuppression, no relapse of the underlying disease, no recent IVIg (at least 3 months)		Two doses of MMR vaccine to seronegative patients with same criteria applied		Two doses of MMR vaccine, 6 months apart in adult recipients of autologous and allogeneic HCT who are 24 months post procedure, no GvHD, no systemic immunosuppression for >12 months, and are seronegative	MMR vaccine at 24 months post‐HCT if the patient does not have GvHD and is considered immunocompetent	One dose of MMR vaccine at 24 months post‐HCT if they have met criteria. Check serology at 4–6 weeks after 1st vaccine dose—if no seroconversion, repeat the dose

Abbreviations: 4vHPV, 4‐valent human papillomavirus vaccine; 9vHPV, 9‐valent human papillomavirus vaccine; ACIP, Advisory Committee on Immunization Practices; ACYW‐135, meningococcal quadrivalent conjugate vaccine; AIH, Australian Immunization Handbook; ap, acellular pertussis vaccine; aRZV, adjuvanted recombinant zoster virus vaccine; COVID‐19, coronavirus disease 2019; DGHO, German Society of Hematology and Oncology; DT, full dose diphtheria vaccine; DTaP, higher dose diphtheria, tetanus, and acellular pertussis vaccine; DTPa‐IPV, higher dose diphtheria, tetanus, acellular pertussis, and inactivated poliovirus combination vaccine; dTpa‐IPV, reduced antigen formulation diphtheria–tetanus–pertussis–inactivated poliovirus combination vaccine; ECIL‐7, European Conference on Infections in Leukaemia; GvHD, graft‐versus‐host disease; HBV vaccine, hepatitis B virus; Hib, Haemophilus influenzae type B conjugate vaccine; HiB, Haemophilus influenzae B; HPV, human papillomavirus vaccine; IDSA, Infectious Diseases Society of America; IIV, inactivated influenza vaccine; IPV, inactivated polio virus vaccine; IVIg, intravenous immunoglobulin; LAVV, live‐attenuated varicella vaccine; MCV‐4, meningococcal conjugate vaccine; MCV‐C, monovalent meningococcal serogroup C conjugate vaccine; MenB‐fHBP—Trumenba, recombinant lipidated factor H binding protein meningococcal serogroup B vaccine; MenB‐MC, recombinant multicomponent meningococcal serogroup B vaccine; MMR, measles, mumps, and rubella live virus vaccine; PCV, pneumococcal conjugate vaccine; PPSV23, pneumococcal 23‐valent polysaccharide vaccine; SARS‐CoV‐2, severe acute respiratory syndrome coronavirus 2; Td, reduced dose diphtheria–tetanus combination vaccine; Tdap, reduced dose tetanus, diphtheria, acellular pertussis combination vaccine.

^a Combination vaccine available diphtheria–tetanus–pertussis plus polio (dTpa‐IPV).