14
Special Populations
Cancer (Table 3)
69. Patients ≥6 months of age with hematological malignancies (SR-M)
or solid tumor malignancies (SR-L) except those receiving anti-B
cell antibodies* (SR-M) or intensive chemotherapy, such as for
induction or consolidation chemotherapy for acute leukemia (WR-L),
should receive IIV annually.*
70. PCV13 should be administered to newly diagnosed adults with
hematological (SR-VL) or solid malignancies (SR-VL) and children
with malignancies (SR-VL) as described in recommendations 27a-c.
PPSV23 should be administered to adults and children ≥2 years of
age (SR-L) at least 8 weeks after the indicated dose(s) of PCV13.
71. Inactivated vaccines (other than IIV) recommended for
immunocompetent children in the CDC annual schedule can
be considered for children who are receiving maintenance
chemotherapy (WR-L). However, vaccines administered during
cancer chemotherapy should NOT be considered valid doses (SR-L)
unless there is documentation of a protective antibody level (SR-M).
72. Live viral vaccines should NOT be administered during
chemotherapy (SR-VL to M).
73. Starting 3 months following cancer chemotherapy, patients
should be vaccinated with inactivated vaccines (SR-VL to M) and
the live vaccines VAR (WR-VL), MMR (SR-L), and MMRV (WR-VL)
according to the CDC annual schedule routinely indicated for
immunocompetent persons. If regimens included anti-B cell
antibodies, vaccinations should be delayed at least 6 months
(SR-M).
