Live vaccines post-treatment?

[jijic]

Hello!

I'm going to confirm with my specialist of course, but there's a time crunch to this question so I thought I'd check in first.

I'm post-treatment and MRD-, and traveling to Lebanon next month, where there's a brand-new cholera outbreak. It's fairly low-risk, since I'll be staying in a nice hotel in an urban area and know what to avoid (I've traveled to far riskier places) but I've done some calls and Vaxchora is the only available vaccine. It's a weakened live vaccine, which I understand we usually can't have, but I've never been certain if "we" includes people post-treatment who are MRD negative (or if that's any different for a bacteria vs. viral vaccine).

Any info is helpful, and I assure you that I'll check with my doctor as soon as I can!

[cajunjeff]

To my understanding, even after successful treatment we remain immunocompromised and should not take live vaccines. You should probably discuss with your doctor who is better able to balance the risk for you of what to do. It might be if your only choice is a live vaccine versus no vaccine, the risk is worth it. Or it might be the risk of getting cholera from the vaccine outweighs the risk of being unvaccinated. It’s definitely a medical question and since Cll is heterogeneous, the answer might not the same for one Cll patient to the next.

[AussieNeil Administrator]

With CLL, you are immune compromised always, hence the recommendation not to have live vaccine. You are correct about not having CLL actively causing you to have a compromised immune system right now, but being uMRD, I expect you'll also be deficient in healthy B cells, so you might have difficulty making antibodies to any illnesses or vaccines you have, for at least a year or so after your last obinutuzumab infusion. Your degree of immune comroromise will gradually reduce over time as your T cells recover too.

Neil

[jijic in reply to AussieNeil]

Thanks Neil! I'm about two years beyond my last obinutuzumab infusion as of this month, so I'll definitely check in with my doc about this.

[jijic in reply to jijic]

His answer was that we're going to test my immunoglobulin and see

[jijic in reply to jijic]

Fun news: He approved me for the live cholera vaccine because my immunglobulin is normal! It all went well, no reaction

[Big_Dee]

Hello jijic

CLL is commonly referred to as a blood cancer, but even more so it is a cancer of the immune system.