Guide on vaccinating individuals undergoing chemotherapy
- Patients receiving chemotherapy will fall into the CEV groupings set out by the JCVI
- Consider everyone receiving systemic anti-cancer therapy for vaccination in collaboration with secondary care
- If there is sufficient time between the decision to start treatment and the start date, vaccination should take place during this window when the patient has intact immune function
- The shortest licensed dose interval should be used (or as soon as practicably possible) and a third primary dose should be offered
- Try to vaccinate when blood counts are recovered if possible
- Avoid vaccine on same day as chemotherapy is delivered
- Consider thrombocytopenia (as it’s an IM injection) – prefer platelet count over 20×109/L
- Neutropenia: delay if patient is unwell until neutrophils >1×109/L and patient is well again
- Those with chronic neutropenia can be vaccinated as soon as possible
- Chemotherapy delivered by bladder instillation does not impact the timing of the vaccination
- All adult household members of those on systemic chemotherapy should be offered vaccination.
- It is wise to counsel patients that, due to the unknown efficacy of the response to vaccination, ‘shielding’ may still be appropriate regardless of vaccination status.
- The only contraindications are those of allergy to a component; no one vaccine is preferred over another.
Written by Dr Carrie St John Wright