Pretransplant vaccinations in allogeneic stem cell transplantation donors and recipients: an often-missed opportunity for immunoprotection?

Immune deficiency following hematopoietic cell transplantation predisposes the patient to potentially deadly infections. Vaccinations can improve immunity and thus reduce the morbidity and mortality associated with these infections. Over the years different sets of guidelines have been published the most recent by the Infectious Diseases Society of American (IDSA). There is limited evidence that vaccination of donors and/or recipients before transplantation may improve immunity. However, despite the possibility of augmented immunity, there remain logistical, ethical and medical concerns about such a vaccination strategy.