Table 2 Recommendations for vaccination in patients with multiple myeloma.
From: Recommendations for vaccination in multiple myeloma: a consensus of the European Myeloma Network
Infections | Vaccine type | Recommendation | Doses | Supported by | Comments |
|---|---|---|---|---|---|
Influenza | Trivalent or quadrivalent (strains selected according seasonal prevalence) | All patients, nonimmune family members, close contacts and HCWs | Two, if antibody response after 1st administration documented, 1, yearly | CDC NCCN | CDC recommends high-dose flu vaccine in people 65 years of age or older |
Hepatitis A | Inactivated hepatitis A vaccine | Patients traveling to areas of high endemicity | 2 | NCCN | May test ≥1 month after last dose |
Hepatitis B | Recombinant hepatitis B vaccine | Patients traveling to areas of high endemicity, behavioral/occupational exposure, hemodialysis | 3 | NCCN | May test ≥1 month after last dose, Revaccination in non-responder, consider booster dose if antibody level <10 IU/L, may retest every 5 years |
Pneumococci | PCV13 | All patients | 1 | CDC, IDSA, NCCN | Conjugated vaccine to a mutant diphtheria toxin induces T-cell response |
PPV23 | >2 months, or 6–12 months after PCV13 according to other CDC | 1–3 Repeat in 3 years | NCCN for pts <65 years at first dose | Polysaccharide vaccine, less immunogenic than PCV | |
Haemophilus influenzae | Haemophilus influenza type B conjugate | All patients | 1 | CDC, NCCNa | May test ≥1 month after last dose aAlso in patients traveling to endemic areas or in case of local outbreak |
Meningococci | Meningococcal conjugate | Patients with asplenia, complement deficiency, recurrent episodes of bacterial infections | 1 | CDC, NCCNa | aAlso in patients traveling to endemic areas or in case of local outbreak |
Tetanus, diphtheria toxoids, and pertussis combined | Tetanus and diphtheria toxoids, and acellular pertussis | Patients who did not receive a primary vaccination for TDP, or a booster dose of tetanus and diphtheria toxoid vaccine. May be limited to tetanus only based on epidemiological prevalence | 3 | CDC, NCCN, WHO | May test for tetanus antibody titers at baseline and ≥1 month after last dose Booster dose of tetanus every 10 years |
Herpes zoster | Recombinant VZV glycoprotein E vaccine (Shingrix®) | All patients with MM | 2 | EMN | Antibody response in 80.4% |
Live-attenuated VZV vaccinea (Zostavax®) | All patients with MM | 4 | EMN | Estimated vaccine efficacy: 63% |
