Vaccines after chemotherapy

It cannot tell you exactly which vaccines you need or when to have them. That depends on your treatment, blood counts and immune recovery, and your team will advise.

It also cannot replace current national vaccine guidance, which changes over time.

Why protection may be lost

Chemotherapy affects the immune cells that remember past infections and vaccines. For many people, much of this memory remains, but after intensive treatment or stem cell transplant, it can be lost. Blood tests sometimes check immunity to specific infections, such as hepatitis B, measles or chickenpox, to guide decisions.

Timing non-live vaccines

Non-live vaccines can often be given once counts have recovered after treatment, and sometimes during treatment. Responses may be weaker if given too soon, so some vaccines may be repeated later. Ask your team about timing.

Household contacts and live vaccines

Family members can usually have live vaccines such as measles or chickenpox. If a family member develops a rash after chickenpox vaccine, avoid close contact until it clears. For babies receiving oral polio or rotavirus vaccines, careful hand washing after nappy changes is important.

Exposure to infections

If you are exposed to chickenpox, shingles or measles while immunity is low, contact your team quickly, as preventive treatment may be possible.

Keeping a record

Keep a record of vaccines received, dates and any blood tests of immunity, and share it with your doctors.

Where to get vaccines

Some vaccines are available through government programmes; others are given at hospitals or clinics. Ask about cost and availability.

Before future treatment

If further treatment such as a stem cell transplant or immune-suppressing medicines is planned, vaccines may be given beforehand, when the immune system can respond better. Ask your team whether this applies to you.

Blood tests for immunity

Your team may check blood tests for antibodies to hepatitis B, measles, chickenpox or other infections, to decide which vaccines are needed.

Pneumonia and higher-risk groups

Older adults, people with lung disease, diabetes or heart disease, and those who had their spleen removed are at higher risk from pneumonia and often benefit from pneumococcal vaccines.

Shingles after treatment

Shingles is a painful rash caused by the chickenpox virus reactivating when immunity is low. It is more common after cancer treatment. The non-live shingles vaccine can be given to many adults, but ask about timing.

HPV vaccine

Human papillomavirus vaccine may be recommended for some young people after treatment, particularly after transplant. Ask your team.

Children in the household

Children in the family should follow their routine vaccine schedule, as this protects the whole household. Tell their doctor that a family member has had cancer treatment.

Side effects of vaccines

Mild soreness, tiredness or a low temperature for a day or so after vaccines is common. If you develop a high fever or feel very unwell, contact your team, as infection needs to be ruled out.

Keeping vaccines up to date

Immunity needs continue over the years. Ask your family doctor to review your vaccine record regularly.

Pregnancy planning

If you are planning a pregnancy after treatment, ask which vaccines should be given beforehand.

What to do next

Ask your team for a written vaccine plan, have recommended non-live vaccines when advised, avoid live vaccines until cleared, encourage household members to be vaccinated, report exposures to infections quickly, and keep a vaccine record.