Good Question Series: Special Edition – Vaccine Follow-up Questions

Answer:

Great question. Receiving live vaccines is absolutely fine if you are not immunosuppressed. Live vaccines should be avoided in people who have been treated with B cell depletion within the past year unless it has been confirmed that B cell concentrations have returned to normal. Patients who are receiving other immunosuppressive medications such as prednisone, azathioprine, and mycophenolate also should not receive these live vaccines unless the medications are held for approximately 1 month.

Answer:

Yes. We share the significant concern within the scientific community that the failure to continue to invest in life-saving science will bite us in the future. The mRNA vaccines, developed in record time during the COVID pandemic, were enabled by research done only a few years earlier on the problem of Zika virus. During the COVID pandemic, the mRNA vaccines likely saved millions of lives across the world, and their immense contribution to humankind was recognized in the bestowal of the Nobel Prize for Science on the vaccine developers in 2022.

Reduced investment in this powerful science to keep it ready for the next pandemic may leave us exposed in ways that we do not yet appreciate and make it more important than ever to be wise about how we employ immunosuppressive medications.

Answer:

Your excellent question allows us to underscore a couple of points made during the Fireside Chat.

First, it is reasonable to wait to get the flu shot until November or December, because the biggest swell of flu cases doesn’t hit until after that.

Second, even if you wait until December, you will still be only perhaps five months out from your last B cell depletion treatment. Therefore, it makes sense to wait until November or December and THEN get a flu booster (i.e., repeat vaccine) about three months later.

Answer:

Congratulations on timing your Shingrix (shingles vaccine) well – receiving it at least a few weeks before B cell depletion. You may not need to be re-immunized against shingles in the future.

It would be reasonable, however, to have your Varicella IgG measured in a few years, to make sure that your immunity appears to remain robust.

Answer:

The current Centers for Disease Control recommendations are here.

To cut to the chase, though, here are some quick and specific answers:

• RSV– Vaccinated once if you are older than 50.

• Flu– Vaccinated every autumn (November/December).

• Shingles– Vaccinated with one course (two vaccines, with the second some time between 1 and 6 months after the first).

• COVID– Vaccinated annually if you are not immunosuppressed. If you are immunosuppressed, then repeat vaccination every 6 months is ideal.

💡 Tip: Use IgG4ME! to track your vaccination record.

Answer:

Thanks for your query. The link to IgG4ME! can now be found right on our IgG4ME! app page.

Uptake of IgG4ME! by the Community has been brisk. We look forward to your feedback!

Answer:

Yes, this is true, although we don't know if clinically important. Worth doing, perhaps (no reason not to).

Answer:

Shingrix is about 97% effective, so we do see breakthrough infections. Fortunately, breakthrough infections are usually more mild than they would have been had you not been vaccinated. Hope that was the case with you.

Answer:

It would be reasonable to get the COVID booster in the fall once it’s released. The details of the new vaccine, however, once available, could conceivably alter that advice. Happy to confer again once the vaccine is released. (Drop us a line in the Online Community).

Answer:

Yes, just do it!

Answer:

Not that we are aware of, and there are no convincing data that this is the case. Probably not something to worry about.

Answer:

It would be OK (and recommended) to get the first dose now and the next one in six months. After the second dose, you could have Varicella IgG levels checked to see if you’ve had a good response to the vaccines. If you haven’t, getting a booster (a third shot) several weeks before any further B cell depletion would be a good idea.