Vaccination of Adults with Cancer

Publication Date: March 17, 2024
Last Updated: March 18, 2024


Recommendation 1.1

Clinicians should determine vaccination status and ensure that adults newly diagnosed with cancer and about to start treatment are up to date on seasonal vaccines as well as age- and risk-based vaccines (see Tables 1–3). (M, S)

Recommendation 1.2

Vaccination should ideally precede any planned cancer treatment by 2–4 weeks. However, non-live vaccines can be administered during or after chemotherapy or immunotherapy, hormonal treatment, radiation, or surgery. (M, S)

Recommendation 2.1

Complete revaccination starting 6–12 months after hematopoietic stem cell transplant should be offered in order to restore vaccine-induced immunity. Live and live attenuated vaccines should be delayed for at least 2 years and only given in the absence of active graft-versus-host disease (GVHD) or immunosuppression. Coronavirus disease 2019 (COVID-19), influenza, and pneumococcal vaccines can be administered as early as three months after transplant. (M, S)

Recommendation 2.2

Adults with hematopoietic malignancies receiving chimeric antigen receptor T-cell (CAR-T) therapy directed against B-cell antigens (CD19, B-cell maturation antigen [BCMA]) should receive influenza and COVID-19 vaccine no sooner than three months after the completion of therapy. Non-live vaccines should be administered no sooner than 6 months after completion of therapy. (VL, W)

Recommendation 2.3

Adults who receive B-cell-depleting therapy should be revaccinated for COVID-19 only, no sooner than 6 months after completion of treatment. (M, S)

Recommendation 2.4

Long-term survivors of hematologic malignancy with or without active disease or those who have longstanding B-cell dysfunction or hypogammaglobulinemia from therapy or B-cell lineage malignancies should receive the recommended non-live vaccines even though the response may be attenuated. (M, S)

Recommendation 3.0

Adults with solid and hematologic cancers traveling to an area of risk should follow the Centers for Disease Control and Prevention (CDC) standard recommendations for the destination. (M, S)
Note. Hepatitis A, intramuscular typhoid vaccine, inactivated polio, hepatitis B, rabies, meningococcal, and Japanese encephalitis vaccines are safe.

Recommendation 4.0

It is recommended that all household members and close contacts, where feasible, be up to date on vaccinations. (M, S)

Recommendation Grading


The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.



Vaccination of Adults with Cancer

Authoring Organization

Publication Month/Year

March 17, 2024

Last Updated Month/Year

April 9, 2024

Document Type


Country of Publication


Inclusion Criteria

Male, Female, Adult, Older adult

Health Care Settings

Ambulatory, Correctional facility, Home health, Long term care, Outpatient

Intended Users

Nurse, nurse practitioner, community pharmacist, health systems pharmacist, physician, physician assistant


Assessment and screening, Treatment, Management

Diseases/Conditions (MeSH)

D019496 - Cancer Vaccines


influenza, cancer, hepatitis B, varicella, respiratory syncytial virus, RSV, IPV, Measles, HPV, TDAP, MMR, vaccine, Hepatitis A, Hib, Meningococcal Vaccination, Inactivated polio vaccine, Mumps, Rubella, Modified Vaccinia Ankara, Monkeypox, Tdap , Td, Recombinant zoster vaccine, Pneumococcal vaccine, Human papillomavirus

Source Citation

Kamboj M, Bohlke K, Baptiste DM, et al. Vaccination of Adults with Cancer: ASCO Guideline. J Clin Oncol. 2024 March 18. doi: 10.1200/JCO.24.00032

Supplemental Methodology Resources

Evidence Tables


Number of Source Documents
Literature Search Start Date
January 1, 2013
Literature Search End Date
February 16, 2023