{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T17:46:38Z","timestamp":1791567998070,"version":"4.3.4"},"reference-count":151,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T00:00:00Z","timestamp":1744243200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Children with hemato-oncological diseases represent a heterogeneous population at heightened risk for vaccine-preventable diseases. Their immunosuppressed state reduces vaccine efficacy and raises safety concerns regarding live attenuated vaccines due to the risk of viral reactivation. The immunological and clinical implications of the single conditions are significantly different; therefore, specific vaccination strategies are needed. Despite the availability of vaccine guidelines for immunocompromised patients, clinical practice remains highly variable. It is generally recommended to avoid vaccinations during chemotherapy, with some exceptions for influenza, pneumococcal, and, in some countries, hepatitis B vaccines. The timing of immune recovery after chemotherapy depends on the specific treatment and most guidelines recommend administering vaccines 3\u20136 months after treatment cessation. Concerning HSCT, the timing of immune recovery is affected by several factors such as the HSCT platform, graft-versus-host disease (GvHD), and infections. Inactivated vaccines are typically administered 3\u20136 months post-HSCT, while live attenuated vaccines are delayed for at least two years. In children with asplenia or hyposplenism, recommendations focus on immunization against encapsulated bacteria, with tailored schedules based on the patient\u2019s age and underlying condition. This paper explores the biological factors influencing vaccination efficacy and safety in pediatric hematology and oncology patients. It also provides an updated overview of the available evidence and current vaccination guidelines. Finally, this paper highlights the main clinical and research areas for further improvement to provide tailored vaccination schedules for this vulnerable population.<\/jats:p>","DOI":"10.3390\/vaccines13040397","type":"journal-article","created":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T05:28:07Z","timestamp":1744262887000},"page":"397","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Vaccinations in Pediatric Hematology and Oncology: Biologic Basis, Clinical Applications, and Perspectives"],"prefix":"10.3390","volume":"13","author":[{"given":"Baldassarre","family":"Martire","sequence":"first","affiliation":[{"name":"Unit\u00e0 Operativa Complessa (UOC) of Pediatrics and Neonatology, Maternal-Infant Department, \u201cMonsignor A.R. Dimiccoli\u201d Hospital, 70051 Barletta, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6995-4791","authenticated-orcid":false,"given":"Alessandra","family":"Beni","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Felicia","family":"Mastrototaro","sequence":"additional","affiliation":[{"name":"Unit\u00e0 Operativa Complessa (UOC) of Pediatrics and Neonatology, Maternal-Infant Department, \u201cMonsignor A.R. Dimiccoli\u201d Hospital, 70051 Barletta, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronica","family":"Santilli","sequence":"additional","affiliation":[{"name":"Research Unit of Clinical Immunology and Vaccinology, Academic Department of Pediatrics (DPUO), IRCCS Bambino Ges\u00f9 Children\u2019s Hospital, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgio","family":"Ottaviano","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Fondazione IRCCS San Gerardo Dei Tintori, 20900 Monza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Montin","sequence":"additional","affiliation":[{"name":"Division of Pediatric Immunology and Rheumatology, \u201cRegina Margherita\u201d Children Hospital, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caterina","family":"Rizzo","sequence":"additional","affiliation":[{"name":"Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7493-5226","authenticated-orcid":false,"given":"Mayla","family":"Sgrulletti","sequence":"additional","affiliation":[{"name":"Pediatric Immunopathology and Allergology Unit, Policlinico Tor Vergata, University of Rome Tor Vergata, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8369-5957","authenticated-orcid":false,"given":"Michele","family":"Miraglia del Giudice","sequence":"additional","affiliation":[{"name":"Department of Woman, Child and of General and Specialized Surgery, University of Campania \u201cLuigi Vanvitelli\u201d, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4160-3727","authenticated-orcid":false,"given":"Giorgio","family":"Costagliola","sequence":"additional","affiliation":[{"name":"Section of Pediatric Hematology and Oncology, Azienda Ospedaliero Universitaria Pisana, 56100 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7650-0632","authenticated-orcid":false,"given":"Viviana","family":"Moschese","sequence":"additional","affiliation":[{"name":"Pediatric Immunopathology and Allergology Unit, Policlinico Tor Vergata, University of Rome Tor Vergata, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e14100","DOI":"10.1111\/tid.14100","article-title":"Vaccinations in children with hematologic malignancies and those receiving hematopoietic stem cell transplants or cellular therapies","volume":"25","author":"Neemann","year":"2023","journal-title":"Transpl. 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