Eight vaccines that cancer patients should get

Cancer patients experience some degree of immunosuppression and are more vulnerable to infections due to both their underlying disease and the treatments they are given. Therefore, there is a need to protect cancer patients from infections, especially those receiving treatment for the disease.

Vaccination against infectious agents aims to prevent the occurrence of an infection or to reduce the intensity of symptoms in the event that the infection cannot be prevented.

Indeed, a few days ago the updated guidelines from the American Society of Clinical Oncology (ASCO) were published for the vaccination of cancer patients. Based on these guidelines, all adult cancer patients should receive the following vaccinations:

1. for the influenza virus annually.

2. for COVID-19 based on existing guideline recommendations for high-risk patients.

3. for respiratory syncytial virus (RSV) once in those over 60 years of age.

4. for tetanus, diphtheria and pertussis which should be repeated every 10 years.

5. for hepatitis-B for everyone up to age 60 and for those with AIDS, chronic liver disease or intravenous drug use.

6. for herpes zoster virus with the approved recombinant vaccine.

7. for pneumococcus with one dose of the 15-potency vaccine followed after 8 weeks by a dose of the 23-potency vaccine or initially with a dose of the 20-potency vaccine and finally.

8. for human papillomavirus HPV for people up to 26 years of age and after assessment of potential benefit for people up to 45 years of age.

Based on the guidelines, vaccination should be scheduled 2-4 weeks before starting treatment for the disease. In particular, vaccines that do not contain live microorganisms can be administered during treatments. No difference in safety data has been found from the use of the vaccines in patients receiving immunotherapy. The guidelines also recommend that all close contacts of cancer patients have the vaccinations prescribed for their age group.

Specific recommendations exist for specific patient groups. For patients who have undergone hematopoietic stem cell transplantation, a full revaccination is required starting 6 months after transplantation as the immune memory acquired in childhood is completely lost. Vaccines containing live or attenuated organisms should be delayed until 2 years after transplantation and administered only in the absence of host disease and severe immunodeficiency. Influenza, COVID-19, and pneumococcal vaccination may also be scheduled 3 months after transplant. Also, those who have had a splenectomy or have functional asplenia should receive additional Haemophilus influenzae and pneumococcus vaccination.

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