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

Table 7.

Vaccinations Considered Optional or Not Recommended for Both Autologous and Allogeneic HCT Recipients

Optional
Vaccine Recommendations for use Rating
Hepatitis A
  • Follow recommendations for general population in each country
    • •
      Ig should be administered to hepatitis A-susceptible HCT recipients who anticipate hepatitis A exposure (eg, during travel to endemic areas) and for postexposure prophylaxis.
 CIII

  • Varicella (Varivax)

  • (live)

 Limited data regarding safety and efficacy.

  • EIII (<24 months post- HCT, active GVHD, or on immunosuppression)

  • CIII (>24 months, without active GVHD, or on immunosuppression)
Human papillomavirus

  • Follow recommendations for general population in each country

  • No data exist regarding the time after HCT when vaccination can be expected to induce an immune response

 CIII
Yellow fever (live)

  • Limited data regarding safety and efficacy.

  • The risk-benefit balance may favor use of the vaccine in patients residing in or traveling to endemic areas.

  • EIII (<24 months, active GVHD, or on immunosuppression)

  • CIII (>24 months, without active GVHD, or on immunosuppression)
Rabies

  • Appropriate for use in HCT recipients with potential occupational exposures to rabies [827]

  • Preexposure rabies vaccination should probably be delayed until 12-24 months after HCT.

  • Postexposure administration of rabies vaccine with human rabies Ig can be administered any time after HCT as indicated∗ 827, 828

CIII
Tick-borne encephalitis (TBE)

  • According to local policy in endemic areas.

  • No data exist regarding the time after HCT when vaccination can be expected to induce an immune response

 CIII
Japanese B encephalitis

  • According to local policy when residing in or traveling to endemic areas.

  • No data exist regarding the time after HCT when vaccination can be expected to induce an immune response

 CIII
Not Recommended
Vaccine Recommendations for use Rating

  • Bacillus

  • Calmette-Guérin (live)

 Contraindicated for HCT recipients EII
Oral poliovirus vaccine (live) Should not be given to HCT recipients since an effective, inactivated alternative exist EIII
Intranasal influenza vaccine (live)

  • No data regarding safety and immunogenicity.

  • Should not be given to HCT recipients since an effective, inactivated alternative exist

 EIII
Cholera No data were found regarding safety and immunogenicity among HCT recipients DIII
Typhoid, oral (live) No data were found regarding safety and immunogenicity among HCT recipients. EIII
Typhoid (intramuscular) No data were found regarding safety, immunogenicity, or efficacy among HCT recipients. DIII
Rotavirus Must be given before 12 weeks of age to be safe. EIII

  • Zoster vaccine (Zostavax)

  • (live)

 No data regarding safety among HCT recipients. EIII

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

∗

Current Advisory Committee on Immunization Practices (ACIP) and American Academy of Pediatrics guidelines for postexposure human rabies immunoglobulin and vaccine administration should be followed, which include administering 5 doses of rabies vaccine administered on days 0, 3, 7, 14, and 28 postexposure.