Immunizations

  • May an individual with CML receive the shingles vaccine? What about the chicken pox vaccine?

    Using the most current infectious disease guidelines, Zostavax (shingles vaccine) may be given to CML patients who are stable and not experiencing any evidence of relapse or progression, and who do not have other immune suppressive issues such as recent requirements for high dose corticosteroids. 

    For Varivax (chicken pox vaccine), similar principles apply, though there is perhaps more of a need to consider administering Varivax if a patient has never had chicken pox, given the risks associated with a chicken pox infection.

  • May an individual with CML be around someone who has shingles, chicken pox, or has been vaccinated for either?

    If a CML patient has never had prior chicken pox and has never had the chicken pox vaccine, then he or she should avoid contact with individuals with chicken pox or shingles. If the patient with CML had prior chicken pox or vaccination for chicken pox, then the concern is minimal as infection risk is dramatically lower.

  • Now that I have been diagnosed with CML, should I receive the flu shot or the flu mist nasal spray vaccine?

    Given there is an injectable flu vaccine that poses NO risk for infection, then the shot is preferred over live attenuated (weakened) vaccines, which can cause illness or effects similar to the disease. 

  • What Immunizations are safe for patients with CML?

     

     

    IMMUNIZATIONS SAFE FOR INDIVIDUALS WITH CHRONIC MYELOID LEUKEMIA (CML)

    Immunization

    Information

    Hepatitis A

    The Hepatitis A vaccine contains only killed virus and is therefore safe for patients with CML to take.

    Hepatitis B

    The Hepatitis B vaccine does not contain elements of a live virus and is therefore safe for patients with CML to take.

    Human Papilloma Virus or HPV Vaccine

    The HPV vaccine does not contain elements of a live virus and is therefore safe for patients with CML to take. The HPV vaccine is now indicated for both males and females.

    H1N1 or
    Influenza A

    The H1N1 vaccine does not contain elements of a live virus and is therefore safe for patients with CML to take. Indications for this vaccine may change from year to year so it is important to check with your healthcare team before receiving it.

    Influenza (shot)

     

    The flu shot does not contain elements of a live virus and is therefore safe for patients with CML to take. In fact, it is important to get a flu shot each year to decrease your risk of becoming sick with the flu. Patients with CML have not been shown to have increased risk of contracting the flu, but there is information that the flu can be more dangerous to those with CML and other hematological malignancies.

    Flu Shot - may be given into the muscle – usually the upper arm or smaller doses may be given intradermally – just under the skin. 

    Tetanus Shot
    (Td, TdaP, or DTaP)

    These different combination vaccines for diphtheria, tetanus and pertussis contain only portions of disease elements and are generally safe for patients with CML. Alert your healthcare team to your CML status prior to receiving a “Tetanus” shot.

    Meningococcal  or Meningitis Vaccine

    The Meningococcal vaccine contains only killed virus and is therefore safe for patients with CML to take.

    Pneumonia shot or Pneumococcus Vaccine

    Individuals with CML should in general, receive the Pneumococcal pneumonia vaccine. This vaccine helps individuals with compromised immune systems fend off potentially dangerous pneumonias.

    Polio Shot

    The polio shot given by most practicing pediatricians in the United States contains inactivated polio virus and is safe for patients living with CML.

    Rabies

    The rabies vaccine is given to individuals at risk for exposure to rabies. The dosage schedule is different for those who have been in direct contact with suspected rabies, including those who have been previously vaccinated. The rabies vaccine contains inactivated rabies and is safe for patients living with CML.

  • What immunizations should I avoid?

    The safety and efficacy of any immunization is based on highly patient-specific variables, including the phase of your CML, the treatments you are receiving and their effect on your immune system, as well as the risk you experience for exposure to dangerous illnesses for which there are effective immunizations. The table below will provide general guidelines for immunizations that should be taken only with careful consultation with your CML Specialist.

     

    CONSULT YOUR CML SPECIALIST  

    It is best to have a fully restored immune system prior to receiving any of these immunizations.

    IMMUNIZATION

    INFORMATION

    Influenza (nasal spray)

    Flu-Mist®
    flu spray
     

    Spray vaccines include elements of the live influenza virus and although safe for the general population, should not be administered to individuals who have CML UNLESS APPROVED BY THEIR CML SPECIALIST. Although risk is considered low, patients living with CML should avoid contact with individuals who have received immunizations with a live vaccine for one week.

    Measles, Mumps and Rubella (MMR) Vaccine

    Individuals with CML should not receive the Measles/Mumps/Rubella vaccine UNLESS APPROVED BY THEIR CML SPECIALIST since it contains elements of live viruses. It is safe however for family members or those in close contact with CML patients to receive the vaccination. If you have CML and are exposed to someone who has measles, alert your healthcare team quickly so that you might be eligible to receive measles immune globulin to help fight a measles infection.

    Polio – older formulation given by mouth

    The oral polio vaccine contains elements of live virus and should not be given to individuals who have CML UNLESS APPROVED BY THEIR CML SPECIALIST. Although risk is considered low, patients living with CML should avoid contact with individuals who have received immunizations with a live vaccine for one week.

    Rotavirus

    Rotavirus vaccines are generally given only in pediatric patients. They are given orally and contain whole live viruses, making them off-limits for patients with CML. Do not administer Rotavirus vaccination to children with CML UNLESS APPROVED BY THEIR CML SPECIALIST.

    Smallpox

    Individuals living with CML should not receive the smallpox vaccination and should avoid close contact with individuals who have received the smallpox vaccination for approximately 21 days UNLESS APPROVED BY THEIR CML SPECIALIST. The virus is spread by contact, therefore individuals living with a CML patient should also not get the smallpox vaccination. Exceptions can be made if stringent protective measures are in place including covering the vaccination site at all times to avoid contact with sheets, towels, clothes or other shared surfaces. It is important to discuss with your healthcare team, any exposure to smallpox or to those recently vaccinated for smallpox.

    Varicella or Chickenpox vaccine

    Individuals with CML who have restored and stable immune systems are eligible to receive the chicken pox vaccine if APPROVED BY THEIR CML SPECIALIST, since it contains elements of live virus. It is safe, however, for family members or those in close contact with CML patients to receive the vaccination. If you have CML, have never had chicken pox and have never had the chicken pox vaccine, and are exposed to someone who has chickenpox, alert your healthcare team quickly so that you might be eligible to receive VZV immune globulin to help fight a chicken pox infection. The VZV immune globulin must be given within 3 days of the chickenpox exposure in order to be effective. 

    Varicella Zoster or Shingles Vaccine

    Individuals with CML who have restored and stable immune systems are eligible to receive the shingles vaccine if APPROVED BY THEIR CML SPECIALIST, since it contains elements of live virus. It is safe, however, for family members or those in close contact with CML patients to receive the vaccination.