Hematologist
CION Cancer Clinics
Vaccination during and after lymphoma treatment | CION Cancer Clinics
Most lymphoma patients should have non-live vaccines, such as flu, pneumonia and COVID-19, while live vaccines like MMR, oral polio and yellow fever are usually avoided during treatment and for a while after. Timing matters: vaccines work best before treatment or once the immune system recovers, which after rituximab can take many months. This page explains which vaccines come up, when they are given, and what your family should do. At CION Cancer Clinics, our haematology team plans myeloma and lymphoma care with you, discussed at a tumour board and explained in plain words.
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Medically reviewed by Dr. Basudev PokhrelConsultant Haematologist · last reviewed September 2026, next review due September 2027
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On this page
- Which vaccines can lymphoma patients have?
- Which vaccines are usually allowed, and which are usually avoided?
- When are vaccines usually given around lymphoma treatment?
- Which vaccines is your team most likely to talk about?
- What do families believe about vaccines and lymphoma?
- What should family members do about their own vaccines?
- What should you bring, and what can this page not tell you?
- Common questions about vaccines and lymphoma
The short answer
Which vaccines can lymphoma patients have?
Most people with lymphoma can and should have non-live vaccines, such as the flu, pneumonia and COVID-19 vaccines. Live vaccines are usually avoided during treatment and for a period afterwards, because a weakened immune system may not control even the weakened germ in them.
Live and non-live, in plain words
A non-live vaccine contains a killed germ, a piece of one, or a set of instructions for making a piece. It cannot cause the infection. A live vaccine contains a weakened germ that can still multiply a little. In a healthy person that is harmless. In someone whose defences are lowered by lymphoma or its treatment, it can occasionally cause real illness.
Why timing matters as much as the vaccine
A vaccine only protects if your immune system responds to it. Rituximab removes the B cells that make antibodies, so a vaccine given during or soon after it may produce little protection. That does not make it harmful. It means your team may time some vaccines for before treatment starts, or for later, when your B cells have begun to recover.
Lymphoma itself, even before treatment, can weaken vaccine responses. Your haematologist plans around both.At a glance
Which vaccines are usually allowed, and which are usually avoided?
Usually allowed (non-live)
Usually avoided for now (live)
Flu injection
Flu vaccine given as a nasal spray
Pneumococcal (pneumonia) vaccines
MMR (measles, mumps and rubella)
COVID-19 vaccines
Live chickenpox and older live shingles vaccines
Hepatitis B, tetanus and the non-live shingles vaccine
Yellow fever, oral typhoid and oral polio drops
Not sure whether this applies to you?
Ask an oncologistThe schedule
When are vaccines usually given around lymphoma treatment?
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Before treatment starts
If there is time, this is when vaccines work best. Your team may offer flu, pneumonia or COVID-19 vaccines before the first cycle. Treatment is never delayed for long just to fit vaccines in.
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During chemotherapy or rituximab
Non-live vaccines such as the yearly flu injection are usually still recommended, even if the response is weaker. Your team may time them between cycles. Live vaccines are not given.
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In the months after treatment
Your team checks recovery before deciding on more vaccines. After rituximab this can take longer than after chemotherapy alone. Some vaccines may be repeated once your immune system has recovered, because earlier doses may not have worked. Live vaccines are only considered once your team is satisfied that your defences have recovered, which is usually well after treatment has ended.
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After a stem cell transplant
A transplant usually wipes out protection from childhood vaccines. The transplant centre gives a full re-vaccination schedule, starting some months later. Keep that schedule with your records.
Commonly discussed
Which vaccines is your team most likely to talk about?
Your own list depends on your age, treatment, past vaccines and other illnesses. These are the ones that come up most.
Flu
Flu can turn into pneumonia in people with weak defences. The injected vaccine is usually offered every year, before the flu season, for you and for the people you live with.
Pneumonia
Pneumococcal vaccines protect against a common cause of serious chest and blood infections. Adults with lymphoma are usually advised to have them, sometimes as two different vaccines given some time apart.
COVID-19
People with blood cancers, especially after rituximab, can respond poorly to COVID-19 vaccines. Extra or updated doses may be advised. Ask your team what is current.
Shingles and hepatitis B
A non-live shingles vaccine can be considered for adults on or after treatment. Hepatitis B vaccine may be offered if tests show you have never been infected or protected.
The older live shingles vaccine is not suitable.Commonly believed
What do families believe about vaccines and lymphoma?
"All vaccines are dangerous during cancer treatment."
Only live vaccines carry that concern. Non-live vaccines cannot cause the infection. Skipping flu and pneumonia vaccines leaves you exposed to infections that can be serious in lymphoma.
"If the vaccine will not work well, there is no point having it."
Partial protection is still worth having, and the people around you being vaccinated adds another layer. Your team decides whether to give it now, later, or both.
"The grandchildren must skip their vaccines so they do not infect him."
Children should keep to their own vaccine schedule. Their protection helps shield the patient. For a few live vaccines there are simple precautions, which the child's doctor and your team can explain.
"Childhood vaccines last for life, so nothing more is needed."
Treatment can weaken old protection, and a stem cell transplant can erase it. Some adults need boosters or a fresh course.
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For the household
What should family members do about their own vaccines?
Family vaccine
What to know
Yearly flu injection for adults and children
Strongly encouraged; it protects the patient too
Oral polio drops for a child in the house
Ask whether the injected polio vaccine can be used; if drops are given, wash hands after nappy changes
Rotavirus drops for a baby
Can usually go ahead; the patient should avoid handling nappies for a while
Chickenpox or MMR for a child
Can usually go ahead; if a rash appears afterwards, keep the patient away from it
Being straight with you
What should you bring, and what can this page not tell you?
Bring every vaccine record you can find to your haematology visit, including old certificates and COVID-19 certificates. If you are planning travel, a pilgrimage or a move, mention it early. Some destinations need vaccines that are not safe during treatment, and the team will need time to plan an alternative.
If you cannot find old records, say so. Your team will not guess. They may simply give a vaccine again, which is generally safe for non-live vaccines, or check antibody levels first.
Who this advice does not fit
Everything on this page is general. People who have had a stem cell transplant, CAR-T therapy or long courses of other immune-lowering medicines follow their own, stricter schedules from the treating centre. Children with lymphoma follow a paediatric plan.
What this page cannot tell you
It cannot tell you when your own immune system has recovered enough for a live vaccine, or whether a vaccine you had during treatment worked. It cannot replace the schedule your haematologist writes for you. Ask for that schedule in writing, and keep it with your treatment summary.
Before any vaccine from another doctor or a pharmacy, say you have lymphoma and name your treatment.Questions we are asked
Common questions about vaccines and lymphoma
Can I have the flu vaccine during chemotherapy?
Usually yes. The injected flu vaccine is non-live and is generally recommended every year for people with lymphoma, including during treatment. Your team may suggest a day between cycles when your counts are better. The nasal spray flu vaccine is live and is not used.
How long after rituximab should I wait for vaccines?
Non-live vaccines can often still be given, though they work less well soon after rituximab. For best effect, some are timed for when B cells have recovered, which is often many months later. Live vaccines usually wait longer still. Your haematologist sets the timing for you.
Is the COVID-19 vaccine safe with lymphoma?
COVID-19 vaccines are non-live and are generally considered safe. The concern is weaker protection, particularly after rituximab, not harm. You may be advised to have additional doses and to keep taking sensible precautions during outbreaks. Ask your team what is currently recommended.
My grandson is due for polio drops. Is that a risk?
The oral drops contain live, weakened virus that can pass in a child's stools for a while. Ask the child's doctor whether the injected polio vaccine can be given instead. If drops are given, careful hand washing and letting someone else change nappies lowers the risk.
Will a vaccine make the lymphoma worse?
There is no good evidence that non-live vaccines make lymphoma grow or return. A sore arm, mild fever or tiredness for a day or so is a normal reaction. A high fever or feeling very unwell afterwards should be reported, as it may be an unrelated infection.
Do I need to restart childhood vaccines after treatment?
After a stem cell transplant, yes, usually a full course. After chemotherapy and rituximab alone, most people do not restart everything, but some boosters may be advised. Your team decides once your immune system has had time to recover.
Are adult vaccines covered by schemes or insurance?
Coverage for adult vaccines varies. Some are part of government programmes, while others are paid for privately. Aarogyasri, CGHS, ECHS, EHS, PM-JAY and insurance policies each set their own rules, and these change. Check the current rules for your own scheme or policy.
Can I travel abroad or go on pilgrimage during treatment?
Discuss any travel with your team first. Some destinations need live vaccines, such as yellow fever, which are not safe during or soon after treatment. Crowded journeys also raise infection risk. The team may suggest timing, precautions or a written letter explaining why a vaccine was not given.
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Sources
- NHS — Vaccinations
- World Health Organization — Vaccines and immunization
- Cancer Research UK — Rituximab
- Blood Cancer UK — Blood Cancer UK
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Low Immunoglobulins After RituximabWhy vaccines work less well after rituximabHepatitis B Reactivation Risk With RituximabHepatitis B testing before treatmentLymphoma guideThe types of lymphoma and how they are treatedLymphoma Treatment Experience and Side EffectsEvery side-effect guide for lymphoma treatment
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Not sure which vaccines are right for you?
Tell us about your treatment so far and bring your vaccine records. Our haematology team will help you plan the timing. One helpline serves every CION centre.