The NHSGGC Guidance, developed by NHSGGC Specialist Oncology and Haemato-oncology services, governs vaccination in patients receiving Systemic Anti-Cancer Therapy (SACT), which includes chemotherapy and the newer immunotherapies.
Seasonal influenza vaccine
There are a few patient groups in whom seasonal influenza vaccination cannot be given - see links to tables below:-
National guidance has been issued for Shingles vaccination in those aged > 70yrs. Generally speaking, this vaccine is contraindicated in immunocompromised patients. See NES Guidance (page 6).
Zostavax® is contraindicated in lymphoma, acute and chronic leukaemia, all patients receiving immune suppressive chemotherapy, biological therapies and radiotherapy, including high dose steroids (equivalent of 40 mg Prednisolone per day for more than 1 week) for at least 3 months. Such patients should be at least 6 months after the end of treatment and documented to be in remission before receiving this vaccine. (See SPC for more details).
The Zoster Vaccine Screening Tool should be used for all patients prior to vaccination.
Pneumococcal Polysaccharide Vaccine
The PPV SPC advises the following under the section Posology, Special Dosing:
It is recommended that pneumococcal vaccine should preferably be given at least two weeks before elective splenectomy or the initiation of chemotherapy or other immunosuppressive treatment. Vaccination during chemotherapy or radiation therapy should be avoided.
Following completion of chemotherapy and/or radiation therapy for neoplastic disease, immune responses to vaccination may remain diminished. The vaccine should not be administered any sooner than three months after completion of such therapy. A longer delay may be appropriate for patients who have received intensive or prolonged treatment.