Vaccines You Need When You Have Chronic Lymphocytic Leukemia

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Vaccines, or immunizations, help prevent you from getting certain infections or diseases. When you are living with chronic lymphocytic leukemia (CLL), some vaccines may be helpful but others—especially those containing live viruses—may not be safe, because both CLL and its treatments can weaken the immune system.


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When to get vaccines

You should avoid getting vaccines during chemotherapy or radiation therapy because your immune system will be at its weakest, and most vulnerable to infection. You can get some vaccines two weeks before of between cycles of chemotherapy. Your doctor can discuss which vaccines are safe for you to take.


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Flu shot

An annual flu shot is especially recommended for people who have or have had cancer, since they are at greater risk for serious complications if they catch the flu. The flu shot contains dead viruses and is safe for people with cancer, but the nasal spray version, which contains live viruses, should be avoided. You can get the flu shot at least two weeks before you start chemotherapy or in between chemo cycles.


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Pneumococcal vaccine

Adults with blood cancers generally need both types of pneumococcal vaccines to help prevent pneumonia. When you have CLL, it is recommended you receive the pneumonia vaccine every five years, at least two weeks before chemotherapy.


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Polio vaccine

Most people received a polio vaccine as a child and do not need a second one.  However, some people with cancer who have low antibody levels may need to be revaccinated with the inactivated polio shot (not the oral form, which contains a live virus). You should get the shot at least four weeks before chemotherapy or radiation treatment.


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Chickenpox (varicella) vaccine

The chickenpox vaccine, intended for people who never had the illness, contains a live virus and should be avoided by people with leukemia, lymphoma, or other cancers of the bone marrow or lymphatic system unless the disease is treated and under control. If your immunity is weak and you’re exposed to chickenpox, you may need a treatment to help fight the virus and stop cancer therapy for a few weeks.


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Shingles (herpes zoster) vaccine

People who previously had chickenpox carry the virus that causes shingles. The risk of getting shingles increases with age, so the vaccine is recommended for people age 50 and over. However, the shingles vaccine contains a live virus, and shouldn’t be taken by people in CLL treatment, although their doctor may recommend the shot once you’re in remission.


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MMR: Measles-mumps-rubella vaccine

The measles-mumps-rubella (MMR) vaccine contains a live virus and should not be given to people with weakened immune systems. If you’re exposed to measles, you may need to stop cancer therapy for a few weeks and receive a treatment to help fight the virus.


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Tdap: tetanus-diphtheria-pertussis vaccine

The Tdap vaccine is a booster shot to protect adolescents and adults against tetanus, diphtheria and pertussis (whooping cough). It contains dead viruses, so it may be safe for people with CLL to take; the doctor can determine if your immune system is strong enough to handle it.


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HPV vaccine

The human papillomavirus (HPV) vaccine can protect against several different gynecological, genital, and oral cancers, and the CDC recommends a three-dose series of the HPV vaccine up to age 27 for all females, and males with weakened immune systems. However, research shows that young childhood cancer survivors are less likely to be offered or to receive the HPV vaccine. These survivors and their parents need to be vigilant in accessing this important new anticancer vaccine.