The
immune response of the body is suppressed by
cytotoxic antineoplastics. The effectiveness of
vaccines may be poor and generalised
infection may occur in patients immunised with live
vaccines. In one study the antibody response to pneumococcal
vaccination was reduced by 60% in patients receiving antineoplastics, and suboptimal responses to influenza and measles
vaccines have been reported.
Extreme care should be taken when considering vaccinating immunosuppressed patients, especially with live vaccines, which should generally be avoided. Monitor the
immune response to other types of
vaccine. Consider whether
vaccination can be carried out prior to or following
methotrexate use.