[WeatherNurse13]

Vaccines post ASCT

by WeatherNurse13 on Thu Nov 21, 2013 6:12 pm

I am curious why some transplant doctors will not allow live vaccines (like MMR), while some consider giving them at 24 months.

My transplant doctor told me NEVER to receive another live vaccine, ever! I had to give up my nursing position in the hospital nursery since I am not immune to measles mumps or rubella (titers were drawn). I moved to another department and went back to work just this week, 13 months after diagnosis, 9 months post ASCT.

Thanks!

[Multibilly]

Re: Vaccines post ASCT

by Multibilly on Fri Nov 22, 2013 5:29 pm

There just doesn't seem to be a consensus in the medical industry (which seems to be the case with so many things wrt multiple myeloma) regarding vaccine types and schedules after transplant. Some facilities and organizations have set policies, such as Alberta's policy listed here:

http://www.albertahealthservices.ca/hp/if-hp-cancer-guide-bmt-hsct-slideshow.pdf

On the flip side, I've had two different doctors here in the US tell me different stories when I discussed this topic with them. I have no idea if their respective transplant centers in the USA have set policies on vaccine timing after ASCT (including the use of live vaccines), or if they are just administered at the discretion of the doctor.

[Dr. Jason Valent]

Re: Vaccines post ASCT

by Dr. Jason Valent on Fri Nov 22, 2013 5:41 pm

If you are in the US, the recommendations for vaccines post ASCT are on the CDC website which is http://www.cdc.gov. Search vaccine and transplant and it is pretty easy to find (currently it's at this link). MMR is recommended at 2 years.

[darnold]

Re: Vaccines post ASCT

by darnold on Fri Nov 22, 2013 7:41 pm

I have a related question about whether the vaccines work. After my (autologous) SCT, I went through a process of getting all my childhood immunizations again. The last was chicken pox, followed by testing to see if I had antibodies. I didn't. My oncologist then ordered a test for Hep B. I had no antibodies to it, either. I've had a Hep B booster, and I get a flu shot every year, but I have no idea if I have any protection from the vaccines.

Has anyone else experienced this?

Dana

[JimNY]

Re: Vaccines post ASCT

by JimNY on Fri Nov 22, 2013 7:47 pm

There was an opinion column about vaccinations a while back, where the columnist (Nancy Shamanna) went through her experience with vaccinations after transplantation. It might be of interest to some people reading this thread:

https://myelomabeacon.org/headline/2012/08/09/northern-lights-getting-my-cv-in-order/

[Nancy Shamanna]

Re: Vaccines post ASCT

by Nancy Shamanna on Fri Nov 22, 2013 8:54 pm

Thanks for referencing my column, Jim NY, and posting the AHS info on revaccination after a stem cell transplant, Multibilly!
Although here not all patients do get re-vaccinated after an ASCT, it is available. You have to be cleared though the bone marrow transplant unit. I have been told that sometimes the vaccinations do not 'take' in immunocompromised patients, but I would rather have the vaccines since I am just doing everything possible to maintain good health!
I see that the guidelines here have changed since I had my vaccines back in 2011. I had them starting a year after my ASCT, but now it is six months.
There are recurrent outbreaks of infectious diseases such as measles since nowadays there is an 'anti vaccine' movement which deters many parents from vaccinating their infants. Hope that helps!

[darnold]

Re: Vaccines post ASCT

by darnold on Sun Nov 24, 2013 1:38 pm

Thanks everyone. Just as an FYI, my post-transplant instructions from Johns Hopkins included getting re-vaccinated. My local oncologist had a vaccination schedule which he shared with my internist. I didn't need pre-clearance from anyone, including insurance, to get the vaccines.