From the Guidelines
There is limited merit to this person's concern about receiving the MMR vaccine after cancer treatment with lymph node removal, as the current state of her immune function, not her history of cancer or lymph node removal alone, is the key consideration for vaccination safety. The MMR vaccine is a live attenuated vaccine, which means it contains weakened but still living virus particles, and for patients with severely compromised immune systems, live vaccines can potentially cause infection 1. However, most cancer survivors who are not actively undergoing immunosuppressive treatment can safely receive the MMR vaccine.
Key Considerations
- The time since cancer treatment completion: if she completed cancer treatment more than 3-6 months ago, the MMR vaccine would likely be safe.
- Current immune status: she should consult with her oncologist to assess her specific situation, including the type of cancer treatment received and current immune status.
- A negative measles titer indicates she lacks immunity to measles, which puts her at risk if exposed to this highly contagious disease. Some key points to consider:
- Adults born before 1957 generally are considered immune to measles and mumps, but this patient's negative measles titer indicates she lacks immunity to measles 1.
- The benefits of vaccination typically outweigh the risks for most cancer survivors who are not actively immunocompromised.
- The MMR vaccine can be administered to any person for whom the vaccine is not contraindicated, and adults who may be at increased risk for exposure to and transmission of measles, mumps, and rubella should receive special consideration for vaccination 1.
From the Research
Measles Titer and MMR Vaccine Concerns
- A 53-year-old female with a negative measles titer is concerned about receiving an employer-required MMR vaccine due to her prior cancer and lymph node removal.
- The concern is whether there is any merit to her worry, given her medical history.
Relevant Studies
- A study on vaccine-draining lymph nodes of cancer patients for generating anti-cancer antibodies 2 found that B cells can be recovered and expanded from human cryopreserved vaccine-draining lymph nodes, which could potentially be relevant to understanding immune responses in cancer patients.
- Another study on vaccine delivery systems toward lymph nodes 3 discussed the design principles and challenges of lymph node targeting vaccine delivery systems, which may be relevant to understanding how vaccines interact with the immune system in individuals with compromised lymph nodes.
- A review of cancer vaccines 4 highlighted the potential of therapeutic cancer vaccines, including their ability to target tumor neoantigens and induce antigen cascade, but did not specifically address the concern of MMR vaccine administration in cancer patients with lymph node removal.
- A study on the evaluation of peptide vaccine immunogenicity in draining lymph nodes and peripheral blood of melanoma patients 5 found that immune responses to vaccines can be detected in lymph nodes draining the vaccine site, which may be relevant to understanding immune responses in individuals with compromised lymph nodes.
- A recent review of mRNA vaccines for cancer immunotherapy 6 discussed the potential of these vaccines in advancing oncology, but did not specifically address the concern of MMR vaccine administration in cancer patients with lymph node removal.
Merit to the Concern
- While there is no direct evidence to support or refute the concern of MMR vaccine administration in a cancer patient with lymph node removal, the studies suggest that immune responses to vaccines can be complex and influenced by various factors, including lymph node function.
- The patient's concern may be related to the potential impact of lymph node removal on her immune response to the MMR vaccine, which is not directly addressed by the available studies.