Injected live-attenuated vaccines such as measles-mumps-rubella (MMR), measles-mumps-rubella-varicella (MMRV) and varicella (chickenpox) monovalent vaccination may be affected by circulating antibodies in immunoglobulin therapy or other blood products. This includes normal human immunoglobulin therapy for conditions like Kawasaki’s disease or a red blood cell, platelet or plasma transfusion for treatment of a medical condition.

There are recommended intervals between immunoglobulins or other blood products and administration of injected live attenuated vaccines [see resources].

These intervals are based on the expected amount of immunoglobulin (antibody) in the different blood products. Concerns are regarding reduced efficacy of injected live-attenuated vaccines in this setting; there are no additional safety concerns.

For some patients requiring regular red-blood cell transfusions for a chronic haematologic condition, it may be considered appropriate to proceed with immunisation with a live-attenuated vaccine. For further details see MVEC: Live-attenuated vaccines in patients receiving regular red blood cell transfusions.

Note that inactivated (non-live) vaccines can be safely administered at any time following blood products.


Authors: Nigel Crawford (Director, SAEFVIC, Murdoch Children’s Research Institute) and Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children’s Research Institute)

Reviewed by: Luisa Clucas (MVEC Immunisation Fellow)

Date: July 2020

Materials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.

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