Vaccination recommendations

Vaccinations recommended for paediatric cancer patients and contact persons during and/or after cancer therapy

Author:  Maria Yiallouros, Dr. med. Gesche Riabowol (née Tallen), Editor:  Maria Yiallouros, English Translation:  Dr. med. Gesche Riabowol (nee Tallen), Hannah McRae, Last modification: 2024/04/23

Whether a child can be vaccinated during a certain treatment phase or not depends on the individual situation. Therefore, immunisations should only be done in agreement with the doctor who is in charge of the cancer treatment. Resumption of vaccinations after completion of treatment (chemotherapy and/or stem cell transplantation following conditioning treatment) should be delayed for some time in order to not put the patient at risk. It is also important that people who come into contact with the patient during or shortly after treatment are fully vaccinated.

Vaccination of contact persons

Relatives and other contacts of the immunocompromised patient should be fully vaccinated in accordance with the vaccination recommendations of the Standing Committee on Vaccination (German: Ständige Impfkommission - STIKO). Complete protection against measles, mumps, rubella and chickenpox viruses (varicella) is particularly important, as infection with any of these pathogens can be life-threatening for the patient. In case the patient never had chickenpox, it is recommended that all family members who never had chickenpox either get immunized against varicella zoster virus. For further information on possible infections in cancer patients or during cancer treatment, please see our information on “supportive care”.

Getting vaccinated after the end of therapy

The timing of vaccination after completion of cancer treatment should be chosen in a way that, on the one hand, immune protection is restored as early as possible, and on the other hand, the vaccination is safe and effective for the patient. The latter is only given when the immune cells impaired by the therapy have recovered, so that a sufficient immune response can be achieved by the vaccination. Hence, appropriate timing of vaccination depends on the type of treatment and the patient's state of health. The type of vaccine to be used also plays an important role: there are inactivated vaccines, which consist of dead pathogens that are no longer capable of reproducing, and live vaccines, which contain pathogens that are still alive, but have been weakened.

Depending on the kind of cancer therapy the patient received and the type of vaccine to be given, the German Society of Paediatric Oncology and Haematology (GPOH), the German Society of Paediatric Haematology and Infectious Diseases (DGPI) and the German Continuous Committee on Vaccination (Ständige Impfkommission, STIKO) recommend the following vaccination schedules after treatment:

  • For patients who received standard chemotherapy, it is recommended to wait three to six months before vaccinating with an inactivated vaccine and at least six months before vaccinating with a live vaccine.
  • For patients who received stem cell transplantation (autologous and allogeneic), it is recommended to wait at least six months before vaccinating with a dead vaccine, and at least 24 months before vaccinating with a life vaccine. After autologous stem cell transplantation, live vaccines are sometimes given earlier in clinical practice. More detailed information about vaccination after stem cell transplantation can be obtained directly from the transplant team.
  • After treatment with new methods/substances (such as antibodies, tyrosine kinase inhibitors or checkpoint inhibitors, special recommendations are to be followed.

Further information

For further information on the German "Standing Committee on Vaccination (Ständige Impfkommission, STIKO) and current recommendations available in English there, please see the STIKO website.

Recommended Reading

  1. Ifversen M, Meisel R, Sedlacek P, Kalwak K, Sisinni L, Hutt D, Lehrnbecher T, Balduzzi A, Diesch T, Jarisch A, Güngör T, Stein J, Yaniv I, Bonig H, Kuhlen M, Ansari M, Nava T, Dalle JH, Diaz-de-Heredia C, Trigoso E, Falkenberg U, Hartmann M, Deiana M, Canesi M, Broggi C, Bertaina A, Gibson B, Krivan G, Vettenranta K, Matic T, Buechner J, Lawitschka A, Peters C, Yesilipek A, Yalçin K, Lucchini G, Bakhtiar S, Turkiewicz D, Niinimäki R, Wachowiak J, Cesaro S, Dalissier A, Corbacioglu S, Willasch AM, Bader P: Supportive Care During Pediatric Hematopoietic Stem Cell Transplantation: Prevention of Infections. A Report From Workshops on Supportive Care of the Paediatric Diseases Working Party (PDWP) of the European Society for Blood and Marrow Transplantation (EBMT). Frontiers in pediatrics 2021, 9: 705179 [PMID: 34395344] IFV2021
  2. Lawitschka A, Lucchini G, Strahm B, Dalle JH, Balduzzi A, Gibson B, Diaz De Heredia C, Wachowiak J, Dalissier A, Vettenranta K, Yaniv I, Bordon V, Bauer D, Bader P, Meisel R, Peters C, Corbacioglu S, European Society for Blood, Marrow Transplantation (EBMT) Pediatric Diseases Working Party: Pediatric acute graft-versus-host disease prophylaxis and treatment: surveyed real-life approach reveals dissimilarities compared to published recommendations. Transplant international 2020, Epup ahead of print [PMID: 32133691] LAW2020