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. 2009 Sep 9;15(10):1143–1238. doi: 10.1016/j.bbmt.2009.06.019

Table 6.

Vaccinations Recommended for Both Autologous and Allogeneic HCT Recipients

Vaccine Recommended for Use after HCT Time Post-HCT to Initiate Vaccine Number of Doses∗ Improved by Donor Vaccination (Practicable Only in Related-Donor Setting)

  • Pneumococcal

  • Conjugate (PCV)

 Yes (BI) 3-6 months 3-4† Yes; may be considered when the recipient is at high risk for chronic GVHD

  • Tetanus, diphtheria,

  • acellular pertussis‡

  • Yes

  • Tetanus-diphtheria: (BII)

  • Pertussis (CIII)

 6-12 months 3§

  • Tetanus: likely

  • Diphtheria: likely

  • Pertussis: unknown

  • Haemophilus

  • influenzae

  • conjugate

 Yes (BII) 6-12 months 3 Yes
Meningococcal conjugate Follow country recommendations for general population (BII) 6-12 months 1 Unknown
Inactivated polio Yes (BII) 6-12 months 3 Unknown

  • Recombinant

  • Hepatitis B

 Follow country recommendations for general population (BII) 6-12 months 3 Likely

  • Inactivated

  • Influenza

 Yearly (AII) 4-6 months 1 -2⊥ Unknown

  • Measles-

  • Mumps-

  • Rubella††

  • Measles: all children and seronegative adults Measles: BII

  • Mumps: CIII

  • Rubella: BIII

 24 months 1 -2‡‡ Unknown

  • (live)

  • EIII (<24 months post-HCT, active GVHD, on immune suppression)

HCT indicates hematopoietic cell transplant; GVHD, graft-versus-host disease.

∗

A uniform specific interval between doses cannot be recommended as various intervals have been used in studies. As a general guideline, a minimum of 1 month between doses may be reasonable.

†

Following the primary series of 3 PCV doses, a dose of the 23-valent polysaccharide pneumococcal vaccine (PPSV23) to broaden the immune response might be given (BII). For patients with chronic GVHD who are likely to respond poorly to PPSV23, a fourth dose of the PCV should be considered instead of PPSV23 (CIII).

‡

DTaP is preferred, however, if only Tdap is available (eg, because DTaP is not licensed for adults), administer Tdap. Acellular pertussis vaccine is preferred, but the whole-cell pertussis vaccine should be used if it is the only pertussis vaccine available. (See text for more information.)

§

See text for consideration of an additional dose(s) of Tdap for older children and adults.

Significant improvement of recipient response to hepatitis B vaccine posttransplant can be expected only if the donor receives more than 1 hepatitis vaccine dose prior to donation.

⊥

For children <9 years of age, 2 doses are recommended yearly between transplant and 9 years of age [306].

††

Measles, mumps, and rubella vaccines are usually given together as a combination vaccine. In females with pregnancy potential, vaccination with rubella vaccine either as a single or a combination vaccine is indicated.

‡‡

In children, 2 doses are favored.