Visiting family abroad after a long period of illness, realizing a dream or gaining distance from cancer – these can all be reasons why cancer patients plan a long-distance trip. This now allows for improved treatment options and an associated better quality of life for many of those affected.
However, cancer patients who have a weakened or impaired immune system due to their illness or therapy are considered “travellers with special risks”:
- They are more susceptible to infections than healthy people.
- The vaccination protection you have already developed may be impaired or new vaccinations may only show a reduced vaccination response.
- Not every travel vaccination is suitable for you.
The Standing Vaccination Commission (STIKO) and the German Society for Tropical Medicine, Travel Medicine and Global Health (DTG) dedicate a separate chapter to these risk groups in their travel vaccination recommendations updated in 2023.
Good to know
If the illness or cancer treatment has not particularly weakened the immune system, the same travel vaccination recommendations apply as for healthy people.
Influence of chemotherapy and other cancer drugs on travel vaccinations
Important
Most of the study data on vaccinations after or during cancer therapy is available for classic chemotherapy. However, the number of new cancer drugs is constantly growing. In the following we will therefore speak of “antineoplastic therapy”: It includes classic chemotherapy, but also other classes of substances.
Antineoplastic therapy can reduce the protection acquired through previous vaccinations.
That’s why experts advise: Were vaccinations fully completed before cancer treatment – i.e. had the patient completed basic immunization? You should then repeat these vaccinations once. The prerequisite is that the immune system has already recovered. In the case of travel vaccinations, this applies, for example, to vaccinations with inactivated vaccines against
- rabies
- TBE (“tick vaccination”)
- Japanese encephalitis
- Hepatitis A and B
- Polio (child paralysis)
Inactivated vaccine: killed pathogen or fragments of a pathogen. This also includes so-called vector and mRNA vaccines.
Live vaccine: weakened pathogen
When to repeat vaccinations? Normally, 3 months after antineoplastic therapy, the immune system has returned to normal to such an extent that an adequate immune response from inactivated vaccines can then be expected. If the trip requires vaccination with a live vaccine against yellow fever, for example, experts recommend an interval of 6 months after the end of cancer therapy.
Has there been no basic immunization for travel vaccinations yet? Then the same travel vaccination recommendations apply as for healthy people, as soon as the immune system has normalized.
What applies after a stem cell transplant?
Cancer patients need to go after one Stem cell transplantation assumes that any previously established vaccination protection has been completely lost. The background is that the preceding intensive chemotherapy leads to a complete loss of the existing immune system.
Live vaccines are initially contraindicated: As long as those affected have a very weakened immune system, they are not allowed to receive live vaccines. This can result in life-threatening infections. In travel medicine, this primarily applies to yellow fever vaccinations and live vaccinations against typhoid and cholera.
- Important to know: At least 24 months apart and after the immune system has recovered, a live vaccination is in principle possible again for people after stem cell transplantation.
Inactivated vaccines possible at a distance: Transplant patients can only receive inactivated vaccines required for travel from 6 months after the stem cell transplant without safety concerns. However, experts point out that one cannot always assume that there is sufficient protection. For individual vaccines, such as against hepatitis A, a later start to vaccination or, depending on the time of vaccination, several doses of vaccine may be necessary.
Get advice on vaccinations in good time before traveling
- If you want to travel during or after cancer treatment, you should seek travel medical advice in good time before long-distance travel. As a rule, there must be an interval of several months between the end of cancer therapy and the travel vaccinations.
- If the cancer treatment has severely affected the immune system, you should also start travel vaccinations several months before departure if possible. This allows the doctor to check the success of the vaccination in the blood if necessary. This way he or she can decide whether additional vaccine doses are necessary.
- Expect that not only will individual new vaccinations be required, but booster vaccinations of existing vaccinations may also be necessary.
For further reading
Recommendations from the Standing Vaccination Commission (STIKO) and the German Society for Tropical Medicine, Travel Medicine and Global Health (DTG) on travel vaccinations (PDF). Epid Bull 2023;14:1–194, doi: 10.25646/11201.2
Laws HJ, Baumann U, Bogdan C, Burchard G, Christopeit M, Hecht J, Heininger U, Hilgendorf I, Kern W, Kling K, Kobbe G et al. Vaccination for immunodeficiency: Application instructions for the vaccinations recommended by the Standing Vaccination Commission. (III) Vaccination in hematological and oncological diseases (antineoplastic therapy, stem cell transplantation), organ transplantation and asplenia. Federal Health Gazette Health Research Health Protection. 2020 May;63(5):588-644. doi: 10.1007/s00103-020-03123-w.
The text Preventing Cancer Infections provides information on vaccination recommendations for cancer.
To download and print: Information sheet “Cancer vaccination: Safe and effective?” (PDF)
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