Table 1.

Comparison of guidelines for immunization after ALL chemotherapy and post-HSCT.

Organization	NACI10	ATAGI7	EBMT11	RCPCH8	IDSA9
Country/Region	Canada	Australia	Europe	United Kingdom	United States
Immunization after ALL chemotherapy
Vaccines recommended	No specific recommendation	DTaP or Tdap	N/A	DTaP or Tdap	Routine immunizations only
		IPV		IPV
		MMR		MMR
		Hepatitis B		Hib
		HPV		MenC-C
		PCV13*
		Varicella
Timing of immunization after chemotherapy	Not specified	6 months	N/A	6 months	3 months
Timing of initiation of immunization after HSCT
Pneumococcal conjugate vaccine	3–9 months	6 months	3–6 months	15 months	3 months or later
Other inactivated vaccines†	6–12 months	6 months	6–12 months	12–18 months	3–6 months or later
Live vaccines‡	24 months	24 months	24 months	18–24 months	24 months

ALL, acute lymphocytic leukemia; ATAGI, Australian Technical Advisory Group on Immunization; EBMT, European Group of Blood and Marrow Transplantation; HSCT, hematopoietic stem cell transplant; IDSA, Infectious Disease Society of America; NACI, National Advisory Committee on Immunization; RCPCH, Royal College of Paediatrics and Child Health; DTaP, diphtheria-tetanus-acellular pertussis vaccine; Hib, Haemophilus influenzae type b conjugate vaccine; IPV, inactivated polio vaccine; MenC-C, meningococcal conjugate serogroup C vaccine; MMR, measles, mumps, rubella vaccine; PCV13, 13-valent pneumococcal conjugate vaccine.

^*If previous age-appropriate dose not received.

^†Includes tetanus, diphtheria, pertussis, Haemophilus influenzae type b, inactivated polio, hepatitis A, hepatitis B, human papillomavirus, quadrivalent meningococcal conjugate, meningococcal conjugate serogroup C vaccines.

^‡Includes measles, mumps, rubella, varicella.