目前接種的活性疫苗項目條列如下:

²  腺病毒疫苗

²  卡介苗

²  減毒活流感疫苗（鼻內）*

²  減毒口服脊髓灰質炎病毒活疫苗*

²  麻疹、腮腺炎和風疹疫苗

²  麻疹、腮腺炎、風疹和水痘疫苗

²  麻疹疫苗

²  腮腺炎疫苗

²  口服傷寒疫苗*

²  輪狀病毒疫苗

²  德國麻疹疫苗

²  天花疫苗

²  水痘疫苗

²  黃熱病疫苗

²  帶狀皰疹疫苗活性疫苗

關於癌友可能需要接種的活性疫苗，我們再來複習一下:

2013 年美國免疫實踐諮詢委員會 (ACIP) 建議指出，嚴重免疫功能低下患者當暴露於麻疹的應該接受 400 mg/kg 的靜脈注射免疫球蛋白，無論先前的疫苗接種或免疫狀態如何。而嚴重免疫功能低下的癌症患者，包括急性淋巴細胞白血病接受治療直至完成治療至少六個月的患者。

由於水痘疫苗很少會造成傳染，因此易感家庭和癌症患者的其他密切接觸者可以接種將水痘疫苗。如果家庭接觸者在接種疫苗後出現皮疹，則家庭接觸者應避免直接接觸免疫功能低下的癌症患者。

一項研究評估了水痘疫苗對於白血病治療後處於緩解期兒童的療效。第一次和第二次接種後的血清抗體轉化率分別為 88% 和 98%。幾乎沒有副作用，根據這項研究，在完成化療後接種水痘疫苗對於易感的成年腫瘤患者進行免疫保護是合理的。

據報導，一名罹患有復發性瀰漫性大 B 細胞淋巴瘤的成人在自體造血幹細胞移植後4 年接種疫苗，因水痘疫苗的活化病毒導致了播散性致命感染；該患者雖已多年未接受化療，但後來追查其腹部出現新的淋巴結，證實是瀰漫性大 B 細胞淋巴瘤復發。

最後的總結和建議

²  對於越來越多的免疫力低下的患者來說，尤其是癌友，感染的預防確實是至關重要。這些患者的感染通常會導致過高的發病率和死亡率，並且抗感染治療的療效通常不如免疫力未受損的健康者有效。

²  雖然接種疫苗似乎是預防感染的具體方法，但許多免疫力受損的患者無法因疫苗接種而主動產生確切的保護性免疫反應。此外，多免疫力受損的患者進行活性病毒疫苗接種可能導致減毒活化而不受控制地增殖。

²  對於成年癌症患者，所有符合適應症的疫苗均應該在化療、其他免疫抑制藥物前、放療治療開始前或脾臟切除術前給予。符合適應症的滅活疫苗應在化療前至少2 週前給予，符合適應症的活性病毒疫苗應在化療前至少4 週給予。

²  原則上，接受化療或其他免疫抑制治療的癌症患者不應該接種活性疫苗。目前已有的活性減毒疫苗包括卡介苗（BCG）、水痘疫苗（Varicella）、麻疹腮腺炎德國麻疹混合疫苗（MMR）、黃熱病疫苗（Yellow fever）、輪狀病毒疫苗（Rota）、口服小兒麻痺疫苗（OPV）、日本腦炎疫苗（JE）等。白血病、淋巴瘤或其他惡性腫瘤患者，其疾病處於緩解期，未接受過抗 B 細胞抗體（如利妥昔單抗、阿崙單抗），且化療已終止至少三個月，可以接受活病毒疫苗，例如根據年齡特定的建議接種麻疹、腮腺炎、風疹和水痘疫苗。對於已接受抗 B 細胞抗體的患者，滅活疫苗和活疫苗的接種應至少推遲六個月。

#癌症病患疫苗

#疫苗接種時間

#肺炎鏈球菌結合疫苗

#帶狀皰疹疫苗#流感疫苗

#新冠疫苗#水痘疫苗

#破傷風疫苗

#白喉疫苗

#百日咳疫苗

#感冒噬血桿菌疫苗

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此處文章乃是醫療照護資訊的整理，請勿引據文章內容自行採取醫療決定；如有臨床治療之需求，建議還是應該尋求專業醫療人員的協助。

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