Vaccinations

Vaccinations support your immune system and help protect against common bugs, like flu. But if you have blood cancer and a weakened immune system, you should only have non-live vaccines. Find out about the difference between non-live and live vaccines, which vaccinations you’re eligible for and when to have them.

Injection or vaccination icon: a syringe next to a medicine bottle

Summary

Blood cancer can weaken your immune system and put you at risk of serious illness from infection. Vaccinations are a safe way to help protect you from infection.
If you have blood cancer and a weakened immune system, you should only have non-live vaccines. Live vaccines could make you very ill.
Some people who have had successful treatment or whose blood cancer is stable may be able to have live vaccines.
When you have blood cancer, your immune system may not respond as strongly to vaccinations as other people’s. But vaccines can still help protect you from disease and serious infection.
People you live with can help protect you too, by keeping up to date with their vaccinations.
After a stem cell transplant or CAR T-cell therapy, vaccinations help rebuild your immune system. You’ll need vaccines you may have had before treatment, including childhood vaccines.
If you’re not sure what vaccines you’re eligible for, ask your haematology team. They can tell you which vaccines you need and the best time to have them.

Download our factsheet on vaccinations

How vaccinations may help you

Vaccinations are a safe way to help protect you from infections when you have blood cancer.

Vaccinations aim to protect you from viruses and bacteria (germs) that cause infections. They can also make an illness milder if you get an infection. They’re designed to train your immune system to respond fast to germs.

Blood cancer, and its treatments, can stop your immune system from working well. It puts you at higher risk of getting infections and becoming very ill. You may hear people call this immunosuppression or immunocompromise.

When you have blood cancer, vaccinations may:

Reduce your chance of getting infections
Protect you from infections that wouldn’t be of notice, or affect, other people
Reduce the chance of any infections you do get becoming serious
Help you live well

When you have a weakened immune system, you’re in an ‘at risk’ group of people. This means you’re eligible for vaccinations that other people may not be. It also means there are some vaccinations that may not be suitable for you.

How vaccines work

Vaccines work by stimulating your immune system to respond to germs or parts of germs.

Some contain weakened or non-live versions of germs that prompt your white blood cells to fight. Some contain small fragments of germs. Others teach your cells to make proteins that set off an immune response to certain germs.

The aim of vaccines is to train your immune system to remember the germs. If you catch the same germs later, your immune system may respond faster. This helps it kill the germs before they can cause you serious harm.

It’s normal to have mild symptoms after vaccination. You may have a fever and feel tired or unwell while your body responds to the vaccine.

Live and non-live vaccines

Adults with blood cancer and a weakened immune system should have non-live vaccines.

There are two main types of vaccination: non-live and live vaccines.

Non-live vaccines

Non-live vaccines cannot give you the disease they’re designed to protect you from. That’s why they’re safer for immunosuppressed people than live vaccines.

Non-live vaccines:

May contain bacteria or viruses that have been killed or changed. This stops them from making copies of themselves.
Or they may teach your cells to make proteins that set off an immune response to certain germs.

Non-live vaccinations are safe for people with blood cancer. They include vaccinations against:

Flu (injected vaccine only)
COVID-19
Pneumococcal infections
Shingles
Respiratory syncytial virus (RSV)
Diphtheria, tetanus and acellular pertussis (whooping cough), polio, Haemophilus influenza type b (Hib), hepatitis B: 6 in 1 vaccine
Meningococcal infections (MenB, MenACWY)
Human papillomavirus (HPV)

Live vaccines

Live vaccinations are not safe for people with blood cancer who have a weak immune system. They could make you seriously ill. Your haematology team may need to write to your GP to explain this.

Live vaccines contain weakened versions of bacteria or viruses. If your immune system is weak, they can cause the infection they’re trying to prevent and make you ill.

Live vaccinations are not recommended for adults with blood cancer and immunosuppression. They include:

Flu nasal spray vaccine (but the flu jab is non-live and is safe)
Measles
Mumps
Rubella
Varicella (chickenpox)
BCG (tuberculosis)

Travel vaccines

You may need travel vaccines for safe travel or entry to certain countries.

Some travel vaccines are live vaccines, including:

Cholera (Vaxchora® oral vaccine)
Dengue
Typhoid (oral vaccine)
Yellow fever

There are non-live alternatives for cholera (Dukoral® oral vaccine) and typhoid (injection).

For individual advice, consider consulting the Hospital for Tropical Diseases’ complex travel clinic.

There may be other live vaccines not included in these lists. Always check with your GP or travel clinic whether any vaccine they offer you is live or not.

If you’re well enough to have a live vaccine

If you have blood cancer and your immune system is strong enough, you may be able to have some live vaccines. This may apply to you if you’ve had successful treatment or your blood cancer is stable. You and your haematology team can discuss the risks and benefits for you as an individual.

If your haematology team thinks you’re well enough for a live vaccine, they may need to write to your GP to explain this.

If you have a live vaccine by mistake

If you have a live vaccination by mistake, tell your haematology team or GP immediately. Sometimes, you may need an anti-infective medicine to support your immune system. It depends on the vaccination.

Otherwise, you may be monitored in case you develop a serious illness in response to the vaccine.

If you have a bad reaction to a vaccine, you can report it via the Ye https://yellowcard.mhra.gov.uk/llow Card scheme.

Vaccinations you’re eligible for

Your team will check which vaccines you’ve already had. They can tell you which vaccines you’re eligible for and how many doses you’ll need and when.

If you’re living with blood cancer, it’s important to get the vaccinations you’re eligible for.

Your haematology team may recommend the following vaccinations:

Annual flu jab in line with national vaccination campaigns
COVID-19 in line with national vaccination campaigns with additional doses, if needed
Pneumococcal: two doses at least 4 weeks apart
Respiratory syncytial virus (RSV), if you’re 65 to 79
Shingles (Shingrix vaccine): two doses at least 8 weeks apart

If you’ve had a stem cell transplant or CAR T-cell therapy, you’ll be eligible for more vaccines after treatment.

If you’re offered a COVID-19 vaccine in the autumn, it’s usually safe to have the flu jab at the same time.

The UK Health Security Agency sometimes updates the routine immunisation schedule. It may list other non-live vaccinations you become eligible for.

Your immune response to vaccination

If you have a weakened immune system, your immune response to some vaccinations may not be as strong as other people’s. But vaccinations are still recommended.

They offer you some protection against infection, even if it may not be full protection. This can still make a difference to you. It may mean self-care at home instead of hospital treatment for a serious infection.

Everyone’s immune system is different. You may respond better than someone else with the same condition or on the same treatment as you.

Getting support if you’re declined a vaccine

Sometimes a GP or practice nurse may not agree to you having a vaccination you’re eligible for. Or they may decline a vaccination that someone you live with should have to help protect you.

Information and advice on vaccinations changes often. It can be hard for all health care professionals to keep up to date.

If you’re declined a vaccine that you think you're eligible for, contact your haematology team. Ask them to write a letter of support to your GP.

Timing of vaccination

Your haematology team or GP will tell you which vaccinations they recommend for you. They may ask you to have them at certain points in your illness, depending on which blood cancer you have. It’s best if you have them when your immune system is as strong as it can be.

This will vary depending on your situation:

Recently diagnosed with a chronic blood cancer. You may benefit from vaccinations soon after your diagnosis.
On active monitoring. You may benefit from vaccinations while your blood cancer is stable.
Having treatment for blood cancer with a targeted medicine or chemotherapy. You may benefit from vaccination before treatment starts.
Having treatment with an antibody therapy. You may benefit from some vaccinations before treatment and others several weeks after.
Having a stem cell transplant or CAR T-cell therapy. You’ll need to have vaccinations after treatment. But it will be several months, at least, before you can start having them.

Timing of booster doses

You may need some vaccinations on a different dosing schedule to healthy people.

Your haematology team or GP may recommend:

More than one dose of vaccine
Having booster doses of vaccine closer together

This can improve how your immune system responds to them.

Ask your haematology team or GP what they recommend for you and when.

Vaccinations after a stem cell transplant or CAR T-cell therapy

Your post-treatment vaccination schedule takes account of the strength of your immune system. It is individual to you.

Stem cell transplants and CAR T-cell therapy both wipe out part, or all, of your immune system. You’ll lose protection against diseases you had vaccinations for before treatment.

After treatment, you’ll need to have a range of vaccinations to help rebuild your immune system. This includes childhood vaccinations, even if you’ve had them before.

Your haematology team will tell you which vaccinations and booster doses you’ll need. They’ll also tell you when to have them. This may be different to the schedule for children having these vaccinations. Your vaccination schedule will take account of your recovering immune system.

It may be at least:

3 to 6 months before you’re offered non-live vaccines
2 years before you’re offered live vaccines

While your immune system is low, you’re at high risk of getting infections. You may want to take extra care managing your infection risk while you recover.

Vaccinations for people you live with

Your close contacts and people you live with can help by having their vaccinations. This helps protect you from germs and infection. But they may need to avoid live vaccines.

It’s recommended that people you live with keep up to date with their vaccinations. This also applies to other people you have close contact with on most days. This helps reduce your risk of infection.

It’s best if everyone is up to date with their vaccinations. This includes most childhood vaccinations and seasonal vaccinations, like the annual flu jab. It’s safe for people close to you to have non-live vaccinations.

For live vaccinations, it depends on:

What’s happening with your blood cancer
What treatment you’re having

Sometimes the benefits of someone having a live vaccine outweigh the potential risks.

This may apply to the following routine childhood vaccinations:

Rotavirus vaccine

Babies usually have the rotavirus vaccine at 8 weeks and 12 weeks. It is a live vaccine.

It’s possible for you to get a tummy bug if you have contact with a baby’s poo after vaccination. So, for at least 2 weeks after vaccination it’s best to:

Wash your hands regularly
Avoid changing the baby’s nappy, if you can

Flu nasal spray vaccine

The nasal spray flu vaccine is a live vaccine. It’s offered to:

Children aged 2 or 3 years
All school-age children from reception to year 11

It may be possible to catch the weakened live virus from a child who’s recently had this vaccine. It’s shed from the child’s nose for at least a few days after vaccination. It can also cause a runny nose and other cold-like symptoms.

If your immune system is very weak, it’s best to avoid close contact with children for 1 to 2 weeks after they’ve had this vaccine. Or ask if they can have the non-live flu jab, instead.

Measles, mumps, rubella and varicella (chickenpox) vaccine (MMRV)

The MMRV vaccine is a live combination vaccine. Babies usually have it at 1 year, with booster doses at 18 months and around 3 years 4 months.

After this vaccination, babies and children may develop two types of rash:

A measles-like rash about a week after vaccination that lasts for a few days. This is from the measles part of the vaccine and is not a risk to immunocompromised people.
A blistering rash within a month of vaccination. This is from the varicella (chickenpox) part of the vaccine. It’s possible to catch chickenpox from this rash. It’s a low risk but more likely if the rash is widespread and not covered by clothing. If this happens and you’re immunocompromised, your doctor may prescribe post-exposure medicine. This aims to reduce your chance of serious infection.

Your haematology team can tell you if it’s safe for people you live with to have live vaccines. They’ll base this on the strength of your immune system and any treatments you’re having or have recently had.

Vaccinations for pets you live with

If you have blood cancer and a weak immune system, avoid your dog or cat having live vaccines.

Some pet vaccines are live. They contain weakened versions of bacteria or viruses (germs). If your immune system is low, you may become ill following contact with a weakened germ from a pet vaccine.

Although rare, it’s possible to catch germs from a pet that’s recently had the live kennel cough vaccine. This is a nasal vaccine, and your pet can shed it from their nose after vaccination.

If your pet is due for their vaccinations, tell the vet if you’re immunocompromised. Ask your vet about using non-live versions of routine vaccines for your pets.

Sources

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This material was produced with the financial support of an educational grant from Otsuka, who had no editorial input into its content.

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Page last reviewed: 02 September 2026

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