ESMO Clinical Practice Guidelines recommend that antiviral prophylaxis should be used in patients at very high risk of developing infections and pneumococcal vaccination as well as seasonal influenza vaccination are recommended in early-stage CLL (Eichhorst et al., 2017).

Similarly, the UK guidelines recommend (Oscier et al., 2012):

  • Streptococcus pneumoniae and Haemophilus influenzae type B vaccination at diagnosis.
  • Yearly vaccination against seasonal and novel influenza strains.
  • Avoidance of vaccination with live vaccines.
  • Avoidance of vaccination 2 weeks prior to, or for 6 months after chemoimmunotherapy.