CAGT- POST ALLOGENEIC STEM CELL TRANSPLANT IMMUNIZATIONS		version 5/9/2025		

Appointment Requests 	

	
	Interval	Defer Until	Duration	
	☐	Provider communication	Every visit	S	 treatments	
		If vaccines will be given in one of the outpatient infusion centers, please add a REF1000, Therapy Plan Appointment Request, to the plan.		

CAGT Nursing Communication 	

	
	Interval	Defer Until	Duration	
	☐	Nursing communication	Every visit	S	Until discont'd	
		Decision to initiate immunizations in patients who are post stem cell transplant will be based on if the patient has ongoing immunosuppression or active disease and appropriateness will be determined by the primary BMT physician. Contact the provider BEFORE administering a live vaccine to determine appropriateness		

CAGT Provider Communication 	

	
	Interval	Defer Until	Duration	
	☐	Provider communication	Every visit	S	Until discont'd	
		Immunizations will start between 6-12 months post allogenic stem cell transplant depending on provider preference. Each following vaccine series will be spaced approximately three months apart from the previous one. Please review individual orders for minimal intervals between doses in each vaccine series.		

CAGT Allogeneic Vaccine Series 1 (Starting between 6-12 months post-transplant) 	

	
	Interval	Defer Until	Duration	
	☐	Tdap (BOOSTRIX) vaccine 0.5 mL	Once	S	1 treatment	
		0.5 mL, intramuscular, once, Starting when released
	Given as a 3-dose series. 4-week minimal interval between doses.		
	☐	haemophilus b polysac/tetanus toxoid (ActHIB) 0.5 mL IM vaccine, MUST DILUTE	Once	S	1 treatment	
		0.5 mL, intramuscular, once, Starting when released
	Administer 0.5 mL by INTRAMUSCULAR Injection. Given as a 3-dose series. 4-week minimal interval between doses
	To reconstitute, withdraw 0.6 mL of saline diluent and inject in ActHIB vaccine vial.  Shake well to ensure reconstitution.  Vaccine should be clear and colorless.  Withdraw 0.5 mL dose of the reconstituted vaccine and inject intraMUSCularly.  If not administered immediately after reconstitution, contact Pharmacy.

	☐	pneumococcal conj. 20 valent (PREVNAR-20) vaccine (patients > 2 months,one dose series)	Once	S	1 treatment	
		0.5 mL, intramuscular, once, Starting when released
	Given as a 3-dose series. 4-week minimal interval between doses		
	☐	poliovirus vaccine (inactivate) (IPOL) 40-8-32 unit/0.5 mL injection 0.5 mL	Once	S	1 treatment	
		0.5 mL, intramuscular, once, Starting when released
	Given as a 3-dose series. 4-week minimal interval between dose #1 and #2; 6-month minimal interval between dose #2 and #3		
	☐	hepatitis A-hepatitis B (TWINRIX) 720 ELISA unit- 20 mcg/mL vaccine 1 mL	Once	S	1 treatment	
		1 mL, intramuscular, once, Starting when released
	Given as a 3-dose series. 4-week minimal interval between dose #1 and #2; 6-month minimal interval between dose #1 and #3		

CAGT Allogeneic Vaccine Series 2 (9-15 months post-transplant) 	

	
	Interval	Defer Until	Duration	
	☐	Tdap (BOOSTRIX) vaccine 0.5 mL	Once	S+84	1 treatment	
		0.5 mL, intramuscular, once, Starting when released
	: Given as a 3-dose series. 4-week minimal interval between dose #1 and #2; 6-month minimal interval between dose #1 and #3		
	☐	haemophilus b polysac/tetanus toxoid (ActHIB) 0.5 mL IM vaccine, MUST DILUTE	Once	S+84	1 treatment	
		0.5 mL, intramuscular, once, Starting when released
	Administer 0.5 mL by INTRAMUSCULAR Injection. Given as a 3-dose series. 4-week minimal interval between doses.
	To reconstitute, withdraw 0.6 mL of saline diluent and inject in ActHIB vaccine vial.  Shake well to ensure reconstitution.  Vaccine should be clear and colorless.  Withdraw 0.5 mL dose of the reconstituted vaccine and inject intraMUSCularly.  If not administered immediately after reconstitution, contact Pharmacy.

	☐	pneumococcal conj. 20 valent (PREVNAR-20) vaccine (patients > 2 months,one dose series)	Once	S+84	1 treatment	
		0.5 mL, intramuscular, once, Starting when released
	Given as a 3-dose series. 4-week minimal interval between doses		
	☐	poliovirus vaccine (inactivate) (IPOL) 40-8-32 unit/0.5 mL injection 0.5 mL	Once	S+84	1 treatment	
		0.5 mL, intramuscular, once, Starting when released
	Given as a 3-dose series. 4-week minimal interval between dose #1 and #2; 6 month minimal interval between dose #2 and #3		
	☐	hepatitis A-hepatitis B (TWINRIX) 720 ELISA unit- 20 mcg/mL vaccine 1 mL	Once	S+84	1 treatment	
		1 mL, intramuscular, once, Starting when released
	Given as a 3-dose series. 4-week minimal interval between dose #1 and #2; 6 month minimal interval between dose #1 and #3		

CAGT Allogeneic Vaccine Series 3 (12-18 months post-transplant) 	

	
	Interval	Defer Until	Duration	
	☐	Tdap (BOOSTRIX) vaccine 0.5 mL	Once	S+168	1 treatment	
		0.5 mL, intramuscular, once, Starting when released
	: Given as a 3-dose series. 4-week minimal interval between dose #1 and #2; 6-month minimal interval between dose #1 and #3		
	☐	haemophilus b polysac/tetanus toxoid (ActHIB) 0.5 mL IM vaccine, MUST DILUTE	Once	S+168	1 treatment	
		0.5 mL, intramuscular, once, Starting when released
	MIX THE TWO VIALS BEFORE ADMINISTRATION. Scan Vaccine. Do Not Scan DILUENT.
	-  Administer 0.5 mL by INTRAMUSCULAR Injection. Given as a 3-dose series. 4-week minimal interval between doses.
	To reconstitute, withdraw 0.6 mL of saline diluent and inject in ActHIB vaccine vial.  Shake well to ensure reconstitution.  Vaccine should be clear and colorless.  Withdraw 0.5 mL dose of the reconstituted vaccine and inject intraMUSCularly.  If not administered immediately after reconstitution, contact Pharmacy.

	☐	pneumococcal conj. 20 valent (PREVNAR-20) vaccine (patients > 2 months,one dose series)	Once	S+168	1 treatment	
		0.5 mL, intramuscular, once, Starting when released
	Given as a 3-dose series. 4-week minimal interval between doses.		
	☐	varicella zoster (SHINGRIX)  50 mcg/ 0.5 mL IM vaccine, MUST DILUTE	Once	S+168	1 treatment	
		0.5 mL, intramuscular, once, Starting when released
	Given as a 2-dose series. 8-week minimal interval between doses
	MIX THE TWO VIALS BEFORE ADMINISTRATION. Scan Vaccine. Do Not Scan DILUENT.		

CAGT Allogeneic Vaccine Series 4  (15-21 months post-transplant) 	

	
	Interval	Defer Until	Duration	
	☐	pneumococcal conj. 20 valent (PREVNAR-20) vaccine (patients > 2 months,one dose series)	Once	S+252	1 treatment	
		0.5 mL, intramuscular, once, Starting when released
	One dose series. 4-week minimal interval from third PCV 20 dose.		
	☐	poliovirus vaccine (inactivate) (IPOL) 40-8-32 unit/0.5 mL injection 0.5 mL	Once	S+252	1 treatment	
		0.5 mL, intramuscular, once, Starting when released
	Given as a 3-dose series. 4-week minimal interval between dose #1 and #2; 6-month minimal interval between dose #2 and #3		
	☐	hepatitis A-hepatitis B (TWINRIX) 720 ELISA unit- 20 mcg/mL vaccine 1 mL	Once	S+252	1 treatment	
		1 mL, intramuscular, once, Starting when released
	Given as a 3-dose series. 4-week minimal interval between dose #1 and #2; 6 month minimal interval between dose #1 and #3		
	☐	meningococcal ACWY conjugate vaccine (Menveo) IM injection	Once	S+252	1 treatment	
		0.5 mL, intramuscular, once, Starting when released
	Given as a 2-dose series. 8-week minimal interval between doses. Menveo does NOT prevent N. meningitidis serogroup B infections. Meningococcal B vaccine (Trumemba or Bexsero) should be considered for high-risk patients including HIV patients, patients with asplenia, complement deficiency, or receiving a complement C5 inhibitor		

CAGT Allogeneic Vaccine Series 5 (24 months post-transplant) 	

	
	Interval	Defer Until	Duration	
	☐	Provider communication	Once	S+365	1 treatment	
		Please adjust vaccine due dates accordingly.		
	☐	measles-mumps-rubella-(PRIORIX) 0.5 mL SC vaccine, MUST DILUTE	Once	S+365	1 treatment	
		0.5 mL, subcutaneous, once, Starting when released
	2 dose series. 4-week minimal interval between doses. Give no earlier than 24 months post-allogeneic transplant. Patients should be 24 months post HSCT, no active GvHD, remain in remission, no systemic immunosuppressive therapy for 12 months including monoclonal antibodies, no IVIg in last 3 months
	MIX THE 2 VIALS BEFORE ADMINISTRATION. SCAN THE VACCINE. DO NOT SCAN THE DILUENT. GIVE SUBCUTANEOUSLY ONLY!!		
	☐	meningococcal ACWY conjugate vaccine (Menveo) IM injection	Once	S+365	1 treatment	
		0.5 mL, intramuscular, once, Starting when released
	Given as a 2-dose series. 8-week minimal interval between doses. Menveo does NOT prevent N. meningitidis serogroup B infections. Meningococcal B vaccine (Trumemba or Bexsero) should be considered for high-risk patients including HIV patients, patients with asplenia, complement deficiency, or receiving a complement C5 inhibitor.		
	☐	varicella zoster (SHINGRIX)  50 mcg/ 0.5 mL IM vaccine, MUST DILUTE	Once	S+365	1 treatment	
		0.5 mL, intramuscular, once, Starting when released
	Given as a 2-dose series. 8-week minimal interval between doses
	MIX THE TWO VIALS BEFORE ADMINISTRATION. Scan Vaccine. Do Not Scan DILUENT.		

CAGT Allogeneic Vaccine Series 6 (25 months or more post-transplant) 	

	
	Interval	Defer Until	Duration	
	☐	Provider communication	Once	S+365	1 treatment	
		Please adjust vaccine due dates accordingly.		
	☐	measles-mumps-rubella-(PRIORIX) 0.5 mL SC vaccine, MUST DILUTE	Once	S+365	1 treatment	
		0.5 mL, subcutaneous, once, Starting when released
	2 dose series. 4-week minimal interval between doses. Give no earlier than 24 months post-allogeneic transplant. Patients should be 24 months post HSCT, no active GvHD, remain in remission, no systemic immunosuppressive therapy for 12 months including monoclonal antibodies, no IVIg in last 3 months
	MIX THE 2 VIALS BEFORE ADMINISTRATION. SCAN THE VACCINE. DO NOT SCAN THE DILUENT. GIVE SUBCUTANEOUSLY ONLY!!