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Should new childhood vaccinations include HPV vaccination (even if not received as a child)?
We know that post transplant there comes the time when patients need to have their childhood vaccinations again. For some younger patients they will have received the HPV vaccination when a teenager. I have two questions directed to the medical staff: firstly, do those patients who had received the HPV vaccination as a child receive those vaccines again, and, secondly, do/should all patients be offered the HPV vaccination (given a (extended) period of suppressed immunity)? Thanks
Comments
Hi AH67,
I'm Rachel- Lead Nurse here at Anthony Nolan. Thank you for your enquiry, it's a really important question to ask. The short answer is yes to both. There was recent guidance published from the British Society of Bone Marrow Transplant jointly with the Children's Cancer and Leukaemia Group and the British Infection Association which addresses the HPV vaccination/re-vaccination. The joint consensus statement outlines that patients should receive it following stem cell transplant whether they have been vaccinated in childhood or not (see excerpt from the article below)
"we recommend that all HSCT recipients aged 12 or over are offered 3 doses of HPV vaccine. Pragmatically in order to limit the number of vaccinations given at any one time point to a maximum of 4, we recommend commencing paediatric HPV vaccination from 6 months post-HSCT, and adult HPV vaccination from 18 months. However, consideration can be given to earlier HPV vaccination in selected adult patients considered at higher risk of HPV in the first 18 months post HSCT."
In the UK the vaccination guideline is called the 'Green Book' within this vaccination of patients following stem cell transplant is addressed under Chapter 7 and acknowledges the need for re-vaccination of childhood vaccines, it is yet to be updated to include this specific information but it does outline that speciality guidance should be followed (which is the BSBMT guidance).
The HPV vaccine is important as it reduces the risk of secondary cancers developing, this is because the human papillomavirus virus that vaccine works against, is known to increase the risk of cervical, mouth and throat cancers occurring.
I hope this has been a helpful response to your question.
Kind regards
Rachel
Good Afternoon
I am new to this Forum so many thanks for allowing me to join!
I had my SCT on February 2nd I am now taking a maintenance tablet daily when should I have my immunisations?
Thanks
Anita x
Hi Anita,
If you have had an Allograft then you would usually be advised to re-start childhood vaccinations 6 months after transplant. The timing should be confirmed by your transplant team for you individually as they'll know the details of any complications you may have encountered and current medication you are taking. Live vaccines are not commenced until at least 2 years after SCT- this would be the MMR vaccination. The shingles vaccination is generally suggested for administration a year after SCT and for transplant patients this should be the shingrix vaccine not the live vaccine. You should also recommence COVID vaccinations.
I hope that's of some help to you. At your next appointment (if its in the near future) I'd definitely ask about when they'd like you to start your vaccination programme- this is delivered by your GP practice (COVID vaccination by a vaccination hub) so your transplant centre may provide a letter to advise of the need. If you don't have an appointment with your transplant centre soon then get in touch with your specialist nurse for some advice.
Kind regards
Rachel
Hi Rachel
Thank you for your response I will certainly ask the team at my next appointment.
Anita x