Special Populations
16
Table 3. Vaccination of Patients With Cancer - Footnotes
R, recommended—administer if not previously administered or not current; such patients may be at
increased risk for this vaccine-preventable infection
U, usual—administer if patient not current with recommendations for dose(s) of vaccine for
immunocompetent persons in risk and age categories
X, contraindicated.
a
Administer inactivated influenza vaccine (IIV) annually to patients with hematological malignancies
(SR-M) or solid tumor malignancies (SR-L) except those receiving anti–B-cell antibodies such
as rituximab or alemtuzumab or intensive chemotherapy such as for induction or consolidation
chemotherapy for acute leukemia (WR-L). Administrations of inactivated vaccines other than IIV
routinely recommended for healthy children in the annually updated CDC recommendations can
be considered for children with malignancies who are receiving maintenance chemotherapy (WR-L).
However, vaccines administered while receiving cancer chemotherapy should not be considered
valid doses (SR-L).
b
IIV can be administered ≤3 months aer chemotherapy, but response rate may be low.
c
ese live vaccines should not be administered unless the vaccine is otherwise indicated based on the
annually updated CDC recommendations AND the patient is not immunosuppressed AND there
will be an interval of ≥4 weeks prior to initiation of chemotherapy.
d
For patients ≥19 years of age with HIV who have previously received PPSV23, PCV13 should be
administered aer an interval of ≥1 year aer the last PPSV23 dose (WR-L).
e
Although MMR has been given safely 3 months aer completion of chemotherapy, data on the
safety, immunogenicity, or efficacy of varicella or zoster vaccine aer completion of chemotherapy
are not available.
f
For patients ≥19 years of age who have previously received PPSV23, PCV13 should be administered
aer an interval of ≥1 year aer the last PPSV23 dose (WR-L).
