Table 8.
Vaccine | Recommendations for Use | Rating |
---|---|---|
Hepatitis A [829] |
|
BIII |
|
||
AII | ||
AI | ||
Polio‡ | Not routinely recommended for adults but inactivated§ polio vaccine should be administered when polio vaccination is indicated | AII |
Rotavirus |
|
CIII |
Measles-mumps-rubella (MMR) (live) |
|
AIII |
Pertussis | Vaccination with DTaP is recommended for children < 7 years and with Tdap for adolescents and adults. | BIII |
|
|
AIII |
HCT indicates hematopoietic cell transplant.
Children aged 6 months to <9 years receiving influenza vaccination for the first time require 2 doses and those who only receive 1 dose in the first year should receive 2 doses the following year 304, 307.
If HCWs, family members, or other close contacts of HCT recipients receive influenza vaccination during an influenza outbreak, they should also receive chemoprophylaxis, based on strain susceptibility (BI), while the vaccinee develops an immunologic response to the vaccine. However, if a nosocomial outbreak occurs with an influenza strain that is not contained in the available influenza vaccine, HCWs, family members, and other close contacts of HCT recipients and candidates should be administered influenza chemoprophylaxis based on strain susceptibility, until the end of the outbreak (BIII) 307, 830, 831.
Vaccine-strain polio virus in oral polio vaccine can be transmitted person to person; therefore, oral polio vaccine administration is contraindicated among household contacts of immunocompromised persons. If oral polio vaccine is inadvertently administered to a household contact of an HCT recipient, ACIP's and the American Academy of Pediatrics' recommendations should be followed to minimize close contact with the immunocompromised person for 4-6 weeks after vaccination 304, 832, 833.
Although vaccine-associated paralytic poliomyelitis has not been reported among HCT recipients after exposure to household contacts inadvertently vaccinated with oral polio vaccine, inactivated polio vaccine should be used among family members, close contacts, and HCWs to avoid person-to-person transmission of vaccine-strain polio virus [832].
HCWs, family members, close contacts, and visitors who do not have a documented history of varicella-zoster infection or who are seronegative should receive varicella vaccine before being allowed to visit or have direct contact with an HCT recipient (AIII). Ideally, varicella-zoster- susceptible HCWs, family members, household contacts, and potential visitors of immunocompromised HCT recipients should be vaccinated as soon as the decision to perform an HCT is made. The vaccination dose or doses should be completed >4 weeks before the conditioning regimen begins or >6 weeks (42 days) before contact with the HCT recipient is planned (BIII). If a varicella vaccinee develops a postvaccination rash within 42 days of vaccination, the vaccinee should avoid contact with HCT recipients until all rash lesions are crusted or the rash has resolved 282, 304
Children 12 months to 12 years should receive two doses 3 months apart; adolescents ≥13 years and adults should receive 2 doses 4 weeks apart.