Shingrix OK For Immunocompromised Adults

[lankisterguy]

This article was posted today on CLLSLL groups.io and is reposted here with permission from Dr. Furman

groups.io/g/CLLSLL/message/...

Re: Shingrix OK For Immunocompromised Adults

From: Rick Furman Date: Fri, 30 Jul 2021 08:43:32 EDT

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Shingles is the result of the varicella zoster virus which causes chicken pox and shingles. The primary infection, which universally happened during the first few years of life before vaccinations for it were approved, is chicken pox. The virus lies dormant in the spinal cord and emerges later in life as the immunity wanes or during periods of stress. What the vaccine does is “refresh” the immune system’s memory of the virus in order to maintain a strong cell mediated immunity against the virus and help prevent its recurrence.

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Shingrix is extremely effective and not a live virus and should be taken by everyone. 1 out of 3 adults over the age of 65 years will develop shingles and the complications and discomfort can be life-long (post-herpetic neuralgia). Patients who are immunosuppressed are more likely to develop shingles and more likely to have life-long complications. The vaccine is currently stated to be 90% effective in healthy adults, and very importantly, 60% effective in patients who are post-autologous stem cell transplantation and are thus very immunosuppressed. Of note, efficacy is measure not just by the prevention of recurrence, but also by shortening the duration and severity of discomfort and lessening the incidence of post-herpetic neuralgia.

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In the US, Shingrix is currently approved for everyone over the age of 50. It is supposed to be one (series of 2 jabs 60 days apart) dose for life. There are still other shingles vaccines available, but these should not be used by anyone. These other vaccines are live vaccines, and more importantly, inferior to Shingrix in effectiveness. I do recommend everyone receive the vaccine.

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Len

[cllady01 Former Volunteer]

Thanks for that post, Len. I need to investigate my getting those shots asap.

[cujoe]

Thanks for posting, Len. I just got the OK to get the 2-dose vaccination at my June appt with my CLL doc. Here in the US, apparently many pharmacies had stopped giving the Shingrix during the pandemic.

I got the second pneumonia vax (PPSV23) at my PCP appt a month ago and the advice is to wait several weeks to a month after getting that to do another vaccine, so I'm going to schedule Shingrix #1 next week. Here is a recent article about the recent FDA approval for the vaccine in immunocompromized people

hcplive.com/view/fda-approv...

Get vaccinated (all of them), Be Safe, and Stay Well - Peace, K9

[RosettaClapp]

thank you for this post ..Iam delighted the jab is 60% effective for the immuno-supressed as I had one just before I started obunutumazab+venetoclax treatment in Feb this year and the other one just as I started the venetoclax ..this is in the uk where it has to be bought privately and isnt at all easy to get your hands on it..I had been waiting over two years for an order through City Docs Bath

[janvog]

I got the second Shingrix in December. Age 86, CLL Rai 4. My hematologist approved. First shot in Oct.: No reaction at all. Second shot in Dec. no reaction except sore arm for three days. I am probably protected to 70%. That is why a keep 10 tbs. of 1 gm Valacyclovir on hand in case of some signs of shingles, because time is of essence and it would be necessary to start the Valacyclovir at once. I had shingles and it was terrible and left me with post-herpetic neuralgia (irritation of skin on one side of torso). Insurance paid and the supermarket pharmacist applied the vaccination.

[Freya444]

Hi there, I live in South Africa and I can't seem to find the Shingrix vaccine anywhere. I have been suffering from Shingles since the age of 7 and I really want to take the best possible vaccine. Any idea how I could get it in South Africa?

[Vizilo in reply to Freya444]

Vaccine is made by GlaxoSmithKline. It may not be available in every country. But you can find out for sure by contacting their South African customer care line. The details are on their website:

gsk.com/en-gb/contact-us/wo...

[Emerfly]

I am on prophylactic antivirals for shingles as I have had them several times . Anyone know if I can still have the vaccine & stop taking the antivirals . In other words I have the virus so will Shingrix get rid of it ?

[lankisterguy Volunteer in reply to Emerfly]

Hi Emerfly, -

The virus that causes shingles is incurable, but the Shingrix vaccine is excellent at controlling outbreaks. See medpagetoday.com/infectious...

SNIP "A post-hoc analysis of adults with hematologic malignancies showed 87.2% vaccine effectiveness"

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Len

[Emerfly in reply to lankisterguy]

Thank you Len

[HopeME in reply to Emerfly]

That is an excellent question for your specialist. Does a greater frequency of shingles mean the vaccine is less likely to work? Or more simply with a history of shingles outbreaks is it worth the risk to stop prophylactics after vaccination? I’d be curious to hear the answer. I suspect the advice may be to take the vaccination but continue with the prophylactic. Please let us know.

Best

Mark

[Emerfly in reply to HopeME]

Another question for my infectious diseases Prof who I will be seeing again at the end of this month . I am taking part in a Research Study into Long Covid . Will let you know what he says Mark . Thank you . Emer