Table 4. Vaccinations Prior to or After Allogeneic or
Autologous HSCT
Recommendation
(Strength, Evidence Quality)
Vaccine Pre-HSCT Post-HSCT
H influenzae type b
conjugate
U (SR-M) R: 3 doses (SR-M) at 6 mo
post-tx
Hepatitis A U (SR-VL) R: 2 doses (WR-L) at ≥6 mo
post-tx
Hepatitis B U (SR-L) R: 3 doses (SR-M) at 6–12
mo post-tx
DTaP, DT, Td, Tdap U (SR-L) R: age <7 y: DTaP 3 doses
(SR-L) at ≥6 mo posttx
R: age ≥7 y: DTaP* 3 doses
(WR-VL) at ≥6 mo post-tx
OR
1 dose Tdap, followed by
either 2 doses DT* or 2 doses
Td (DTaP: WR-M; DT, Td:
WR-L)
HPV U: age 11-26 y (SR-VL) U: 3 doses at ≥6 mo post-tx
(WR-VL)
Influenza, inactivated U (SR-L) R: ≥4 mo post-tx (SR-VL)
if community outbreak;
otherwise ≥6 mo post-tx
(SR-M)
Influenza, live attenuated X (WR-VL) X (WR-VL)
MMR, live U
a
(SR-VL) X
b
(SR-L)
MMRV, live U
a
(WR-VL) X (SR-VL)
Meningococcal conjugate U (SR-VL) R: age 11-18 y: 2 doses
(SR-L) at 6-12 mo post-tx
Pneumococcal conjugate
(PCV13)
R
c
(SR-L) R: 3 doses (SR-L) at 3-6 mo
posttx
Pneumococcal
polysaccharide (PPSV23)
R
c
(SR-VL) R: ≥12 mo post-tx if no
GVHD (SR-L)
Poliovirus, inactivated U (SR-VL) R: 3 doses (SR-M) at ≥3 mo
post-tx
Rotavirus, live X (WR-VL) X (WR-VL)
Varicella, live U
a
(SR-L) X
d
(SR-L)
Zoster, live R
a,e
: age 50–59 y*
(WR-VL)
U
a
: age ≥60 y (SR-L)
X (SR-L)
X (SR-L)
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