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Vaccines required before entering bone marrow transplant centers in Germany
Patient protection starts with early vaccination
A bone marrow / stem cell transplant (Stammzelltransplantation) is among the most complex and delicate medical procedures used to treat blood diseases such as leukemia (Leukämie) or inherited immune disorders. Because the immune system is intentionally suppressed or destroyed before transplantation, preparation includes strict preventive measures—most importantly, completing core vaccinations for the patient and those around them.
Below is a detailed overview of vaccinations recommended before transplantation according to German standards (DGHO and STIKO).
Why are vaccines essential before a transplant?
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Because chemotherapy or radiotherapy before the transplant can severely weaken the immune system.
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Because after the transplant, the patient becomes highly vulnerable to serious infections.
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Because some vaccines cannot be given immediately after transplantation.
Core vaccines recommended before transplantation
According to German medical recommendations, the following vaccines should ideally be administered at least 4–6 weeks before the transplant date, if the immune system can still respond:
| Vaccine | Notes |
|---|---|
| Seasonal influenza (Influenza) | yearly; preferably shortly before transplant |
| Tetanus | if not updated within the last 10 years |
| Diphtheria | according to the primary schedule |
| Pertussis (whooping cough) | especially if not vaccinated in recent years |
| Polio | using an inactivated vaccine (not live) |
| Pneumococcal (Pneumokokken) | very important to prevent pneumonia |
| Hepatitis B | especially for unrelated-donor transplants |
| Measles–mumps–rubella (MMR) | only if clinically appropriate—live vaccine |
| Varicella (Varizellen / chickenpox) | with caution, only if there is enough time before transplant |
Note: Some live vaccines (such as MMR and varicella) are generally not allowed after transplantation until at least 24 months have passed and immune recovery is adequate.
What about people close to the patient?
Close contacts (family members, caregivers, frequent visitors) should:
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be fully vaccinated against measles, varicella, and influenza,
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have no active infection,
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follow strict hygiene measures (Hygienemaßnahmen).
Vaccinating the patient’s close environment is a direct protective strategy known as “cocooning.”
Who determines the vaccination schedule?
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the treating physician (oncologist or transplant physician),
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in coordination with the family doctor or vaccination center,
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based on comprehensive blood testing to assess existing antibodies.
Are vaccines different after transplantation?
Yes. After transplantation, the vaccination schedule is rebuilt gradually:
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usually starting 3–6 months post-transplant (for inactivated vaccines),
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live vaccines typically only after 24 months, if immune function is sufficient.
This process is called revaccination (Revakzinierung) and must be closely supervised.
Practical summary
| Question | Answer |
|---|---|
| Should vaccines be given before transplant? | Yes, if immune responsiveness is still present. |
| Are live vaccines allowed? | Only in limited cases and with sufficient time before transplant. |
| Should family members be vaccinated? | Yes, to protect the patient from infection. |
| Are vaccines repeated after transplant? | Yes, fully, according to a special schedule. |
| Who supervises the plan? | The transplant team + the family doctor. |
The site’s writing and editorial team strives to provide accurate information through intensive research and consulting multiple sources. However, errors may occur or certain information may be uncertain. Please treat the information as an initial reference and always consult the competent authorities for confirmed guidance.
