Vaccinations and blood cancer

• People with blood cancer are often entitled to extra vaccines on the NHS.
• It’s important to get all the vaccines you’re recommended, to help protect you from infections.
• You may need to avoid some vaccines, called live vaccines.
• Your hospital team can give you advice about which vaccines you need, and when to have them.

Blood cancer and its treatment can weaken your immune system. This means you may be prone to picking up infections, as well as being more likely to get seriously ill from them. Vaccinations are one of the best ways to protect yourself from infection and keep yourself as well as possible. So it’s important to get all the vaccines you’re eligible for.

People you live with should also get any vaccinations they’re eligible for, to keep themselves safe and to reduce the risk of passing infections on to you.

As well as the routine vaccines recommended for everyone, people with blood cancer are often eligible for extra vaccines on the NHS. The main ones your doctor is likely to recommend are:

• flu vaccine
• pneumococcal vaccine
• shingles vaccine
• covid vaccine

Depending on your circumstances, you may also be eligible for:

• RSV (respiratory syncytial virus) vaccine – if you’re pregnant or aged 75 to 79 years
• MenACWY and MenB vaccines – if your spleen does not work well or has been removed.

All these vaccines are safe for people with blood cancer. You can read more about each of these vaccines below.

If you’re not sure what vaccines you need, speak to your GP or hospital team. They can check what vaccines you’ve had and which ones you might need.

You should be offered a free flu vaccine each year. This is available on the NHS for anyone at increased risk of getting seriously ill from flu. This includes people with blood cancer and people who’ve had blood cancer in the past.

People who live with you should also get a free flu vaccine on the NHS, to help protect you from infection.

How often do I need the flu vaccine?

You should get one dose of the flu vaccine every year, around autumn. The protection given by the vaccine fades over time, and the vaccine is updated each year to match the circulating flu viruses.

How to get the flu vaccine:

If you’re eligible for the flu vaccine you can:

• book an appointment at your GP surgery
• book an appointment online in England, Scotland, Wales or Northern Ireland.
• book an appointment through the NHS App
• visit a pharmacy or pop-up clinic offering walk-in appointments.

For winter 2025/2026, the last date you can get your flu vaccine is 31 March 2026. It’s best to get vaccinated as soon as you can to protect yourself through the winter.

Is the flu vaccine safe?

It’s safe to have the flu vaccine injection if you have blood cancer. The only people who cannot have the vaccine are those with serious allergies to the vaccine or its ingredients.

The nasal spray version of the flu vaccine is not recommended for people with a weakened immune system.

If your immune system is severely weakened (such as after a stem cell transplant) you should avoid close contact with anyone who’s recently had the nasal spray flu vaccine. You can have close contact again around two weeks after the vaccination.

The nasal spray flu vaccine is usually offered to children. Tell your child’s school nurse or GP if you’re concerned about them having the nasal spray flu vaccine. They may offer your child the flu injection instead.

The nasal spray flu vaccine is a live vaccine. Read more about live and non-live vaccines below.

You may need the pneumococcal vaccine. This can help to protect against pneumonia and some other serious illnesses. It’s offered on the NHS to people at higher risk from infection, including people with a weakened immune system from their condition or treatment. It’s also offered to everyone aged 65 and over.

How many doses do I need?

Your GP or hospital doctor will tell you how many doses you need, and when to have them. Many people just need a single, one-off injection. But some people may need more, such as:

• If you have a severely weakened immune system (including people with myeloma, chronic lymphocytic leukaemia (CLL) and other types of leukaemia): two injections, at least four weeks apart.
• If you’re getting re-vaccinated following a stem cell transplant: three injections. Your hospital team will let you know the interval needed between doses.
• If your spleen does not work well or has been removed: you’ll need a booster dose every five years.

When to have the pneumococcal vaccine

Your hospital team or GP can tell you the best time to have the pneumococcal vaccine. It’s available at any time of year.

If possible, you should have the pneumococcal vaccine before starting any blood cancer treatment that suppresses your immune system. The best time to have it is four to six weeks before starting treatment, but it can be given up to two weeks before.

If it’s not possible to have the pneumococcal vaccine before starting treatment, your hospital team will let you know the best time to have it. They may recommend waiting until after you’ve finished treatment. This is to make sure the vaccine works as effectively as possible.

Read more about the pneumococcal vaccine on the NHS website.

You will usually be invited to get a covid vaccine twice a year, in spring and autumn. It's important to repeat covid vaccinations regularly because the vaccines are updated to be more effective against new versions of the virus.

For up-to-date information, read our information about covid vaccinations for people with blood cancer.

The shingles vaccine is offered on the NHS for anyone who is 18 or over and has a severely weakened immune system. This includes many people with blood cancer.

You might also be eligible for the shingles vaccine because of your age. It’s available on the NHS for anyone turning 65, and for everyone aged 70 to 79.

How many doses will I need?

The shingles vaccine is given in two doses, between eight weeks and six months apart. These two doses give you long-term protection, so once you’ve had them, you won’t need to have the shingles vaccine again.

How to get the shingles vaccine

Your GP surgery should contact you about the shingles vaccine if you’re eligible for it. Speak to your GP if you think you should have the vaccine and haven’t heard from them. You can get the shingles vaccine at any time of year.

Is the shingles vaccine safe?

The shingles vaccine used in the UK (called Shingrix©) is a non-live vaccine, so is safe for people with blood cancer. The only people who cannot have the vaccine are people who’ve had a serious allergic reaction to the vaccine or an ingredient in it.

An older version of the shingles vaccine called Zostavax© was a live vaccine, but it’s no longer used in the UK.

Read more about the shingles vaccine on the NHS website.

The NHS has started vaccinating people against respiratory syncytial virus (RSV). RSV is a common cause of coughs and colds, but can lead to serious lung infections including pneumonia.

Whether you have blood cancer or not, you're eligible for the RSV vaccine if you’re aged 75 to 79, or turned 80 after 1 September 2024. It’s also recommended for people who are pregnant.

How many doses will I need?

If you’re eligible for the RSV vaccine because of your age, you will only need one dose. This gives protection for many years.

If you’re eligible for the vaccine because you’re pregnant, the vaccine is recommended during every pregnancy.

How to get the RSV vaccine

Your GP surgery may contact you about getting the vaccine if you are eligible. If you don’t hear from them, you can contact them to book an appointment. You can get the RSV vaccine at any time of year.

Read more about the RSV vaccine on the NHS website.

Sometimes blood cancer can affect how well your spleen works. The spleen is an important part of your immune system.

If your spleen does not work well, or needs to be removed, your doctor will usually recommend you have the MenACWY and MenB vaccines, to help protect you from serious illnesses like meningitis and sepsis. These doses are in addition to the ones most people have as a child and young adult.

Read more about the MenACWY and MenB vaccines on the NHS website.

People you live with should make sure they’re up-to-date with their routine vaccinations. This will help to protect you from infection, as well as protecting themselves.

To help protect you, the people you live with may be offered extra vaccines on the NHS. These are:

• annual flu vaccine
• chickenpox vaccine – if they’ve not had chickenpox before.

Live vaccines contain a weakened but live version of the illness they protect against. They’re also called attenuated vaccines.

Live vaccines should not usually 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.

Occasionally, your doctor might recommend you have a live vaccine if the benefits of having the vaccine outweigh the risk.

Examples of live vaccines include:

• nasal spray flu vaccine (usually given to children)
• MMR (measles, mumps and rubella)
• rotavirus
• BCG
• oral typhoid
• chickenpox
• yellow fever.

Vaccines that contain bacteria or viruses that have been destroyed are called ‘non-live’ or ‘inactivated’ vaccines. These are considered safe for people with blood cancer to receive.

Pneumococcal, shingles, covid-19, RSV, MenACWY and MenB vaccines are all types of non-live vaccine. The flu vaccine injection is also non-live.

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

After finishing treatment, you should avoid having live vaccines until your immune system has recovered. This is often six to 12 months after treatment, but if you’ve had a stem cell transplant or CAR T-cell therapy you should usually wait two years. Your hospital team can tell you when it’s safe to have live vaccines.

Some people may need to avoid live vaccines for life, even when they’re not on treatment. This includes people with chronic lymphocytic leukaemia and people with myeloma.

In most cases, it’s safe for people you’re in close contact with to have live vaccines. This is because there’s either no evidence that the live virus can pass on to you, or there is small risk of transfer, but this risk can be minimised by following simple steps.

You should take some precautions if someone you’re in close contact with has had the rotavirus, chickenpox or nasal spray flu vaccine. Click on the headings to find out more.

After a stem cell transplant, you’re likely to lose immunity to diseases you’ve been vaccinated against in the past. You’ll need to have some of your vaccinations again, including ones you had as a child.

You may also need to repeat some of your vaccinations after having CAR T-cell therapy. Your hospital team will give you advice about which vaccinations you need.

You’ll usually have your vaccinations at your GP surgery. Your hospital team will write to your GP to let them know which vaccinations you need and when. They should give you a copy of this letter too.

You’ll usually start your vaccinations six to 12 months after treatment, although some people might start them after three months if they’re well enough.

First published January 2026. Next full review due January 2029. We may make factual updates between reviews.

We would like to thank Consultant Haematologist Dr Dima El-Sharkawi and Advanced Pharmacist Nicholas McCabe for checking the clinical accuracy of this information.