Vaccine Considerations for People with Weakened Immunity
Diseases or conditions
If a child or adult has leukemia, lymphoma, other types of cancers or HIV, they should not receive vaccines made with what are known as the "live, weakened" viruses — that is, they should not receive the measles, mumps, rubella (MMR), rotavirus, varicella (chickenpox), or intranasal version of influenza vaccines.
Find more specific guidance:
- People with immune-compromising conditions
- People with cancer
- People who have had or will be having a solid organ transplant
Steroids
Steroids, which can weaken the immune system, are often given to people with diseases such as asthma, rheumatologic diseases and poison ivy. If people are taking steroids for any reason, they should discuss with their doctor whether it is safe to proceed with the vaccination schedule. In general, the following rules apply:
Steroid creams or sprays (aerosols)
It is safe to be vaccinated. The use of topical or inhaled steroids does not prevent the administration of vaccines.
Steroids taken by mouth for less than two weeks
It is safe to be vaccinated.
High doses of steroids taken by mouth for more than two weeks
People should not receive "live, weakened" vaccines if they have been taking high doses of steroids by mouth for more than two weeks. A high dose is considered to be that greater than 2 milligrams (mg) per kilogram [2.2 pounds] of prednisone per day. The live viral vaccines include measles, mumps, rubella, varicella (chickenpox), rotavirus, and intranasal version of influenza. These vaccines can be given about three months after steroids have been stopped, although the rotavirus vaccine has age restrictions, so patients should discuss their situation with their healthcare provider.
Biologics
People taking biologics, which are medications that target the immune system, may have particular vaccine considerations. See “Vaccines and biologics: What you should know” for more information.
Additional resources
Reviewed by Paul A. Offit, MD on September 06, 2022