I'm getting ready to get all my vaccines up to date, I will need most all of them. I'm curious if its Ok to get most at one time like they do with infants or should I space them outa bit ? I'm still W&W blood work fairly stable, my neutrophils were a little low at 31% in July. ALC was 9.1 and WBC @ 15.9 plts normal....other than that and a few slightly swollen nodes here and there I'm fine. just wanted to see what the consensus was. Thanks! Garrick


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9 Replies

  • Hi Garrick

    I spaced them out over several months, no point in stressing an already wonky immune system...


  • thanks Chris, that makes Doc is getting use to seeing me on a regular basis these days anyway, so what's a few more visits. You are a master CLL'er and were all fortunate to have you as a source of information. Wishing you a great weekend, were soaking up the last bit of sunshine we'll see in the NW for a while, should be 85 degrees this weekend, I love it!.... Cheers!

  • Forget percentages when assessing your white blood counts. Absolute counts matter, NOT percentages. Looking at percentages is misleading at best and downright dangerous at worst.

    I suspect you've provided a perfect example: ' neutrophils were a little low at 31% in July. ALC was 9.1 and WBC @ 15.9 plts normal.' I'll be very surprised if your actual neutrophil count is 'a little low', because 31% of a WBC of 15.9 is a very healthy absolute neutrophil count of 4.9 and the normal neutrophil count falls between 1.8 and 7.5. Your calculated neutrophil count of 4.9 is above the average (4.65) of those. What has most likely happened is that your WBC has climbed because you have CLL, so your lymphocyte count (and hence the percentage contribution to your WBC) climb over time. The non-lymphocyte percentage (not necessarily the count), must decrease accordingly, even if the absolute counts of other white blood cells remain unchanged. Your non lymphocyte count is (WBC - ALC) or (15.9 - 9.1 = 6.8), of which we calculated 4.9 were neutrophils. The remaining (6.8 - 4.9) or 1.9 will be the less common white blood cell types eosinophils, basophils and monocytes - again healthy levels.

    Well done getting all your vaccines up to date and don't forget that for some vaccinations, they only come in combinations, such as the one for Tetanus, diphtheria, and pertussis (Tdap), so it makes sense to space the rest out as Chris suggests.


    PS In my experience, doctors (GPs) examine the percentages all the time, rather than the absolute counts, so it's no surprise that we also quote these...

  • Neil, I enjoyed your little maths tutorial... unlike you, I'm not an expert on CLL so this was informative... I used to teach maths up to A level and beyond, and get irritated by politicians (of all parts of the spectrum) who deliberately misrepresent figures, in the knowledge that the public (or, more shamefully, the journalists who question them) won't notice the sleight of hand... anyway, I doubt that most of the politicos are clever enough to 'cheat' in this way - they doubtless have special advisors who tell them what to say...

    In this case, of course, there is no deliberate misrepresentation, just a misunderstanding.

  • Thanks Scarletnoir - and here's the non-maths explanation for those with less interest in numbers.

    GPs see so few blood cancer patients, it is quite understandable why percentages are more useful to them - at a glance they can quickly see what's out of balance. We already know what's out of balance - too many lymphocytes.

    White blood cells protect us from invading pathogens, so using white blood cell percentages to assess our health with CLL is akin to a small country deciding whether to invade a much larger country on the basis of having a greater percentage of soldiers than the larger country. When you are fighting a war, superior numbers matter - percentage differences in the make up of your forces are inconsequential. With CLL gradually reducing our bone marrow's ability to make all blood cell types, we need to concentrate on which blood cell types we are struggling to make - so absolutes are what counts.


  • I'm just learning the prevnar 13 shot and the regular pneumonia shot (23) must be given a year apart with the prevnar 13 given first I think.


  • I believe the recommendation is 8 weeks between 13 and 23 , check with your doctor...he won't likely know because it is a very rare situation, but he can find out....


  • Chris: I'm between GPs at the moment because of changing insurance. My CLL specialist, Dr. Ma at Northwestern, said I should get 23 because I have not had it in well over 5yrs. ( I remember Terry Hamblin saying it wasn't likely to work at all) So I went to my pharmacist to get the shot. He said that I would need a prescription since I was under 65, but they had a Dr. that would give me one only if it had been at least 1yr since I had 13. I took this to mean that you must wait 1yr between shots, but perhaps you are correct. However, I also thought I heard something like that in one of these forums.


  • Just make sure to never get a live virus vaccine. I always ask before getting any vaccine.

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