Immunisations are used to stimulate your body’s natural defences, to try and reduce the chance of you catching certain infections. If you have had particular types of cancer, or particular cancer treatments, you may not be able to have some of the vaccinations that you need in order to travel to some parts of the world. This may influence your choice of holiday destination.

Live attenuated vaccines use tiny amounts of the live virus or bacteria, which has been changed (attenuated) so that it does not cause the infection. They stimulate the immune system to develop protective white blood cells (antibodies) to protect against the infection.

If you have a weakened immune system you should not have live vaccines. Your immune system may be weakened if you have had chemotherapy or total body radiotherapy during the previous six months, or if you have had high-dose chemotherapy with a a stem cell transplant within the last six months. Steroid therapy can weaken your immunity for three months.

Live vaccines include:

• MMR
• oral typhoid
• BCG
• yellow fever.

Some people may need to avoid live vaccines for the rest of their lives; if they have had a lymphoma or leukaemia, for example, or if their cancer is related to HIV infection. You can check with your GP or cancer specialist whether it’s safe for you to have vaccinations.

Although inactivated vaccines are not dangerous, and are safe to give after cancer treatment, they may be less effective in people who have a weakened immunity.

Inactivated vaccines include:

• diphtheria toxoid
• tetanus toxoid
• pertussis (whooping cough)
• poliomyelitis injection
• haemophilus influenza B (Hib)
• influenza
• hepatitis A
• typhoid injection
• meningococcal meningitis
• Japanese encephalitis
• tick-bourne encephalitis
• hepatitis B
• rabies
• cholera.

If you have had high-dose chemotherapy and a stem cell transplant, you may have lost immunity to diseases that you were previously vaccinated against. You may need to be re vaccinated six months after your treatment.

The type of vaccinations you may need for your holiday will depend on where you are going. Your doctor can give you advice on what is best for you.

If you have lymphoedema in an arm, it’s important to make sure that vaccinations are given in the unaffected arm.

If you have had, or are about to have, your spleen removed (splenectomy), you will have a lower resistance to particular types of infection and should be vaccinated against pneumococcus haemophilus influenza type b and meningococcus, preferably before the splenectomy. Before travelling, your doctor should give you a supply of antibiotics and tell you when you should take them.

Malaria can be especially severe if you have had your spleen removed, and you may want to avoid travelling to countries where malaria is common. If you wish to travel to these countries, it’s essential to have appropriate protection against malaria. However, no medicinal protection is 100% effective, and using bed nets and repellents is important to make sure that you reduce your risk of getting malaria.

The Medical Advisory Service for Travellers Abroad (MASTA) can give information on vaccination.