The Immunization Clinic for Hematopoietic Stem Cell Transplant Recipients

This information describes the care you will receive at the Immunization Clinic at Memorial Sloan Kettering (MSK).

Your immune system is your body’s own defense against infection and disease. After having a hematopoietic stem cell transplant (HSCT), you will probably have a weakened immune system. This means you are at a higher risk for infection and disease. This happens after both allogeneic and autologous transplants. 

After your HSCT, you will need to receive several vaccines. Vaccines can protect you from preventable infections and diseases, such as tetanus, diphtheria, pertussis (whooping cough), Haemophilus influenzae, polio, and pneumococcal pneumonia. You probably had some or all of these vaccines as a child, but they may no longer protect you after your transplant. Your doctor has referred you to the Immunization Clinic to ensure you receive all of the vaccinations you need during your follow-up care.

Most people will start receiving vaccines about a year after their transplant. Once the vaccination process begins, it can take up to 2 years to complete. The vaccines are given in “rounds” or series, one after the other. To ensure you are protected, we will measure your body’s immunity (ability to avoid an infection or disease) after all your vaccinations are completed.

Clinic Guidelines

The vaccines we give in the Immunization Clinic are routine ones that both children and adults commonly receive in the US. You will not be given any experimental vaccines, unless you previously enrolled in a clinical trial with your doctor.

The clinic follows recommendations from the Centers for Disease Control and Prevention (CDC) and the Advisory Committee for Immunization Practices (ACIP), as well as guidelines from the Center for International Blood and Marrow Transplant Research (CIMBTR).

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Receiving Your Care

At the Immunization Clinic, you will be cared for by a nurse practitioner (NP). Your NP and your doctor(s) work together and are part of the same treatment team. During your visits, your NP will:

  • Review your medical history.
  • Perform a short physical exam.
  • Draw your blood to check if you still have immunity from vaccines you received as a child. These blood levels are called titers.
  • Review the results of your immune function tests and titers.
  • Create a vaccination schedule for you.
  • Give you the vaccines (up to 6 in 1 visit).
  • Review your future travel plans, as well as make referrals to the MSK travel clinic, if necessary.
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Your Vaccination Schedule

You will receive a vaccination schedule while you are at the Immunization Clinic. The sample schedule below includes vaccines you may get at the clinic. Your NP will review these with you during your first visit, along with any other vaccines that may be offered to you. For each vaccine you receive, you will be given information about possible reactions.

After you received 3 rounds of vaccinations, you will have another blood test to make sure your body has responded to them. If you have not responded well to any of the vaccines received, you may receive an additional 4th dose of certain vaccines before receiving the booster round. 

Start time
after transplant
Number of Doses
Dose  #1 Date Dose #2 Date Dose #3 Date Dose #4 Date Booster Date
Inactivated influenza
4-6 months
    NA NA  
12 months
Haemophilus influenza conjugate
12 months
Inactivated polio
12 months
Combined Hepatitis A and B 12 months 3       NA NA
Pneumococcal Conjugate (PCV) 12 months 4-5          
Measles/Mumps/ Rubella 24 months 1-2     NA NA NA
Varicella 24 months 2     NA NA NA
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