From the Guidelines
It is generally not recommended to receive the MMR vaccine if you have lymphocytopenia, even if you're no longer on immunosuppressant therapy, due to the potential risk of vaccine-related complications or inadequate protection against measles, mumps, and rubella. The MMR vaccine contains live attenuated viruses, which can potentially cause infection in people with weakened immune systems. Your immune system needs to be functioning adequately to safely receive this vaccine and develop proper immunity. Before considering the MMR vaccine:
- Consult your doctor for a thorough evaluation of your current immune status.
- Get a complete blood count (CBC) to assess your immune cell levels.
- Your doctor may recommend waiting until your immune cell counts have recovered to normal levels.
- In some cases, alternative vaccination strategies or additional precautions may be necessary. The reason for caution is that even without current immunosuppressant therapy, lymphocytopenia indicates your body may not be able to properly control the vaccine viruses or mount an effective immune response, as supported by the study 1. This could potentially lead to vaccine-related complications or inadequate protection against measles, mumps, and rubella. Additionally, the study 1 suggests that live-attenuated vaccines, such as the MMR vaccine, should be avoided in patients under immunosuppressive therapy, but may be considered in patients at risk of contracting measles infection, such as travelers, after a thorough evaluation of their immune status. It is essential to follow the specific advice of your healthcare provider regarding vaccinations, as individual medical situations can vary.
From the Research
Lymphocytopenia and MMR Vaccine Administration
- Individuals with lymphocytopenia may be able to receive the Measles, Mumps, and Rubella (MMR) vaccine after discontinuing immunosuppressive therapy, depending on their immunological parameters 2.
- A study found that immunization with live attenuated vaccines, including MMR, might be effective and safe for patients receiving immunosuppressive agents if their cellular and humoral immunological parameters are within normal levels 2.
- However, another study noted that live vaccines are generally contraindicated in patients on immunosuppressive therapy due to the risk of replication of the attenuated vaccine microorganism 3.
Safety of Live Vaccines in Immunocompromised Patients
- A retrospective study found that live vaccines, including MMR, were administered to patients on immunosuppressive/immunomodulatory therapy without serious side effects or infections by the attenuated vaccine strain 3.
- Another study found that the risk of transmission associated with live attenuated vaccines is low, and routine vaccination with live attenuated vaccines is recommended for all household contacts of immunocompromised patients and for healthcare workers caring for such patients 4.
- A study on multiple myeloma patients on maintenance lenalidomide or bortezomib after autologous hematopoietic cell transplantation found that live-attenuated MMR vaccination was safe and well-tolerated 5.
Considerations for Vaccination
- The safety of live-attenuated vaccines in patients using IL-1 or IL-6 blockade has not been extensively studied, and guidelines recommend withholding live-attenuated vaccines in these patients due to the risk of infection 6.
- However, a survey found that some patients on IL-1 or IL-6 blockade who received live-attenuated vaccines did not experience serious adverse events, but prospective trials are needed to acquire more evidence about the safety and efficacy of live vaccines in these patients 6.