My great great grandparents emigrated to Nova Scotia from Scotland in the 1840’s. 

Of course their lives were much more difficult compared to how we live today, but the thing that stands out in my great great grandmother’s own account of her life is how many children she had and how many died during childhood. 

Of her 14 children, seven did not survive to adulthood. All of them died of infec­tious diseases. This cast a pall on her remaining life. My great grand­mother, who was the seventh child, wrote that her mother forever mourned those children she had lost.

So in those days, before antibiotics had been discovered and vaccinations were available, people were very vulnerable to any sort of deadly infection. 

Being immune-compromised because of the treatments I have had for myeloma brought the story of my great-grandmother’s life to my mind.

Although most of us are protected by vaccines we have received, there are isolated outbreaks of preventable diseases resurfacing in pockets all over the country. In recent years, cases of measles and whooping cough have been reported, mostly in children. 

This development is probably due to the fact that some parents are no longer having their children vacci­nated. They are frightened of the vaccines and the adjuvants that make the vaccines more effective. They are relying on the ‘herd effect,’ the fact that most of the population is vaccinated, to keep their children healthy.

Most of us are protected by vaccines, and thus it is difficult for an epidemic to occur, since it has to be spread from person to person. The main ‘herd’ will prevent an epidemic. 

Terrible devastation can be caused by deadly communicable diseases when a population is not immune to a particular pathogen. For example, the Black Death in Europe (1348-1350), caused by the Yersinia Pestis bacterium, killed an estimated 30 percent to 60 percent of the population. First Nations peoples in the Americas could not withstand the epidemics of smallpox, measles, and influenza introduced by the Europeans at the time of ‘contact.’ As a result, in many tribes, more than half of the people succumbed to those diseases.  Early in the last century, the Spanish Flu epidemic of 1918 killed more people than had died in WW1 - an estimated 20 to 40 million, the worst recorded health disaster. 

The knowledge of these sorts of historical pandemics has convinced most people to obtain vaccinations when they are available.

Before my stem cell transplantation, I read a thick handbook of what to expect during and following the procedure. Along with other information (for example, that I would stay in hospital for two to three weeks, which proved to be outdated), it was mentioned that I could probably receive back my attenuated vaccines that I had received during childhood one year after the transplant and the ‘live’ vaccines two years after the transplant. 

So 11 months after my transplant, in December 2010, I called the public health clinic about this. It turned out that I could not just book an appointment to get vaccinated, so I talked to my oncologist about it.  He had to get the ‘go ahead’ from the bone marrow transplant clinic. That clinic faxed the request over to the public health clinic. That took some time, but by mid-February 2011, I went into the clinic to receive my childhood vaccines again.   

I don’t know if the majority of myeloma patients who are eligible to receive vaccines do get the whole series of them. The ‘herd effect’ certainly protects most of us from any contact with those infections. 

However, I was nervous about my compromised immune system and the lack of antibodies in my blood.  A random encounter with another person carrying viruses or bacteria could mean that I could catch such diseases as tuberculosis, measles, diphtheria, pertussis (whooping cough), and more.

During the first session of immunization, I received diphtheria, tetanus, pertussis, polio, hepatitis B, and influenza vaccines as well as Haemophilus influenza B (Hib), meningococcal, and pneumococcal vaccines. 

The public health nurse who administered the vaccines to me worked solely with patients who had received transplants, including autologous and donor stem cell transplants as well as solid organ transplants, such as kidneys. (The vaccination protocols, however, differ depending on which kind of transplant the patient receives.)   

The nurse was very thorough and caring. She meticulously noted which vaccine she used on which arm. The procedure was to have me wait for awhile afterwards to make sure I felt okay to drive myself home. Any fevers were to be reported to the clinic. I did have some side effects of swelling and itching afterwards and had to use an ice pack and take antihistamines and Tylenol to reduce both.  It reminded me of being stung by wasps.  Oh well, no outdoor biting insects in February, but the same general effect. 

Two month later, in April, I had booster shots for those vaccines. Going into the health clinic, amongst all the young moms and dads and their infants, I had a sense of déjà vu. I had taken my babies into the same clinic a quarter century earlier!   

The second anniversary of my transplant prompted more faxes from the cancer clinic stating that I was well enough to receive the ‘live’ vaccines. These included measles, mumps, rubella, and varicella.  The varicella (chickenpox) vaccine is supposed to also protect against shingles, since both diseases are caused by the same virus, varicella zoster. I also had to get the third in the series of shots for diphtheria, tetanus, polio, hepatitis B and Hib. 

This was a major undertaking, and they split all the shots over two weeks and once again used both arms to administer them. The side effects were quite bothersome again, but myeloma treatments make you nothing if not stoical in regard to medical procedures!

As I write, I still need to get booster shots for measles, mumps, and rubella, but basically I could say that my CV (childhood vaccines) is complete now. 

I have also received the pneumococcal shot, which protects against many strains of pneumonia. It is recommended for seniors over the age of 65 and for anyone with immune deficiencies. 

I still get my flu shots every fall and any other recommended vaccines. If I were brave enough to go some­place in the tropics where other vaccines are recommended, I could go to a travel clinic to get them, but should get medical advice on that too.

Because I started to get my vaccines when I was taking Revlimid ^[1] (lenalidomide) at a low dose, I worried that my compromised immune system at that time, as shown by blood tests, would counteract the effectiveness of the vaccines in producing antibodies. That was when I had started to read The Beacon, and I noticed an article stating that Revlimid had actually been shown to enhance the effect of vaccines (see related Beacon ^[2] news)! That was a pleasant surprise.

Every time I go past our local health clinic now I think of the kindness of the nurses assigned to transplant patients and all the recently acquired antibodies that I hope are circulating within me!  

I also smile when I think of all the little ones who go there to start out on life with a better chance of good health.

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The quotation for this month is from Jonas Salk (1914-1995), inventor of the Salk vaccine against polio, who wrote "Nothing happens quite by chance. It’s a question of accretion of information and experience."