Safe and Unsafe Vaccines for Cancer Patients: A Quick Guide
Health ConditionsCancer

Vaccines to Take or Avoid During Cancer Treatment

Vaccines to Take or Avoid During Cancer Treatment
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Published on November 5, 2025
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Cancer treatments like chemotherapy or radiation therapy kill cancer cells, but they can also kill healthy cells in the process, weakening your immune system and making it harder to fight infections. Vaccines can protect you from some serious infections — and for the most part, they’re safe to take during cancer treatment.

 But some vaccines may need to be given at certain times or delayed altogether, so it’s important to check with your oncologist before getting any.

Here’s what experts say about vaccination during cancer treatment.

Are Vaccines Safe for Cancer Patients?

Many inactivated (non-live) vaccines are safe to get during cancer treatment.

 But live, attenuated vaccines (those that contain a weakened form of the live virus) can make you sick if your immune system is too weak to handle them, says Diego Hijano, MD, a pediatric infectious diseases specialist and the medical director of occupational health at St. Jude Children’s Research Hospital in Memphis, Tennessee. “These [live] vaccines are generally avoided until the immune system recovers sufficiently,” he says.

Even when a vaccine is safe to receive during cancer treatment, it may not provide full protection, says Michael J. Davis, DO, MPH, an infectious diseases physician with Parkview Health in Fort Wayne, Indiana.

Your immune system is your body’s defense against viruses, bacteria, and other germs, Dr. Davis explains.

 When you get vaccinated, your body creates antibodies, which are proteins that recognize and fight infections.

 Because cancer treatments can weaken your immune system, your body might not be able to produce enough antibodies to make the vaccine work properly, says Dr. Davis.

Timing Matters

When you get vaccinated during cancer treatment is just as important as which vaccines you receive. Ideally, you’ll get all your vaccines before starting cancer treatment, but that’s not always possible, says Liz O’Riordan, MD, a breast cancer surgeon and survivor, and the author of The Cancer Roadmap.

The timing depends on several factors, including your blood counts (a measure of your white blood cells and immune function), the type of treatment you’re receiving, and which vaccine you need.

 Here’s a general timeline.
  • Before treatment starts: Live vaccines should be given at least four weeks before treatment, and non-live vaccines can be given at least two weeks ahead.

     This gives your body enough time to create antibodies and build protection before cancer treatment weakens your immune system, says Davis.
  • During treatment: Some vaccines, like the flu shot or COVID-19 vaccine, can be given while you’re in cancer treatment.

     “We usually don’t wait [to give the flu shot or COVID-19 vaccine], as even a partial immune response can offer some protection, which is especially important during outbreaks or the respiratory virus season,” says Dr. Hijano. Depending on your treatment schedule, your care team may recommend that you get vaccinated at the end of one cycle, just before the next one begins, says Dr. O’Riordan.

  • After treatment: Once treatment is completed, vaccines are usually delayed until your immune system has had time to recover, which is typically about three to six months for non-live vaccines.

     Live vaccines usually require waiting longer, often one to two years after finishing therapy, says Hijano.

Family members and close contacts should also stay up-to-date on their own vaccines to create a “protective cocoon” around you and reduce the risk of infection at home, says Hijano.

Type of Treatment Matters

If you’ve had a stem cell transplant, you’ll likely need to wait about six months before getting the flu or COVID vaccines, says O’Riordan. And if you have a blood cancer like leukemia, lymphoma, or myeloma, your oncologist may recommend avoiding vaccines during treatment altogether, she adds.

 Stem cell transplants tend to have the most significant and longest-lasting immune suppression (when your body’s ability to fight infections is weakened), says Hijano.
Chemotherapy and radiation usually cause temporary immune suppression.

 Once blood counts bounce back, vaccines can often be resumed, says Hijano. Targeted therapies and immunotherapy medications may affect specific parts of the immune system, so the decision about vaccination often depends on the exact medication and your overall health, he says. Your care team will look at your treatment plan, immune status, and timing to help decide which vaccines are safe and when you should receive them.

Vaccines to Consider

Below are some vaccines that may be recommended if you’re receiving cancer treatment, though you should only get them with approval from your cancer care team.

Influenza (Flu Shot)

The influenza (flu) vaccine is updated every year and is one of the most important ones to get during cancer treatment, says O’Riordan. Catching the flu while you’re already immunosuppressed from treatment can make you seriously ill and lead to complications, she says. You should get the flu shot every year to stay protected against the latest virus strains, and check with your oncologist about when to schedule it during your treatment cycle.

But get the injectable flu vaccine, not the nasal spray, known as FluMist. The nasal spray contains a live, weakened virus that isn’t recommended during cancer treatment.

COVID-19 Vaccine

Like the flu shot, the COVID-19 vaccine is updated annually to protect against new variants, says Davis. Getting vaccinated each year can help decrease your risk of severe COVID-19 complications.

 And you can get both the flu and COVID-19 vaccines at the same time, says O’Riordan.
COVID-19 vaccines that use messenger RNA (mRNA) might have extra benefits for people with certain cancers. One preliminary study found that people with lung cancer or melanoma who received the mRNA COVID-19 vaccine while taking a type of immunotherapy known as checkpoint inhibitors lived longer than those who didn’t.

 Researchers believe the vaccine may help the immune system better recognize and attack cancer cells, though more studies are needed to confirm this.

Respiratory Syncytial Virus (RSV) Vaccine

RSV is another respiratory infection worth protecting yourself against, especially during fall and winter months when these viruses spread more easily, says Davis. An RSV infection can cause serious illness in adults with weakened immune systems, including those in cancer treatment.

The Centers for Disease Control and Prevention (CDC) recommends RSV vaccination for everyone ages 75 and older, and for adults ages 50 to 74 who are at risk for severe illness from RSV.

Unlike the flu and COVID-19 vaccines, protection from an RSV vaccine lasts more than one year, so you don’t need to get it annually.

 If you haven’t had the RSV vaccine yet, your cancer care team can advise when it fits best with your treatment schedule.

Pneumococcal Vaccine

This vaccine helps protect against bacterial pneumonia, bloodstream infections, and meningitis, all illnesses that can lead to more complications during cancer treatment.

If you’ve had your spleen removed as part of your cancer treatment, getting the pneumococcal vaccine becomes even more important.

 “The spleen normally eliminates these bacteria from the body, so without your spleen, you need extra protection,” says O’Riordan. These vaccines are normally given at least two weeks before surgery to remove the spleen or two weeks (or more) after, she says.

Tetanus, Diphtheria, and Pertussis (Tdap)

If you are not up-to-date with Tdap, you should consider getting an adult booster, says O’Riordan. This combination vaccine helps protect against three bacterial infections.

 It’s generally safe during cancer treatment and doesn’t require any special precautions, says Davis.

HPV Vaccine

The human papillomavirus (HPV) vaccine helps prevent certain cancers caused by HPV infection. It may be recommended during treatment depending on your age and vaccination history.

Recombinant Herpes Zoster (Shingles) Vaccine

Shingles is a painful rash caused by the reactivation of the chicken pox virus. The recombinant zoster (shingles) vaccine is a non-live virus that’s recommended for adults 50 years and older, as well as those 19 years and older who have a weakened immune system.

Check with your oncology team about whether and when to get the shingles vaccine if you’re currently receiving cancer treatment.

Meningococcal Vaccines (MenACWY and MenB)

These vaccines help protect against bacterial meningitis and bloodstream infections. Like the pneumococcal vaccine, meningococcal vaccines are important if you’ve had your spleen removed or are scheduled for spleen removal surgery.

 When possible, these vaccines are given before the surgery. Otherwise, they’re typically offered after treatment, once your immune system has recovered.

Vaccines to Avoid

While many vaccines are safe during cancer treatment, live vaccines should be avoided if you’re receiving chemotherapy or any other treatment that weakens your immune system.

Hijano notes that the following live vaccines should be avoided during cancer treatment:

When Can You Get Live Vaccines Again?

Once you finish treatment, you’ll eventually be able to get live vaccines again, but your body needs time to recover first.

“You should wait at least six months before you have a live vaccine, unless you have a blood cancer, in which case you should wait at least one year,” says O’Riordan. If you’ve had a stem cell transplant, you must wait at least two years before getting a live vaccine.

 Your oncology team will let you know when it’s safe to resume these vaccines based on the treatment you received and your recovery.

Timing is important because the goal is to give you vaccines when your immune system is strong enough to build protection against infections, says Davis. Waiting also helps lower the risk of the weakened virus in a live vaccine causing illness while your body is still healing.

The Takeaway

  • Many vaccines are safe during cancer treatment, but live vaccines, which contain a weakened form of a virus, should be avoided until your immune system has recovered.
  • The timing of vaccines depends on your cancer type, treatment, blood counts, and which vaccine you need.
  • Non-live vaccines like the injectable flu shot, COVID-19, pneumococcal, and shingles vaccines are safe to receive during cancer treatment, but always check with your oncology team before scheduling any vaccination.
  • Live vaccines such as MMR, varicella, yellow fever, and the nasal spray flu vaccine should be delayed until your cancer care team confirms it’s safe.

Resources We Trust

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Kamboj M et al. Vaccination of Adults With Cancer: ASCO Guideline. Journal of Clinical Oncology. March 18, 2024.
  2. Einarsson J et al. Vaccination Considerations for Patients Receiving Cancer Therapy. Canadian Family Physician. October 2022.
  3. Immune System. Cleveland Clinic. October 20, 2023.
  4. Vaccines Protect You. U.S. Department of Health and Human Services. April 4, 2024.
  5. Sarkar L et al. Vaccination Practices, Efficacy, and Safety in Adults With Cancer: A Narrative Review. Cancer Research, Statistics, and Treatment. July 2021.
  6. Mekkawi R et al. COVID-19 Vaccination in Cancer Patients: A Review Article. Cancer Control. September 6, 2022.
  7. Altered Immunocompetence. Centers for Disease Control and Prevention. June 26, 2024.
  8. Silva-Pinto A et al. Vaccination After Haematopoietic Stem Cell Transplant: A Review of the Literature and Proposed Vaccination Protocol. Vaccines. December 23, 2024.
  9. Sharma A et al. Effects of Chemotherapy on the Immune System: Implications for Cancer Treatment and Patient Outcomes. Naunyn-Schmiedeberg’s Archives of Pharmacology. October 31, 2023.
  10. Vaccinations and Flu Shots for People with Cancer. American Cancer Society. September 24, 2025.
  11. Grippin AJ et al. SARS-CoV-2 mRNA Vaccines Sensitize Tumours to Immune Checkpoint Blockade. Nature. October 22, 2025.
  12. Vaccines for Adults . Centers for Disease Control and Prevention. July 8, 2025.
  13. Foran C et al. Importance of Vaccination for Disease Prevention in Post-Splenectomy Patients. BMJ Case Reports. October 8, 2021.
  14. Recombinant Zoster Vaccine VIS. Centers for Disease Control and Prevention. February 4, 2022.
  15. MMR Vaccine. Cleveland Clinic. May 9, 2025.
  16. About the Varicella Vaccines. Centers for Disease Control and Prevention. April 28, 2021.
  17. FDA Approves Nasal Spray Influenza Vaccine for Self- or Caregiver-Administration. U.S. Food and Drug Administration. April 28, 2021.
  18. Rotavirus Vaccination. Centers for Disease Control and Prevention. July 19, 2024.
  19. Yellow Fever Vaccine. Centers for Disease Control and Prevention. May 15, 2024.
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Tingting Tan, MD, PhD, is a medical oncologist at City of Hope National Medical Center.

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