UpToDate خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده:
4
September 2025
| Vaccine | Recommendation | Number of doses | Comments |
| 3 to 6 months post-transplant | |||
| Recombinant zoster vaccine (RZV)[1] | Age 18 years or older | 2 (2 to 6 months apart) | Antiviral prophylaxis (eg, acyclovir) is also used to prevent herpes zoster early after transplant. |
| COVID-19 (SARS-CoV-2) vaccine | All HCT recipients ≥6 months of age[2] | 2 or 3 (depending on vaccine formulation) | |
| Pneumococcal conjugate vaccine-21 (PCV-21)* | All HCT recipients | 3 doses (1 month apart) 4th dose at 12 months | If PCV21 is not available, administer PCV20. If patients received PCV15 or lower valency conjugate vaccine for the first 3 doses:
|
| 6 to 12 months post-transplant | |||
| Influenza vaccine (inactivated) | All HCT recipients ≥6 months of age | 1 dose (annually) | Can be given as early as 4 months if community outbreak. If given early, a 2nd dose should be administered at least 4 weeks after initial dose to provide additional protection against influenza. |
| Tetanus, diphtheria, and pertussis vaccine | All HCT recipients | 3 doses DTaP (1 to 3 months apart) | For patients ≥7 years of age, an alternative schedule includes 1 dose of Tdap followed by either 2 doses of DT or Td, with all doses spaced 1 to 3 months apart. |
| Haemophilus influenzae b conjugate vaccine | All HCT recipients | 3 doses (1 month apart) | |
| Polio-inactivated (inactivated poliovirus vaccine) | All HCT recipients | 3 doses (1 to 3 months apart) | |
| Meningococcal conjugate vaccine¶ | Age 11 to 18 years or other risk factors present (eg, asplenia, residing or traveling to areas of hyperendemicity or epidemicity) | 2 doses (4 to 5 years apart) | |
| MenB vaccine¶ | Age 16 to 23 or other risk factors (eg, asplenia, residing or traveling to areas of hyperendemicity or epidemicity) | 3 doses (0, 1, and 6 months) | |
| Human papillomavirus vaccine | Age 9 to 26 years | 2 to 3 dosesΔ | For individuals >26 years old, engage in shared decision-making with the patient. |
| Respiratory syncytial virus | Age 60 years or older | 1 dose | Some clinicians may also choose to vaccinate HCT recipients between 18 and 59 years of age, given limited data suggesting the vaccine is safe and immunogenic in immunocompromised individuals between 18 and 59 years old. Since these individuals are not included in the ACIP recommendations, vaccination cost may not be covered by insurance for those in the United States. |
| Hepatitis A vaccine | If risk factors present (eg, chronic liver disease, travel to endemic areas) | 2 doses (6 months apart) | |
| Mpox virus vaccine (non-replicating, modified vaccinia Ankara vaccine) | If risk factors present (eg, males who have sex with males and have multiple sex partners or a diagnosis of an STI in the past 6 months) | 2 doses (1 month apart) | |
| 1 year post-transplant | |||
| Hepatitis B vaccine | All HCT recipients | 2 to 3 doses (dosing intervals depend on the specific vaccine formulation used) | Can be administered as early as 6 months if necessary. We prefer to wait until 12 months when possible to optimize immunity from vaccine. Test serology ≥1 month following the 3rd dose to assess the response to vaccine. |
| ≥2 years post-transplant | |||
| Measles, mumps, and rubella vaccine | HCT recipients who meet all of the following criteria:
| 2 doses (at least 4 weeks apart) | |
| Varicella | HCT recipients who meet all of the following criteria:
| 2 doses (4 to 8 weeks apart) | |
COVID-19: coronavirus disease 2019; DT: diphtheria toxoid, tetanus toxoid; DTaP: diphtheria toxoid, tetanus toxoid, acellular pertussis; GVHD: graft-versus-host disease; HCT: hematopoietic cell transplant; IVIG: intravenous immunoglobulin; mRNA: messenger ribonucleic acid; PPSV: pneumococcal polysaccharide vaccine; RBCs: red blood cells; SARS-CoV-2: severe acute respiratory syndrome coronavirus 2; STI: sexually transmitted infection; Td: tetanus toxoid, reduced diphtheria toxoid; Tdap: tetanus toxoid, reduced diphtheria toxoid, and reduced acellular pertussis.
* PCV21 formulation is preferred. However, PCV20, PCV15, or another pneumococcal conjugate vaccine formulation is a reasonable alternative if PCV21 is not available.
¶ Pentavalent meningococcal vaccines (MenABCWY) are also available in the United States. If immunization against all 5 meningococcal groups is indicated, a pentavalent meningococcal vaccine (MenABCWY) can be administered instead, if available.
Δ Dosing schedule differs based on initial age of vaccination. Refer to UpToDate content on HPV vaccination for details.
◊ If patient received washed RBCs, no need to delay immunization. If patient received adenine-saline RBCs, then wait at least 3 months until immunization. If patient received packed RBCs or whole blood transfusion, wait at least 6 months until immunization.
Prepared with additional information from:
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