Summary:
Over the last 25 years, the numbers of hematopoietic stem cell transplant (SCT) patients have increased rapidly. Infections have been major obstacles for successful transplantation. Thus, infection prevention is very important in transplant recipients. As the results of transplantation have improved, the number of long-term survivors has increased. Vaccination is a potentially important strategy for reducing the risk for vaccine-preventable infections after SCT. The EBMT produced recommendations for vaccination of SCT recipients published in Bone Marrow Transplantation in 1995. This paper updates the previous recommendations based on current knowledge.
This is a preview of subscription content, access via your institution
Relevant articles
Open Access articles citing this article.
-
Multiple Sclerosis, COVID-19 and Vaccines: Making the Point
Neurology and Therapy Open Access 08 October 2021
-
Immunogenicity and safety of a live herpes zoster vaccine in hematopoietic stem cell transplant recipients
BMC Infectious Diseases Open Access 26 January 2021
-
A prospective trial of vaccine to prevent hepatitis B virus reactivation after hematopoietic stem cell transplantation
Bone Marrow Transplantation Open Access 18 February 2020
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
References
CDC. Guidelines for preventing opportunistic infections among hematopoietic stem cell transplant recipients. Recommendations of CDC, the Infectious Disease Society of America, and the American Society of Blood and Marrow Transplantation. MMWR Morb Mortal Wkly Rep 2000; 49 (RR-10): 1–125.
Ljungman P, Lewensohn-Fuchs I, Hammarstrom V et al. Long-term immunity to measles, mumps, and rubella after allogeneic bone marrow transplantation. Blood 1994; 84: 657–663.
Ljungman P, Aschan J, Barkholt L et al. Measles immunity after allogeneic stem cell transplantation; influence of donor type, graft type, intensity of conditioning, and graft-versus host disease. Bone Marrow Transplant 2004; 34: 589–593.
Engelhard D, Nagler A, Hardan I et al. Antibody response to a two-dose regimen of influenza vaccine in allogeneic T cell-depleted and autologous BMT recipients. Bone Marrow Transplant 1993; 11: 1–5.
Guinan EC, Molrine DC, Antin JH et al. Polysaccharide conjugate vaccine responses in bone marrow transplant patients. Transplantation 1994; 57: 677–684.
Ljungman P, Duraj V, Magnius L . Response to immunization against polio after allogeneic marrow transplantation. Bone Marrow Transplant 1991; 7: 89–93.
Pauksen K, Hammarström V, Ljungman P et al. Immunity to poliovirus and immunization with inactivated poliovaccine after autologous bone marrow transplantation. Clin Infect Dis 1994; 18: 547–552.
Pauksen K, Linde A, Hammarstrom V et al. Granulocyte–macrophage colony-stimulating factor as immunomodulating factor together with influenza vaccination in stem cell transplant patients. Clin Infect Dis 2000; 30: 342–348.
Gandhi MK, Egner W, Sizer L et al. Antibody responses to vaccinations given within the first two years after transplant are similar between autologous peripheral blood stem cell and bone marrow transplant recipients. Bone Marrow Transplant 2001; 28: 775–781.
Engelhard D, Handsher R, Naparstek E et al. Immune responses to polio vaccination in bone marrow transplant recipients. Bone Marrow Transplant 1991; 8: 295–300.
Storek J, Dawson MA, Lim LC et al. Efficacy of donor vaccination before hematopoietic cell transplantation and recipient vaccination both before and early after transplantation. Bone Marrow Transplant 2004; 33: 337–346.
Molrine D, Guinan E, Antin J et al. Donor immunization with Haemophilus influenzae type B (HIB)-conjugate vaccine in allogeneic bone marrow transplantation. Blood 1996; 87: 3012–3018.
Molrine DC, Antin JH, Guinan EC et al. Donor immunization with pneumococcal conjugate vaccine and early protective antibody responses following allogeneic hematopoietic cell transplantation. Blood 2003; 101: 831–836.
Ilan Y, Nagler A, Adler R et al. Adoptive transfer of immunity to hepatitis B virus after T cell-depleted allogeneic bone marrow transplantation. Hepatology 1993; 18: 246–252.
Parkkali T, Stenvik M, Ruutu T et al. Randomized comparison of early and late vaccination with inactivated poliovirus vaccine after allogeneic BMT. Bone Marrow Transplant 1997; 20: 663–668.
Engelhard D, Cordonnier C, Shaw PJ et al. Early and late invasive pneumococcal infection following stem cell transplantation: a European Bone Marrow Transplantation survey. Br J Haematol 2002; 117: 444–450.
Parkkali T, Kayhty H, Ruutu T et al. A comparison of early and late vaccination with Haemophilus influenzae type B conjugate and pneumococcal polysaccaride vaccines after allogeneic BMT. Bone Marrow Transplant 1996; 18: 961–967.
Avanzini M, Carra A, Macccario R et al. Antibody response to pneumococcal vaccine in children receiving bone marrow transplantation. J Clin Immunol 1995; 15: 137–144.
Barra A, Cordonnier C, Preziosi MP et al. Immunogenicity of Haemophilus influenzae type b conjugate vaccine in allogeneic bone marrow recipients. J Infect Dis 1992; 166: 1021–1028.
Hammarström V, Pauksen K, Azinge J et al. The influence of graft versus host reaction on the response to pneumococcal vaccination in bone marrow transplant patients. J Supportive Care Cancer 1993; 1: 195–199.
Lortan J, Vellodi A, Jurges E, Hugh-Jones K . Class- and subclass-specific pneumococcal antibody levels and response to immunization after bone marrow transplantation. Clin Exp Immunol 1992; 88: 512–519.
Spoulou V, Victoratos P, Ioannidis JP, Grafakos S . Kinetics of antibody concentration and avidity for the assessment of immune response to pneumococcal vaccine among children with bone marrow transplants. J Infect Dis 2000; 182: 965–969.
Parkkali T, Kayhty H, Anttila M et al. IgG subclasses and avidity of antibodies to polysaccharide antigens in allogeneic BMT recipients after vaccination with pneumococcal polysaccharide and Haemophilus influenzae type b conjugate vaccines. Bone Marrow Transplant 1999; 24: 671–678.
Nordoy T, Husebekk A, Aaberge IS et al. Humoral immunity to viral and bacterial antigens in lymphoma patients 4–10 years after high-dose therapy with ABMT. Serological responses to revaccinations according to EBMT guidelines. Bone Marrow Transplant 2001; 28: 681–687.
Molrine D, Guinan E, Antin J et al. Haemophilus influenzae type b (HIB)-conjugate immunization before bone marrow harvest in autologous bone marrow transplantation. Bone Marrow Transplant 1996; 17: 1149–1155.
Kroon FP, van Dissel JT, Ravensbergen E et al. Enhanced antibody response to pneumococcal polysaccharide vaccine after prior immunization with conjugate pneumococcal vaccine in HIV-infected adults. Vaccine 2000; 19: 886–894.
Vernacchio L, Neufeld EJ, MacDonald K et al. Combined schedule of 7-valent pneumococcal conjugate vaccine followed by 23-valent pneumococcal vaccine in children and young adults with sickle cell disease. J Pediatr 1998; 133: 275–278.
Avanzini MA, Carra AM, Maccario R et al. Immunization with Haemophilus influenzae type b conjugate vaccine in children given bone marrow transplantation: comparison with healthy age-matched controls. J Clin Immunol 1998; 18: 193–201.
Parkkali T, Kayhty H, Lehtonen H et al. Tetravalent meningococcal polysaccharide vaccine is immunogenic in adult allogeneic BMT recipients. Bone Marrow Transplant 2001; 27: 79–84.
Ljungman P, Wiklund HM, Duraj V et al. Response to tetanus toxoid immunization after allogeneic bone marrow transplantation. J Infect Dis 1990; 162: 496–500.
Hammarström V, Pauksen K, Björkstrand B et al. Tetanus immunity in autologus bone marrow and blood stem cell transplant patients. Bone Marrow Transplantation 1998; 22: 67–72.
Parkkali T, Ölander R-M, Ruutu T et al. A randomized comparison between early and late vaccination with tetanus toxoid vaccine after allogeneic BMT. Bone Marrow Transplant 1997; 19: 933–938.
de la Camara R, Martino R, Granados E et al. Tuberculosis after hematopoietic stem cell transplantation: incidence, clinical characteristics and outcome. Spanish Group on Infectious Complications in Hematopoietic Transplantation. Bone Marrow Transplant 2000; 26: 291–298.
Aschan J, Ringdén O, Ljungman P et al. Influenza B in transplant patients. Scand J Infect Dis 1989; 21: 349–350.
Ljungman P, Andersson J, Aschan J et al. Influenza A in immunocompromised patients. Clin Infect Dis 1993; 17: 244–247.
Ljungman P, Ward KN, Crooks BN et al. Respiratory virus infections after stem cell transplantation: a prospective study from the Infectious Diseases Working Party of the European Group for Blood and Marrow Transplantation. Bone Marrow Transplant 2001; 28: 479–484.
Whimbey E, Elting LS, Couch RB et al. Influenza A virus infections among hospitalized adult bone marrow transplant recipients. Bone Marrow Transplant 1994; 13: 437–440.
Zuckerman M, Brink N, Kyi M, Tedder R . Exposure of immunocompromised individuals to health-care workers immunized with oral poliovaccine. The Lancet 1994; 343: 985–986.
Locasciulli A, Alberti A, Bandini G et al. Allogeneic bone marrow transplantation from HBsAg+ donors: a multicenter study from the Gruppo Italiano Trapianto di Midollo Osseo (GITMO). Blood 1995; 86: 3236–3240.
Wimperis J, Brenner M, Prentice H et al. Transfer of a functioning humoral immune system in transplantation of T-lymphocyte-depleted bone marrow. Lancet 1986; 1: 339–343.
Ilan Y, Nagler A, Zeira E et al. Maintenance of immune memory to the hepatitis B envelope protein following adoptive transfer of immunity in bone marrow transplant recipients. Bone Marrow Transplant 2000; 26: 633–638.
Dhedin N, Douvin C, Kuentz M et al. Reverse seroconversion of hepatitis B after allogeneic bone marrow transplantation: a retrospective study of 37 patients with pretransplant anti-HBs and anti-HBc. Transplantation 1998; 66: 616–619.
Nakano T, Shimono Y, Sugiyama K et al. Clinical features of measles in immunocompromised children. Acta Paediatr Jpn 1996; 38: 212–217.
Kaplan L, Daum R, Smaron M, McCarthy C . Severe measles in immunocompromised patients. JAMA 1992; 267: 1237–1241.
Machado CM, Goncalves FB, Pannuti CS et al. Measles in bone marrow transplant recipients during an outbreak in Sao Paulo, Brazil. Blood 2002; 99: 83–87.
Pauksen K, Duraj V, Ljungman P et al. Immunity to and immunization against measles, rubella and mumps in patients after autologous bone marrow transplantation. Bone Marrow Transplant 1992; 9: 427–432.
Ljungman P, Fridell E, Lönnqvist B et al. Efficacy and safety of vaccination of marrow transplant recipients with a live attenuated measles, mumps, and rubella vaccine. J Infect Dis 1989; 159: 610–615.
King SM, Saunders EF, Petric M, Gold R . Response to measles, mumps and rubella vaccine in paediatric bone marrow transplant recipients. Bone Marrow Transplant 1996; 17: 633–636.
Spoulou V, Giannaki M, Vounatsou M et al. Long-term immunity to measles, mumps and rubella after MMR vaccination among children with bone marrow transplants. Bone Marrow Transplant 2004; 33: 1187–1190.
Sauerbrei A, Prager J, Hengst U et al. Varicella vaccination in children after bone marrow transplantation. Bone Marrow Transplant 1997; 20: 381–383.
Hata A, Asanuma H, Rinki M et al. Use of an inactivated varicella vaccine in recipients of hematopoietic-cell transplants. N Engl J Med 2002; 347: 26–34.
Rio B, Marjanovic Z, Lévy V et al. Vaccination for yellow fever after bone marrow transplantation. Bone Marrow Transplant 1996; 17 (Suppl. 1): 95.
Acknowledgements
This work was supported by the European Leukemia Net and the EBMT.
Author information
Authors and Affiliations
Consortia
Corresponding author
Rights and permissions
About this article
Cite this article
Ljungman, P., Engelhard, D., de la Cámara, R. et al. Vaccination of stem cell transplant recipients: recommendations of the Infectious Diseases Working Party of the EBMT. Bone Marrow Transplant 35, 737–746 (2005). https://doi.org/10.1038/sj.bmt.1704870
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.bmt.1704870
Keywords
This article is cited by
-
Acute graft-versus-host disease
Nature Reviews Disease Primers (2023)
-
Immunogenicity and safety of a live herpes zoster vaccine in hematopoietic stem cell transplant recipients
BMC Infectious Diseases (2021)
-
Predictive factors for vaccine failure to guide vaccination in allogeneic hematopoietic stem cell transplant recipients
Bone Marrow Transplantation (2021)
-
Multiple Sclerosis, COVID-19 and Vaccines: Making the Point
Neurology and Therapy (2021)
-
Association between graft source and response to live-attenuated vaccination in pediatric hematopoietic stem cell transplantation recipients: a single-center retrospective study
Bone Marrow Transplantation (2020)