Immunisation includes a number of vaccines that children and adults routinely have to protect against infections.
Your resistance to infection can be low at times if you are having chemotherapy. There are some vaccinations you shouldn't have when you have low immunity because they could make you feel very ill.
You might also need to avoid contact with other people who have had certain types of vaccination.
This page is about vaccines as part of the immunisation programme and whether people with cancer should have them.
Researchers are also looking at vaccines as a possible way of treating cancer. We have information about this on another page of our site.
Having immunisations during chemotherapy
There are two main types of vaccines. These are live vaccines and inactivated (not live) vaccines.
You shouldn't have immunisations with live vaccines while you are having chemotherapy or for at least 6 months afterwards. Live vaccines contain a very weak version of the illness they are vaccinating you against.
Talk to your doctor if you are due to have a stem cell or bone marrow transplant. They can explain whether to have certain vaccines and when.
You can have vaccines that are not live, such as the flu vaccine injection. But they might not give you as much protection as usual until your immune system has fully recovered from your chemotherapy.
Contact with other people who have had vaccines
It's fine to be in contact with people who have had some types of vaccines. But with certain types, you might need to avoid contact for a period of time.
Liquid vaccines that you swallow are called oral vaccines. If you come into contact with people who have had live vaccines as liquids, this could cause problems for you.
Make sure that you aren't in contact with anyone who has had an oral vaccine recently, such as:
- oral polio
This is particularly important if you live abroad.
It's usually safe for you to be in contact with adults who have had live vaccines as injections, but check with your doctor.
There is usually no risk to you from any child who has had vaccines as part of the national immunisation programme. This applies to most childhood vaccines in the UK including:
- inactivated polio
- whooping cough
- BCG (for tuberculosis)
- Haemophilus influenzae type b
- meningococcal (MenACWY, MenB, MenC)
- Human papillomavirus (HPV)
The exception to these are the rotavirus vaccine and the flu vaccine nasal spray (see below). You will need to take some precautions if your immunity is very low.
Some pre school and primary school children have the flu vaccine as a nasal spray. You should avoid close contact with children who have had the nasal spray for 2 weeks following their vaccination if your immune system is severely weakened.
This is because the nasal spray contains a live, but weakened form of the flu vaccine. So there is a very small chance that the vaccine virus could be passed on to you and cause flu. The injection does not contain a live form, so these precautions do not apply to contact with people who have had the injection.
Check with your doctor if you are unsure whether your cancer or its treatment has severely weakened your immune system.
Babies have a vaccine at 8 and 12 weeks old called the rotavirus vaccine. Rotavirus causes sickness and diarrhoea. The vaccine contains a very weakened form of the rotavirus. The baby swallows the vaccine and rotavirus passes out in their poo for up to 2 weeks afterwards.
This vaccine could pose a risk to you if your immunity is low. There is a small risk you could catch the rotavirus infection while changing their nappy.
However, Public Health England say that there is a far greater risk to a person having chemotherapy if they share a house with a baby that doesn't have the vaccine. The baby is then more likely to pick up the virus from other babies and children, and that is much more infectious than the vaccine.
There is no need to avoid all contact with a vaccinated baby. Speak to your doctor or chemotherapy nurse if you are worried. Make sure that you are particularly careful about hand washing and hygiene for at least 2 weeks after the baby has had the vaccine. Get someone else to change their nappies during this time if you can. If you do have to change their nappy you can wear disposable gloves and discard them afterwards.
Varicella (chickenpox) is a very infectious disease caused by the varicella zoster virus. Shingles is also caused by this virus. Anyone who has had chickenpox in the past may develop shingles.
Who has these vaccines?
The chickenpox vaccine (Varivax and Varilix) is not part of the childhood immunisation programme. The vaccine is only offered to people on the NHS if they are in close contact with someone who has a weak immune system and could become very unwell with chickenpox. For example, children might need to have the vaccine if they are in close contact with a brother or sister, parent or grandparent who is having chemotherapy.
Adults in their 70s are offered the shingles vaccine (Zostavax).
As these vaccines are live, you should not have this vaccine while you are having chemotherapy and for 6 months following your treatment.
Contact with chickenpox
Having chickenpox could make you very unwell if your immune system is weak due to cancer or its treatment.
Contact your GP or consultant if you think you have been in contact with chickenpox. Your consultant might recommend you have an injection of ready made antibodies. This medicine tries to prevent infection with chickenpox. Or reduce the symptoms and side effects if you develop chickenpox.
Contact with those who have been vaccinated
The company who make the chickenpox vaccine (Varivax) have specific advice to people whose immunity is low. They recommend that they should try to avoid close contact with anyone who has had the chickenpox vaccine for up to 6 weeks following the vaccination.
However, Public Health England (PHE) explain that the risk of a person developing chickenpox or shingles as a result of contact with a vaccinated person is very low. Avoiding contact is not always possible and practical. They suggest that contact does not have to be avoided unless the vaccinated person develops a rash.
Some people may develop a rash following their chickenpox or shingles vaccine. There is a very small risk that the vaccine virus could be passed on from the rash of the vaccinated person to a person whose immune system is compromised.
So PHE recommend that anyone with a vaccine related rash should cover up their rash when in contact with a person with low immunity. It should be covered until the rash is dry and crusted. Contact only has to be avoided if the rash cannot be covered.