CLL Support Association
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Flu/ pneumonia injections

Hi I was in clinic last Friday and was put back on w&w but was advised to have flu and pneumonia injections which I did yesterday morning. By bedtime I felt a bit rough, headache, body ache and going to the loo more often. I had slight temperature. This morning feel a bit better . Is this normal, I was only told by the nurse who gave the injections that my arm may become achy and sore- it did

9 Replies

Both Flu AND pneumonia vaccinations at the same time..??

I was advised to leave a few days apart..

Also which pneumonia vaccination, us with CLL are advised to have two types with a minimum of 8 weeks between each vaccination.?


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Thanks Kwenda. I was only told to have a pneumonia injection no mention of two types.. Will ask when I'm next in clinic


Hi Lolleper,

In the last few years there have been changes re recommended pneumonia vaccs, and this message has not got through to all medics. As Kwenda has said, we're advised to have two types now. The official "Green Book" (standard reference for UK medics) recommends two different vaccs - first Prevnar13 (PCV13) then at least eight weeks later, Pneumovax23 (PPV23).

"The Green Book" is a very confusing document - not easy to find the revelent info in it. For more details see .

It would be good to find out exactly what you had last Friday. If it was Prevnar, then unless you've had Pneumovax in the last 5 years, you should have a Pneumovax after at least 8 weeks.

However, if it was Pneumovax that you had (and you've never had the Prevnar), then it would be good to ask for the Prevnar. You will now have to wait at least 6 months (some docs prefer 12 months ) though, as this is not the recommended way round to have these vaccs.

As CLLers we are much more likely to get good responses to Prevnar than Pneumovax. So it does seem very worthwhile to follow this up, so you get the best possible protection.

I hope this makes sense...



Thanks Paula I will follow that up



Here is some more links to papers to show the doctors:_

It is important that BOTH Pneumonia vaccinations are taken by those with CLL, and we find that many many doctors are NOT up to date with the latest regulations which were changed in the UK in July 2015

From the recently updated NHS Website.

Adults and children over the age of five who are severely immunocompromised (including anyone with leukaemia; multiple myeloma; genetic disorders affecting the immune system or after abone marrow transplant) usually have a single dose of PCV13 followed by PPV23.

See also UK.Gov. ‘Green Book’ Chapter 25 Pneumococcal Disease Immune suppressed patients


At the time of study (2015 ) the Joint Committee on Vaccination and Immunization (JCVI) had recently changed their guidance for haematological malignancy and now recommend that patients should be immunized with the conjugated vaccine Prevenar13 followed, at least 6 months later, by the previously recommended vaccine, Pneumovax23.

Parry et al 2015 British Journal of Haematology

9. Nevertheless, JCVI considered that some clinical risk groups with a particularly elevated risk of, and high mortality from, IPD may benefit from immunisation with PCV13 in the short-term (while PCV13 serotypes continue to circulate).

Those indicated for PCV13 would include individuals who are clinically severely immunocompromised, for example: bone marrow transplant patients or those with acute and chronic leukaemias, multiple myeloma.

10. For these patients it is suggested that one dose of PCV13 should be offered even if the routine childhood immunisations with PCV have been received.

11. Whilst the effectiveness and cost effectiveness of PCV13 immunisation of severely immunocompromised individuals are uncertain, the offer of immunisation is warranted given the high increased risk of complications from infection and the likely high cost of treatment of complications in these patients.


Centers for Disease Control and Prevention. ( USA )

An excellent graphical and explanation web page is at this link:-

This publication also shows recommendations for when the vaccines are given in the wrong order….


AND, on the subject of vaccinations…. NO, repeat NO, live vaccines, such as the shingles vaccination…



Prevnar 13 made me very tired the day after with a sore arm. The injection site left a bump for two months. My nodes also enlarged. That was in July. I just had my flu shot two weeks ago, but had no side effects, just a sore spot on my arm from the injection. I have to agree with Kwenda that both at the same time is a little much.

Some people do get aches, headache, and can get a fever from either shot. If it doesn't get better, I'd give your doc a call.

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I've had really bad reactions to flu jabs three times now and I wonder if I'm allergic to something in the jab itself.

A Dr friend told me that the jabs contain mercury along with other possible allergens. Does anyone else have info about what the jabs contain?

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I had the flu and initial pneumonia jab at the same time. I came back for a second pneumonia jab roughly 8 weeks later. I didn't have any adverse reactions. It was 7 years ago. I have asked about having the pneumonia jab again in the last 2 years but have been told it is either after 10 years of the pneumonia jab lasts for life and is only given once

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Two years ago, when I was DX with CLL at age 56 (13qdel, mutated, CD38neg) I received my first flu vaccine and pneumonia vaccine on the same day in different arms. This caused my armpit lymph nodes to swell for a few weeks though they eventually shrunk. Twelve months later, I had the Prevnar13 vaccine after I asked for it based on what I had read, and it was totally covered by my health insurance. Just goes to show you that we have to be our own CLL health advocates!


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