[darnold]

Repeat vaccinations post SCT - anybody had them?

by darnold on Tue Jan 27, 2015 5:41 pm

Hi everyone,

I have a follow-up question to Eric's question about the MMR vaccine.

After my stem cell transplant (SCT), I went through a process to receive vaccines for all of the childhood immunizations plus hepatitis B plus pneumonia. The last vaccine was chicken pox, followed by a test to see if I had developed antibodies. Supposedly, I hadn't developed antibodies to any of the vaccines.

That was three years ago, and I'm considering trying some of the vaccines again, particularly Hep B, TDP, and pneumonia. And probably shingles since I had shingles last summer and don't ever want to go through that again.

Has anyone else gone through the vaccination process twice? Results?

Thanks!

Dana A

[Nancy Shamanna]

Re: Repeat vaccinations post SCT - anybody had them?

by Nancy Shamanna on Wed Jan 28, 2015 9:53 am

Hi Dana,

I think that you should check with the myeloma specialists about taking the vaccines again. The live shingles vaccine isn't recommended because it can cause shingles. If you have already had shingles, would you now have some immunity to it? There was a clinical trial thread in the Beacon about a new type of shingles vaccine that was not as virulent. I took the varicella shot (for chickenpox) which may provide protection also against shingles, since the two diseases share the same type of virus.

I think that the pneumonia vaccine may be given twice, five years apart in time. There are guide­lines for that depending on whether one is older or younger than age 65. Best to check it with the experts!

Hope that helps.

[Eric Hofacket]

Re: Repeat vaccinations post SCT - anybody had them?

by Eric Hofacket on Wed Jan 28, 2015 11:48 am

Dana,

After your first round of vaccinations, you had not developed any antibodies to any of the vaccinations? I have not heard of that being a problem or issue before and I wonder how common that is. That sounds like an immune system that is still not functioning or recovered after the transplant. How was it determined that you had no antibodies to any of the vaccinations?

When I went in for my MMR vaccination last Saturday, the nurse said for an adult they normally take a blood sample and test it for MMR antibodies before they give the MMR vaccination. I told the nurse that my understanding was that after my transplant three years ago all previous vaccination where rendered ineffective and I would not be expected to have any antibodies to measles and to skip the blood test and just go ahead with the MMR vaccination.

Did they do some kind of antibodies test to determine that you had not developed any antibodies to the vaccinations you received after the transplant? I have not had any test like that.

[candydaddario]

Re: Repeat vaccinations post SCT - anybody had them?

by candydaddario on Wed Jan 28, 2015 6:49 pm

I had a SCT 2 years ago. Since then, I have had immunization for tetanus / diphtheria / whooping cough. I received 3 shots, I think, and there was one month each time between them. For pneumonia, I had two different shots, and I think they were two months apart. I had all these shots at stem cell transplant.

I have been told not to get immunizations with live viruses - measles and shingles.

I had the higher dose flu shot this year.

[bluebird]

Re: Repeat vaccinations post SCT - anybody had them?

by bluebird on Wed Jan 28, 2015 9:29 pm

Dana,

I wonder how soon it was after your transplant that you had your immunizations? My specialist doesn't give them until a year after the transplant. His reason is that your immune system won't develop a proper response any sooner. The only thing that I have had is a flu shot.

Bluebird

[wesley]

Re: Repeat vaccinations post SCT - anybody had them?

by wesley on Wed Jan 28, 2015 9:49 pm

I had a stem cell transplant at Mayo in February last year. I started the reimmunization cycle at the local health department in December. I had the second round of shots in January, and I finish up in February.

The shingles vaccine is recommended at two years out, as is measles / mumps / rubella (MMR), because these are live viruses. I was advised to not get the MMR because it would make me ineligible for the massive dose of measles vaccine being tested as a myeloma cure at the Mayo Clinic. And it is a year away, anyway

I've had no problems with the pneumonia / flu / hepatitis vaccines I have received the past two months. There may be a couple more I'm not remembering at the moment.

I know that the different transplant centers tend to make somewhat different recommendations on the immunization issue.

Wesley

[Eric Hofacket]

Re: Repeat vaccinations post SCT - anybody had them?

by Eric Hofacket on Wed Jan 28, 2015 10:13 pm

I had my transplant three years ago and just got the MMR vaccine last Saturday. Normally, my doctor does not give the MMR vaccine unless there is some kind of significant risk of exposure to measles, such as working in health care or around crowds such as those at airports or Disneyland, where they have had a recent outbreak.

It seems improbable to get measles in the US and it is, but Disneyland is just under an hour drive away from me. My friends who have season passes just missed by a few days being there when the recent outbreak occurred, and asked if I want to go back with them during a time period when the outbreak was occurring, but I declined.

My bigger concern is I plan to travel to France this June and I learned measles is much more common in Europe so I decided to go ahead and get the MMR vaccine thinking the risk of exposure could be high there, especially in the airports and on planes. The last thing I want to have happen is to have to be quarantined in a foreign county with the measles, complicated by a compromised immune system and myeloma, unable to get home.

By getting the MMR vaccine, I just eliminated myself from the Mayo clinical trial that uses the measles virus. I do not know how soon that treatment would be available to me if it gets FDA approval, but it seems it would be a number of years out.

If I get another transplant someday, which is highly likely, then I could use that treatment after­wards if it is available.

Last edited by Eric Hofacket on Thu Jan 29, 2015 1:12 pm, edited 1 time in total.

[mikeb]

Re: Repeat vaccinations post SCT - anybody had them?

by mikeb on Thu Jan 29, 2015 11:43 am

As a follow-up to Eric's question/comment about testing for MMR antibodies -- back in June, one year after my SCT, my myeloma specialist tested me for a bunch of different antibodies before I started getting re-vaccinated. I was surprised to see in the test results that I was positive for the measles antibody. But negative for the mumps antibody, as I would have expected.

As a child, I had a pretty rough case of measles, so maybe that built up my measles antibodies to an especially high level. Just guessing ...

I think he said that I would get the MMR vaccine two years out from my SCT. I know I have not gotten that yet.

Mike

[darnold]

Re: Repeat vaccinations post SCT - anybody had them?

by darnold on Fri Jan 30, 2015 9:28 am

After I went through the series of vaccinations, the last step was to take a blood sample and look for antibodies to chicken pox, which was the last vaccine. I didn't have any. My oncologist then did a blood test looking for antibodies to hepatitis B. Not there. Enough time has gone by -- and my immune system is functioning, as evidenced by a lot less respiratory infections than in the first year or two post SCT -- that my oncologist thinks I can try some of the vaccines again.

Although I live in the East, and the current measles outbreak is in the Western states, I am concerned about exposure via someone who flew in from the West for a meeting. So, before I tried the vaccines again, I wanted to see if anyone had had a similar experience to mine.

Thanks for your replies everyone!

Dana A