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Childhood cancer patients may need to temporarily delay getting certain vaccines during cancer treatment because of the effects of cancer or chemotherapy.
Routine vaccines are those recommended for everyone in U.S. The Centers for Disease Control (CDC) publishes a recommended childhood vaccination schedule each year. Vaccination is sometimes referred to as immunization.
Vaccines teach the body how to defend itself when specific germs (such as viruses or bacteria) invade it.
Childhood cancer patients often have weakened immune systems during cancer treatment.
A vaccine requires a good immune response to be effective. Vaccines may not be effective when given to someone receiving treatment for cancer. The weakened immune system cannot respond normally by creating a memory of the germ to be able to attack it later.
In rare cases, vaccines that contain weakened (attenuated) virus can cause patients with very weakened immune systems to become sick if they receive them. Patients should not get these vaccines while their immune systems are weak. But it’s generally OK for people around them to receive them.
The routine vaccines that contain attenuated viruses — and should not usually be given to people with a weakened immune system — are:
The Infectious Diseases Society of America recommends an annual flu shot for all children older than 6 months including those receiving treatment for cancer. People need a flu shot once a year because the makeup of the flu shot is different each year. Influenza viruses are constantly changing. The body’s immune response decreases over time.
Children with weakened immune systems should not receive the flu mist nasal vaccine because it contains live virus.
The flu shot is made with dead (inactivated) flu viruses. It is safe for people with cancer. It may be given at least 2 weeks before chemotherapy or between chemotherapy cycles.
Transplant, cellular (CAR T-cell) therapy, and gene therapy patients may get a flu shot 6 months after their infusion. If there is an influenza outbreak in the community, they may receive a flu shot 4 months after transplant.
Exceptions to these rules would be patients who are not likely to respond to the flu vaccine, although they are unlikely to be harmed by it. Patients not likely to respond include those who have received strong chemotherapy or those who have received anti B-cell antibodies within 6 months.
Children who are receiving treatment for cancer can generally receive all of the routine vaccines except the attenuated virus vaccines.
If your child has not completed their routine vaccines, you can talk with your doctor about continuing these to protect your child during treatment for cancer. Typically, the shots given during this time need to be repeated after your child has finished treatment, because they might not be effective because of the weakened immune system. But they may provide some protection.
The care team will advise families on when to resume the vaccination schedule. Patients may be immunized with vaccines with inactivated virus and live vaccines for chickenpox and MMR.
Siblings and adults who live with a childhood cancer patient should keep current on vaccinations to minimize the chances of exposing the child to a vaccine-preventable disease.
People in the household should not receive the oral polio vaccine. (This vaccine is not used in the United States.)
If an infant in the household has recently received rotavirus vaccination, all family members should wash hands thoroughly and frequently after contact with the vaccinated infant, especially when changing diapers. Transplant patients and those receiving cancer therapy should not change diapers at all.
Children with weakened immune systems should avoid any person who has had:
For more information about vaccinations, visit:
Reviewed: September 2020