[jhorner]

IVIG therapy and vaccination

by jhorner on Fri Sep 19, 2014 11:58 am

Hello,

I am a smoldering patient receiving monthly IVIG therapy and I was wondering if I should get the pneumonia vaccine now that I have a pseudo immune system? I had the varicella vaccine and booster when I had MGUS and still got the variclla virus anyway, so I stopped all vaccinations because they were not working.

I meet with Infectious Disease next month, but was wondering if anyone else on IVIG was told that vaccination was advisable?

Best
J

[Dr. Heather Landau]

Re: IVIG therapy and vaccination

by Dr. Heather Landau on Sat Sep 20, 2014 11:37 am

Hi jhorner,

This can be tricky. IVIG gives you what we call "passive" immunity, meaning that antibodies are transferred to you and those help you fight infection. Although indeed this gives you a "pseudo" immune system, it does not indicate that you can mount an "adaptive" immune response if you were given a vaccine. An adaptive immune response occurs when you are exposed to a bacteria or virus (or parts of viruses / bacteria present in a vaccine), and your own immune cells respond in a robust way such that you are protected in the future from infection due to that particular virus / bacteria.

It does not sound like you responded to the varicella vaccine. But, on the other hand, the down side to getting the vaccine is small. Without knowing the details of your immune cells at present, I can't give firm recommendation on whether you should receive additional vaccinations; I am glad you are seeing infectious disease next month!

Best,
Heather Landau

[lys2012]

Re: IVIG therapy and vaccination

by lys2012 on Sat Sep 20, 2014 1:04 pm

I can't speak to the medical side but can share my experience.

I've had myeloma since 2010 but been in remission until this spring/summer.

I've had shingles twice before my diagnosis ( a few years apart). My doctor thinks I was smoldering back then before my actual diagnosis. The shingles were once on my chest, and once on my face (eyebrow).

Since treatment I've had a few vaccines, one being the Pneumovax shot.

I had a lung infection or pneumonia once. Then I got the vaccine and have not had it again. I think it has some effect. If you can get it for free, I don't think there is any harm in getting the shot?

Shingles vaccine is a live vaccine, I believe, so not recommended for myeloma patients. And seeing how I've had shingles twice, my body does not seem able to make antibodies to this anyway. Instead, I take long term antivirals to prevent it (ask your ID doctor about it).