Table 5.

Specific recommendations for the vaccines in patients treated with rituximab and other anti-CD20 mAbs [107, 111]

Vaccine	Vaccine type	Suggested dose	Suggested timing of vaccination in relation to rituximab	Serological testing post immunisation
Diphtheria, tetanus, polio vaccine	Inactivated	Usual dose and schedule	Preferably 6 months after last infusion and at least 2 weeks prior to next infusion	Not available in routine setting
Haemophilus conjugate vaccine	Inactivated	Usual dose and schedule	Preferably 6 months after last infusion and at least 2 weeks prior to next infusion	Not available in routine setting
Hepatitis B	Inactivated	Higher dose for immunocompromised people: Double dose of age should be given, total 4 doses (months 0, 1, 2, 6–12) [113]	Preferably 6 months after last infusion and at least 2 weeks prior to next infusion Consider to delay the entire vaccine series until completion of rituximab courses	Anti-HBs at 1–2 months following completion of the vaccine series [100]
Human papillomavirus vaccine	Inactivated	Three doses for immunocompromised people [114] Months 0, 2, 6 from 9 years old onwards	Preferably 6 months after last infusion and at least 2 weeks prior to next infusion Consider delaying the entire vaccine series until completion of rituximab courses	Not available in routine setting
Inactivated influenza Vaccine	Inactivated	Usual dose and schedule Second dose is required for children aged < 9 years who have not previously been vaccinated	Preferably 6 months after last infusion and at least 2 weeks prior to next infusion Can receive during influenza seasons without delay to reduce complications of infections	Not available in routine setting
Measles, rubella, mumps (MMR)	Live-attenuated	Usual dose and schedule	Preferably 12 months after last infusion and 4 weeks prior to next infusion [107]	Measles, mumps, rubella IgG antibodies
Meningococcal ACWY vaccine	Inactivated	Usual dose and schedule	Preferably 6 months after last infusion and at least 2 weeks prior to next infusion	Not available in routine setting
Meningococcal B vaccine	Inactivated	Usual dose and schedule	Preferably 6 months after last infusion and at least 2 weeks prior to next infusion	Not available in routine setting
Pneumococcal 23-valent (PPSV-23)	Inactivated	Usual dose and schedule	Preferably 6 months after last infusion and at least 2 weeks prior to next infusion	Not available in routine setting
Pneumococcal vaccine 15-valent (PCV-15)	Inactivated	Usual dose and schedule	Preferably 6 months after last infusion and at least 2 weeks prior to next infusion	Not available in routine setting
Pneumococcal vaccine 20-valent (PCV-20)	Inactivated	Usual dose and schedule	Preferably 6 months after last infusion and at least 2 weeks prior to next infusion	Not available in routine setting
SARS-CoV2-mRNA vaccine	mRNA	Additional doses for immunocompromised people, please refer to latest CDC recommendation [115, 116]	Preferably 6 months after last infusion and at least 2 weeks prior to next infusion Can receive during peak seasons without delay to reduce complications of infections	Not available in routine setting
Varicella	Live-attenuated	Usual dose and schedule	Preferably 12 months after last infusion and 4 weeks prior to next infusion [107]	Varicella IgG antibodies