PCV13 Vaccination After Herceptin Therapy
Yes, you can safely receive PCV13 two months after completing Herceptin (trastuzumab) therapy. Herceptin is a monoclonal antibody targeting HER2, not an anti-B-cell antibody, and does not cause the profound immunosuppression that would contraindicate pneumococcal vaccination.
Key Considerations for Timing
The 2-month interval after Herceptin is appropriate and safe for PCV13 administration. The IDSA guidelines specifically address timing concerns for cancer patients receiving various therapies 1:
- Inactivated vaccines like PCV13 should be given 3 months after completing cancer chemotherapy 1
- For regimens containing anti-B-cell antibodies (such as rituximab), vaccination should be delayed at least 6 months 1
- Herceptin (trastuzumab) is NOT an anti-B-cell antibody—it targets HER2 receptors on cancer cells, not CD20 on B lymphocytes 1
Clinical Rationale
Your immune system should be sufficiently recovered at 2 months post-Herceptin to mount an adequate vaccine response. The evidence supports this approach:
- Patients with solid tumor malignancies should receive PCV13 as newly diagnosed adults with cancer 1
- The standard recommendation is to wait 3 months after chemotherapy for inactivated vaccines, but this primarily applies to intensive cytotoxic chemotherapy 1
- A small study showed similar vaccination responses to PCV13 in patients receiving daratumumab (a CD38 monoclonal antibody) compared to those on non-daratumumab regimens 1
Important Caveats
Do not proceed with vaccination if you are currently receiving intensive chemotherapy or have received anti-B-cell antibodies within the past 6 months 1:
- Patients receiving intensive chemotherapy (such as induction or consolidation for acute leukemia) are unlikely to respond adequately to vaccination 1
- Anti-B-cell antibodies significantly impair vaccine response for at least 6 months 1
- If you received both Herceptin AND chemotherapy, ensure you are at least 3 months out from the last chemotherapy dose 1
Vaccination Schedule
Follow the standard PCV13 dosing for adults with cancer 1:
- Administer PCV13 first as a single dose 1
- Follow with PPSV23 at least 8 weeks after PCV13 for adults and children aged ≥2 years 1
- This sequence optimizes immune response by priming with the conjugate vaccine before the polysaccharide vaccine 1
Annual influenza vaccination is also recommended for cancer patients not receiving intensive chemotherapy or recent anti-B-cell antibodies 1.