Shingrix approved

[bkoffman]

#CLL Society Shingrix approved in the US for prevention of shingles in immunocompromised adults

cllsociety.org/2021/08/shin...

[5240]

Great I am ready for it

[neurodervish]

Dr. Koffman, I got the Shingrix back in 2019, but wasn't able to obtain a 2nd shot for 9 months. I haven't been able to find info about what level of protection that might afford me. I realize there is no clinical data available, but do you know of any anecdotal data on what a 9-month gap might mean? My CLL specialist's response was, "We just don't know yet."

I did find this online: immunize.org/askexperts/exp... My clinic cannot consistently keep Shingrix in stock due to high demand. How should we handle challenges ensuring patients receive a second dose? Clinicians and patients should make every effort to ensure that two doses of Shingrix are administered within the recommended interval of 2 to 6 months. If more than 6 months have elapsed since the first dose of Shingrix, administer the second dose when possible. Do not restart the vaccine series. If you are out of Shingrix and a patient needs a second dose, the Vaccine Finder, sponsored by CDC and other partner organizations, may be helpful for patients to locate other providers that have Shingrix in stock. The Vaccine Finder can be accessed at vaccinefinder.org/find-vaccine or on the CDC website at cdc.gov/vaccines/vpd/shingl....

Apologies for a long-winded question, but I've spoken with other CLLers with the same question, so I thought it might be useful to the group.

Thank you

[jiffer in reply to neurodervish]

The same thing happened to me. Because of Covid I was unable to get the second shot at the correct time through my GP. At nearly a year later I was able to get it through my CLL specialist. Although he seemed dismisssive about the efficacy of the vaccine for immunocompromised individuals, even if both doses were taken at the correct time.

[Ironj]

Great news I got my 1st shot a month ago. I wasn’t aware that it wasn’t FDA approved when I got the shot. I’m happy to hear that’s it’s FDA approved now.

John

[bkoffman CLL CURE Hero]

Might have been approved based on your age. Anyone over 50.

[Ironj in reply to bkoffman]

Sorry for the delayed reply.

Correct I just turned 50 in May. When I got the Shinlex vaccine I also was given a pneumonia vaccine they say I will only get one time. Then another pneumonia vaccine I will get every 3 years.

Thank you

John

[bennevisplace]

Thanks. What speaks in favour of Shingrix versus Aciclovir for preventing shingles?

In the UK we get the latter or, if in our 70s, we can get Zostavax which I understand is live attenuated so maybe a no-no? These meds are free of charge.

Shingrix is in short supply across Europe but can be obtained privately in the UK for roughly 600 USD both shots.

[LeoPa in reply to bennevisplace]

I read that one of the contraindications to Zostavax is CLL.

[AussieNeil Partner Administrator in reply to LeoPa]

Zostavax being an attenuated live vaccine, it's possible with a compromised immune system to become potentially seriously ill with chicken pox. It's the chicken pox virus that stays dormant in our nerves and up to decades later can resurface as shingles.

[bkoffman CLL CURE Hero in reply to LeoPa]

Correct. Zostavax is no longer available in the USA

[janvog]

I got the two SHINGRIX shot with approval of my hematologist. But I also keep on hand 10 tabs of 1 gm Valacyclovir - in case the protection fails. If the rash shows up, the Valacyclovir has to be started at once.

[bkoffman CLL CURE Hero in reply to janvog]

I still take acyclovir 400mg 2 x a day. Have for years.

[janvog in reply to bkoffman]

For general information: Why are you taking it every day, and could there be a benefit for some other patients ?

[Imalpn in reply to bkoffman]

Hi doctor Koffman . I’m in the U.S. in Florida and I started on acyclovir 400 mg twice a day 3 years ago when I began BR and I still take acyclovir and I got both shingrix vaccines and earlier this year I got the 2 Moderna vaccines. I’m part of the LLS trial/study and thus far had one lab draw for SARS Cov 2 AB which was negative and had the Semi Quantitative Spike Protein test whereby I got only 1.1 antibody so hoping it will strengthen. Will definitely get the booster when available.

[bkoffman CLL CURE Hero]

Prophylaxis for zoster or simplex is daily dosing

[GAVIOTA]

Hi Dr. Koffman,I am reading in your post about shingles and pneumonia vaccines.

In a week I start treatment with Ibrutinib, I am 57 years old, and I wanted to ask you if it is advisable to take the vaccine against pneumonia and shingles. I have read that instead of the shingles vaccine you take Acyclovir every day, is there no problem in taking it daily for an unlimited period of time?

Besr regards