A 10-year-old with leukemia is taking immunosuppressive drugs. To maintain health, the nurse should instruct the child and parents to:

• A. Continue with immunizations
• B. Not receive any live attenuated vaccines
• C. Receive vitamin and mineral supplements
• D. Stay away from peers

Answer: (B)

When the immune system is suppressed by leukemia treatment and immunosuppressive drugs, vaccines that contain live, attenuated organisms can cause actual infection rather than protect against it. The safest approach for a child on immunosuppressive therapy is to avoid giving any live attenuated vaccines during treatment and until immune function has recovered, with timing decided by the oncologist. Inactivated vaccines may be considered later if approved, but the live ones pose a real risk now. This doesn’t mean the child can’t receive protection from vaccines entirely—it's about choosing the vaccines that don’t contain live organisms and following the clinician’s guidance on timing. Supporting health also involves good nutrition and preventive practices, like hand hygiene and minimizing exposure to sick contacts, while ensuring household members are current with their vaccines to help protect the child.