Reimmunization after Chemotherapy
Dear OncoLink "Ask The Experts,"
My daughter is almost 16 years old. She was diagnosed with Hodgkin's lymphoma with spine metastases. She has 5 sessions of local radiotherapy and will finish her 6th cycle (12th session) of chemotherapy shortly. I wondered if the chemotherapy negates all or any of the immunizations she has had to date, such as Hep A, Hep B, Typhoid etc. If this is so, how soon before she can retake these vaccinations?
Carolyn Vachani RN, MSN, AOCN, OncoLink's Nurse Educator, responds:
Typically we do not re-immunize patients who have received traditional chemotherapy and/or radiation therapy. I have seen some research in the pediatric oncology community to support checking viral titers to verify immunity to these illnesses, but this is not a standard recommendation.
Transplant patients, including allogeneic, autologous, stem cell, bone marrow, and cord blood recipients, are another story. The Centers for Disease Control has developed a recommended vaccination schedule. In order for the body to develop antibodies and thus make these vaccines effective, the patient must have regained normal immune function. For this reason, re-immunization is typically started a year after transplant.