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Healthy living after treatment of childhood, adolescent, and young adult cancer

Vaccines after Treatment for Cancer Survivors Treated withChemotherapy and/or Radiation (Non-HCT)
Vaccines are an important tool to protect against infections and prevent infection-related deaths. Vaccines help theimmune system recognize and fight serious infections. Most vaccines are given during childhood and provide protection against infection into adulthood. After cancer treatment, survivors may need to catch up on recommended
childhood vaccines that were missed during treatment or get booster vaccines to protect against vaccine-preventable infections.
Sometimes recommended vaccine doses are delayed during cancer treatment. After completing treatment for cancer,
it is important to make a plan to catch up on missed vaccines, even if delayed by months or years.
For childhood cancer survivors who have not missed any vaccinations during treatment, an extra dose of a vaccine (a“booster” vaccine) may be recommended to strengthen the immune system against vaccine-preventable infections.

Who should get booster vaccines?
• All children and adolescents who have received chemotherapy and/or abdominal radiation should discuss vaccines with their cancer team and primary care provider.
• Your child’s provider may recommend boosters with or without checking antibody levels (also called titers) that
confirms loss of immunity before vaccines are given.
Why should childhood cancer survivors receive vaccines or booster doses?
• Vaccines and booster shots after cancer treatment protect from infection and infection-related death.
How do vaccines and booster doses work?
• Vaccines protect you from infection by creating an immune response which makes antibodies and memory
cells, your body’s tools to effectively fight off viruses and bacteria. These antibodies and cells remain in the bodyfor many years and protect against infections into adulthood.
• A booster vaccine is an additional dose of a vaccine. Booster vaccines “boost” the number of antibodies andcells to fight an infection that you have been vaccinated for in the past and provides greater protection against
infection.
What are the risks of booster vaccines?
• Booster vaccines are considered very safe.
• Common side effects include swelling and/or discomfort at the vaccination site and low-grade fever.
• Serious reactions are rare. If you have concerns about vaccine safety, more information can be found at theCenters for Disease Control website: https://www.cdc.gov/vaccines/schedules/index.html

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Health Link

Healthy living after treatment of childhood, adolescent, and young adult cancer

Where should my child go to receive vaccines?
• Vaccines can be given by your primary care provider.
• Some primary care providers may not be familiar with your specific catch up or booster vaccine schedule.
Make sure to give your primary care provider your cancer team’s contact information for questions.
When should my child get vaccines after cancer treatment?
• Most vaccines are delayed at least six months after cancer treatment ends.
• The timing of vaccination should be given to you by your cancer team. Certain treatments such as steroids,IVIG, and immune suppression drugs may affect your vaccine schedule.
Are there any vaccines that protect against cancer?
• Yes!
- The Hepatitis B virus vaccine protects against liver cancer caused by the Hepatitis B virus.
- The human papilloma virus (HPV) vaccine protects against a virus known to cause many different
types of cancer (head and neck cancers, cervical cancer, vaginal cancer, anal cancer, penile cancer,and vulvar cancer).
˚ Survivors of childhood cancer are at increased risk of HPV-related cancers and should receive athree-dose series of the vaccination, regardless of the age at which the first vaccine was given.
Written by S. Ashley Speckhart, MD, MPH, Maine Children’s Cancer Program, Scarborough, ME; and Kayla L. Foster, MD, MPH,
Baylor College of Medicine/Texas Children’s Hospital, Houston, TX.
Reviewed by Melissa Acquazzino, MD, MS; Greg Guilcher, MD; Hesham Eissa, MD; Linda Rivard, RN, BSN, CPON®, Daniel Smith
DNP, FNP; and Christine Yun MSN, PNP, CPON®.

Additional health information for childhood cancer survivors is available atwww.survivorshipguidelines.org
Note: Throughout this Health Links series, the term “childhood cancer” is used to designate pediatric cancers that may occur during childhood, adolescence, or young adulthood.
Health Links are designed to provide health information for survivors of pediatric cancer, regardless of whether the cancer occurred during childhood, adolescence, or young
adulthood.
Disclaimer and Notice of Proprietary Rights
Introduction to Late Effects Guidelines and Health Links: The Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancers and accompanying Health Links
were developed by the Children’s Oncology Group as a collaborative effort of the Late Effects Committee and Nursing Discipline and are maintained and updated by the Children’s Oncology
Group’s Long-Term Follow-Up Guidelines Core Committee and its associated Task Forces.
To cancer patients (if children, their parents or legal guardians): Please seek the advice of a physician or other qualified health provider with any questions you may have regarding amedical condition and do not rely on the Informational Content. The Children’s Oncology Group is a research organization and does not provide individualized medical care or treatment.
To physicians and other healthcare providers: The Informational Content is not intended to replace your independent clinical judgment, medical advice, or to exclude other legitimate criteria
for screening, health counseling, or intervention for specific complications of childhood cancer treatment. Neither is the Informational Content intended to exclude other reasonable alternative
follow-up procedures. The Informational Content is provided as a courtesy, but not intended as a sole source of guidance in the evaluation of childhood cancer survivors. The Children’sOncology Group recognizes that specific patient care decisions are the prerogative of the patient, family, and healthcare provider.
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