I am likely to have an ASCT [autologous stem cell transplant] within the next month or two, most likely in one month. I have never had the pneumonia vaccine. I understand that the transplant wipes out prior vaccinations and after the transplant patients get revaccinated. I think it is also the case that after transplant patients are highly prone to infection, including pneumonia.
My question is should I have the pneumonia vaccine now, prior to transplant, or wait to be vaccinated at the appropriate time after transplant? In other words, is there any residual benefit that might protect me during and immediately following transplant by having the vaccine now?
How long does it take for the vaccine to take effect? Did you have the pneumonia vaccine prior to transplant? What have your doctors recommended? Any side effects to this vaccine?
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Re: Pneumonia vaccination prior to stem cell transplant?
Hi Classic Kate, I had the pneumonia vaccine, as well as all my childhood vaccines, and also the flu vaccine, after my auto transplant. Where I live, I had to wait a year to start the process, and get clearance also from the oncologists involved with the ASCT. I think that now the guidelines have changed and one can start getting re-vaccinated after six months.
The pneumonia vaccine protects against several strains of pneumonia, and is recommended for all seniors over age 65, or immune compromised patients (such as I was or am).
You should perhaps ask at your oncologists' or at the health clinic which gives out the vaccines, to get the guidelines about vaccination. It was presumed that I had lost all those sorts of immunities, but of course that was an assumption, and in order to get back some more protection, I got all the vaccines again!
It's possible that one's system cannot get a defence again after being re-vaccinated. Myeloma is tough on the immune system anyways!
The pneumonia vaccine protects against several strains of pneumonia, and is recommended for all seniors over age 65, or immune compromised patients (such as I was or am).
You should perhaps ask at your oncologists' or at the health clinic which gives out the vaccines, to get the guidelines about vaccination. It was presumed that I had lost all those sorts of immunities, but of course that was an assumption, and in order to get back some more protection, I got all the vaccines again!
It's possible that one's system cannot get a defence again after being re-vaccinated. Myeloma is tough on the immune system anyways!
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Nancy Shamanna - Name: Nancy Shamanna
- Who do you know with myeloma?: Self and others too
- When were you/they diagnosed?: July 2009
Re: Pneumonia vaccination prior to stem cell transplant?
Hi there. My husband had his SCT in September 2012 and is just now getting immunized today! Not sure what all they are immunizing him for but I will find out soon. They did however put him on some sort of a preventative pill after his SCT for pneumonia. He's been taking it every since his SCT.
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LizR
Re: Pneumonia vaccination prior to stem cell transplant?
When I was diagnosed in 2011 and had my SCT 2/12. The first thing my Myeloma Specialist told me was to get the pneumonia vaccine before my treatment even started. I have not revaccinated except for an annual flu vaccine. Why do I read such conflicting reports about getting the vaccine after SCT? I am confused.
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Junebug
Re: Pneumonia vaccination prior to stem cell transplant?
I was diagnosed with multiple myeloma in Feb 2011. I had a SCT in June. I wish I had been told to get the pneumonia vaccine, but I don't know that it would have helped.
One week after my SCT I got pneumonia. A day later I was admitted to the ICU. I became very sick and was put in a parallactic coma. I was given less than 10% chance of survival. After a little over 3 weeks in the ICU I was finally put in a regular room. When I woke up I had no muscle mass left and had a trac. All I could do was blink. It took me almost 3 months to be healthy enough and strong enough to leave the hospital.
Although my story is a rare one, I suggest that everyone's lungs be checked thoroughly before the SCT and get the pneumonia shot if it will help.
One week after my SCT I got pneumonia. A day later I was admitted to the ICU. I became very sick and was put in a parallactic coma. I was given less than 10% chance of survival. After a little over 3 weeks in the ICU I was finally put in a regular room. When I woke up I had no muscle mass left and had a trac. All I could do was blink. It took me almost 3 months to be healthy enough and strong enough to leave the hospital.
Although my story is a rare one, I suggest that everyone's lungs be checked thoroughly before the SCT and get the pneumonia shot if it will help.
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Cpierce
Re: Pneumonia vaccination prior to stem cell transplant?
I completely agree with your point, Cpierce, about getting one's lungs checked. Our son-in-law contracted Hodgkin's lymphoma and was on chemo. His numbers would drop significantly with each treatment so they would postpone the next one. They never gave him Neulasta nor would they even discuss it.
At about the halfway point, the tumor reversed it's shrinking and began to grow again. it was determined to give him another chemo regimen that was much harsher than the first one. When they did, his numbers dropped drastically and he contracted pneumonia. We almost lost him at that point. very scary. We were told later that he most likely had the virus in his lungs before the last chemo treatment but that the chemo caused his immune system to fail which allowed the pneumonia to grow very quickly.
Get your lungs checked out really well if possible. it may very well save your life!
At about the halfway point, the tumor reversed it's shrinking and began to grow again. it was determined to give him another chemo regimen that was much harsher than the first one. When they did, his numbers dropped drastically and he contracted pneumonia. We almost lost him at that point. very scary. We were told later that he most likely had the virus in his lungs before the last chemo treatment but that the chemo caused his immune system to fail which allowed the pneumonia to grow very quickly.
Get your lungs checked out really well if possible. it may very well save your life!
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Guitarnut - Name: Scott Hansgen
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Sept 2011
- Age at diagnosis: 47
Re: Pneumonia vaccination prior to stem cell transplant?
As part of the prep for my SCT (at Johns Hopkins), I was checked for infections (cold, sinus, bronchitis) and breathing capacity. In fact, they sent me for a CAT scan, which indicated a deep seated sinus infection I didn't know I had. Right after the SCT, I was put on a regimen of pills, including ones to fight pneumonia. Like everyone, I became neutropenic, although not like everyone, I got sick enough to be in-patient for a week. I never developed pneumonia, though.
I got two pneumonia injections as part of my re-vaccinations. I know that the childhood disease vaccines didn't take (i.e., I didn't develop antibodies), although I don't know about the pneumonia vaccine. But, knock on wood, I've had bronchitis several times since but not pneumonia.
I got two pneumonia injections as part of my re-vaccinations. I know that the childhood disease vaccines didn't take (i.e., I didn't develop antibodies), although I don't know about the pneumonia vaccine. But, knock on wood, I've had bronchitis several times since but not pneumonia.
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darnold - Name: Dana Arnold
- Who do you know with myeloma?: self
- When were you/they diagnosed?: May 2009
- Age at diagnosis: 52
Re: Pneumonia vaccination prior to stem cell transplant?
See:
"Protective antibody responses to pneumococcal conjugate vaccine after autologous hematopoietic stem cell transplantation"
Antin JH, Guinan EC, Avigan D, Soiffer RJ, Joyce RM, Martin VJ, Molrine DC.
Biol Blood Marrow Transplant. 2005 Mar;11(3):213-22
Abstract: Patients undergoing autologous hematopoietic stem cell transplantation (autoHCT) are at increased risk for infection with Streptococcus pneumoniae and have impaired antibody responses to pneumococcal polysaccharide vaccines. We performed this study to examine the ability of autoHCT patients to respond to a heptavalent pneumococcal conjugate vaccine (PCV7) given after transplantation and to determine whether there was a potential benefit of immunizing these patients before stem cell collection. Sixty-one patients scheduled for autoHCT were randomized to receive either PCV7 or no vaccine before stem cell collection. After stem cell reinfusion, all study patients were immunized with PCV7 at 3, 6, and 12 months. Pneumococcal immunoglobulin G antibody concentrations were measured at the time of each immunization and 1 month after the 12-month dose. Serotype-specific pneumococcal antibody concentrations were significantly higher in patients immunized with PCV7 before stem cell collection compared with patients not immunized before their stem cells were collected for 6 of 7 serotypes at 3 months, 6 of 7 serotypes at 6 months, 4 of 7 serotypes at 12 months, and 3 of 7 serotypes at 13 months. After the 3-dose series of PCV7 after autoHCT, >60% of study patients had protective concentrations of antibody to all 7 vaccine serotypes regardless of immunization before stem cell collection. Pneumococcal conjugate vaccine is immunogenic in autoHCT patients and may be an effective strategy to prevent invasive disease after transplantation.
http://www.bbmt.org/article/S1083-8791(04)00983-8/abstract
But I would really consult with the transplant doctor on this subject, as there appears to be conflicting messages on the web regarding this subject.
"Protective antibody responses to pneumococcal conjugate vaccine after autologous hematopoietic stem cell transplantation"
Antin JH, Guinan EC, Avigan D, Soiffer RJ, Joyce RM, Martin VJ, Molrine DC.
Biol Blood Marrow Transplant. 2005 Mar;11(3):213-22
Abstract: Patients undergoing autologous hematopoietic stem cell transplantation (autoHCT) are at increased risk for infection with Streptococcus pneumoniae and have impaired antibody responses to pneumococcal polysaccharide vaccines. We performed this study to examine the ability of autoHCT patients to respond to a heptavalent pneumococcal conjugate vaccine (PCV7) given after transplantation and to determine whether there was a potential benefit of immunizing these patients before stem cell collection. Sixty-one patients scheduled for autoHCT were randomized to receive either PCV7 or no vaccine before stem cell collection. After stem cell reinfusion, all study patients were immunized with PCV7 at 3, 6, and 12 months. Pneumococcal immunoglobulin G antibody concentrations were measured at the time of each immunization and 1 month after the 12-month dose. Serotype-specific pneumococcal antibody concentrations were significantly higher in patients immunized with PCV7 before stem cell collection compared with patients not immunized before their stem cells were collected for 6 of 7 serotypes at 3 months, 6 of 7 serotypes at 6 months, 4 of 7 serotypes at 12 months, and 3 of 7 serotypes at 13 months. After the 3-dose series of PCV7 after autoHCT, >60% of study patients had protective concentrations of antibody to all 7 vaccine serotypes regardless of immunization before stem cell collection. Pneumococcal conjugate vaccine is immunogenic in autoHCT patients and may be an effective strategy to prevent invasive disease after transplantation.
http://www.bbmt.org/article/S1083-8791(04)00983-8/abstract
But I would really consult with the transplant doctor on this subject, as there appears to be conflicting messages on the web regarding this subject.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Pneumonia vaccination prior to stem cell transplant?
Thanks to each of you. Your responses are greatly appreciated. I see my Doctor Thursday. If I learn something significant, I will report back for others. Cpierce, I am sorry you experienced such a scare, but very glad you are doing well now. Multibilly, thanks for the references/research.
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