Staying safe

If you notice any new symptoms or side effects at any time, always let your hospital team or GP know straight away. Ask if there’s anything in particular you should watch out for.

It’s really important to watch out for infections if you’ve been diagnosed with blood cancer, because a minor infection could become serious very quickly.

Symptoms of an infection include:

• feeling hot or cold (a temperature that’s higher or lower than normal)
• sore throat
• cough producing green mucus
• frequent watery poos (diarrhoea)
• being sick (vomiting)
• feeling dizzy or faint
• headache or stiff neck
• skin feeling red, hot or swollen
• burning or stinging when you wee or passing a small amount
• pain, redness or discharge (fluid) around the site of a central line
• pain, itching or unusual discharge from your penis or vagina
• new pain anywhere in your body
• generally not feeling well.

If you have any symptoms of infection, it's important to get medical help. Follow our guidance on what to do.

We have more information about infections and reducing your risk.

You can reduce your risk of getting infections by getting all the vaccinations you are entitled to. Your doctor may recommend a range of vaccinations to keep you safe. They will also tell you when it's best to have them.

Live vaccines may not be safe for people who are immunosuppressed (who have a weakened immune system) because of blood cancer or its treatment. Ask your doctor whether this applies to you.

All of the vaccinations listed below are safe for people with blood cancer because they are not live.

You will probably be advised to have the flu vaccine each year. This is available on the NHS for anyone who is at increased risk of getting seriously ill from flu. If you haven’t been told about it, ask your hospital team or GP whether you should have it.

If there are people you spend lots of time with, it may be sensible for them to have the flu vaccine too. 

You may also need the pneumonia (pneumococcal) vaccine. This is a vaccine offered on the NHS for people at increased risk from pneumococcal infection. This includes people with a weakened immune system from cancer or cancer treatments.

Most people who need the pneumonia vaccine only need a single, one-off vaccination. But you may need a booster dose every 5 years if your spleen does not work properly. Ask your hospital team or GP if this applies to you.

Covid-19 vaccines are safe and effective for people with blood cancer. It's important to repeat covid vaccinations regularly because the vaccines are updated to be more effective against new versions of the virus, the same as flu vaccines. For up-to-date information, read our information about covid vaccinations for people with blood cancer, and how to book them.

What is shingles?

Shingles is an infection of a nerve and the skin around it. It can affect you if you’ve had chickenpox, even if you had it a long time ago. It's caused by the same virus, which can lie dormant in your body for years. You’re more likely to get shingles if your immune system isn’t working well – for example, if you have blood cancer.

Shingles has some quite obvious symptoms. If you think you have it, let your GP or hospital team know as quickly as possible. Symptoms include:

• a rash – with blisters filled with fluid, which burst and form sores that crust over (the rash is usually confined to one side of the body)
• an itching, tingling or burning feeling
• pain where the rash is.

You can’t catch shingles from someone who has it, but you can catch chickenpox from someone with an open shingles sore, if you haven’t had chickenpox already.

Shingles vaccination programme

In the UK, there is a national vaccination programme to protect people against shingles. The vaccine used is called Shingrix®. Shingrix is not a live vaccine so it is safe for people with blood cancer to have it.

People with a weakened immune system, including people who have blood cancer or had it in the past, can have shingles vaccinations from the age of 50.

Shingrix® is given in two doses. The second dose should be given from 8 weeks to 6 months after the first one. You only need these two vaccinations - you won't need to repeat the course.

You should be invited by your GP for a shingles vaccination. If not, contact them to ask about it.

Shingles vaccinations from age 18 in England

From 1 September 2025, the NHS in England will be offering shingles vaccinations to everyone with a weakened immune system from the age of 18. This means that every adult who is at higher risk from shingles can be protected against it.

We will update this information if we hear that the other nations of the UK are changing the age range for shingles vaccinations.

From September 2024, the NHS has started vaccinating people against respiratory syncytial virus (RSV) for the first time.

RSV is a common cause of coughs and colds, but can lead to serious lung infections including pneumonia which are highly dangerous in older people and young children.

Ahead of the winter, the NHS will be vaccinating older adults (and pregnant people) against RSV. This aims to prevent thousands of hospital admissions and RSV illnesses in older adults.

The RSV vaccine is based on age. So regardless of whether you have blood cancer or not, you are eligible for the RSV vaccine from age 75.

If you're aged 75 to 79, you are eligible for the RSV vaccine. Your GP or local NHS team will invite you.

If you turn 80 on or after 1 September 2024, you are eligible for the RSV vaccine until 31 August 2025. Your GP will invite you.

If you are 74 or under, you are not eligible for the RSV vaccine yet, but you'll be invited when you turn 75.

If you turned 80 before 1 September 2024, you are not eligible for the RSV vaccine.

The vaccine will also be offered to pregnant people (from 28 weeks of pregnancy) to protect the baby for the first few months after they're born.

If you are eligible for the RSV vaccine but have questions or concerns about having it, you should ask your hospital team or GP. The vaccine aims to prevent you getting RSV illnesses, especially over the winter, which can lead to dangerous lung infections in older people. If your immune system is weakened because of blood cancer or its treatment, it is even more important to protect yourself from infection.

As with all vaccines, if you have a weakened immune system, you might not get as much protection from the vaccine as other people. This is because vaccines work with your immune system to give you immunity. Although vaccines can be less effective in some people with blood cancer, they usually still offer some protection, and are seen as highly important in protecting you from avoidable infections.

The patient information leaflet that comes with the RSV vaccine mentions that if you have a bleeding problem, bruise easily, or if you have a weakened immune system, to check with a doctor, pharmacist or nurse before having the vaccine.

This is routine advice for many vaccinations and does not mean the vaccine isn't safe for you. If you have any worries, check with your hospital team before getting an RSV vaccination, so you can be reassured before your appointment.

Live vaccines are vaccinations that contain a weakened but live version of the illness they protect against.

Live vaccines should not be given to people whose immune system isn’t working properly, either due to blood cancer or its treatment, because they can cause infection. Ask your hospital team or GP whether this applies to you.

Examples of live vaccines are the nasal spray flu vaccine, MMR (measles, mumps and rubella), rotavirus, BCG, oral typhoid, chickenpox and yellow fever. The shingles Zostavax® vaccine is also live, but the non-live alternative Shingrix® is now used in national shingles vaccination programmes.

If you are getting any type of vaccination, always mention your diagnosis and say if you’re not allowed a live vaccine. 

People you’re in close contact with should still get all of their vaccinations, including live vaccines. If you are in close contact with someone who’s recently had a live rotavirus vaccine, then regular hand washing and maintaining good hygiene, particularly during close contact, food preparation, or nappy changing if a baby has been vaccinated, should minimize any small risk.

If someone you know has the shingles vaccine and develops a rash afterwards, avoid contact with the rash.

For some people with blood cancer, if they ever need a blood transfusion, they must receive irradiated blood (blood that’s been treated with radiation).

This is because of the risk of transfusion-associated GvHD (graft versus host disease) – where your immune system rejects the transfused blood.

If this applies to you, you should be given an alert card to carry at all times.

People who are at risk of transfusion-associated GvHD and need irradiated blood are:

• All adults and children with Hodgkin lymphoma at any stage of the disease – for life.
• People who’ve had an allogeneic (donor) stem cell transplant – from conditioning therapy until six months post-transplant, or indefinitely if GvHD is present.
• People who will be having an autologous transplant (using their own stem cells) – before and during harvesting of their stem cells or bone marrow, and from conditioning therapy until three months post-transplant (or six months post-transplant if total body irradiation was used).
• Blood stem cell or bone marrow donors – prior to or during harvest.
• People who’ve been treated with fludarabine, cladribine, deoxycoformicin, alemtuzumab, bendamustine or clofarabine.

Some treatments for blood cancer are photosensitive (sensitive to light). If you are on a photosensitive drug, you are more likely to suffer from burns and blisters when out in the sun. You will also have a slightly increased risk of developing skin cancer.

Photosensitive drugs include:

• Hydroxycarbamide
• Ruxolitinib
• Methotrexate
• Nivolumab
• Prembolizumab
• Cytarabine
• Vinblastine
• Co-trimoxazole and ciproflaxin
• Tetracyclines

It is really important to look after yourself and your skin, especially if you are prescribed a photosensitive treatment. The NHS has advice about how to stay safe in the sun, and you can also read our sun safety tips here.

If you're worried or unsure about the treatment you're on, speak to your GP or hospital team or call our Support Service on 0808 2080 888.