Zanubrutinib starting treatment

[FreoSue]

After seeing my specialist yesterday it’s time to start treatment. I haven’t had any vaccinations except COVID and he didn’t mention anything so am wondering if I should have the Shingrix first dose before I start? I did have chicken pox really bad around 25 years ago. Should I also have the Pneumonia vaccine also or have I left it too late?

[AussieNeil Partner Administrator]

How urgently do you need to start treatment? It takes a couple of weeks to build antibody immunity from new vaccinations and around a week for boosters. Zanubrutinib being a maintenance treatment, you'll be taking it indefinitely. While you are on it, you are unlikely to make antibodies/immunoglobulins, but you have a good chance of gaining some T cell immunity from any vaccinations and boosters.

Given you know you've had chicken pox, I strongly recommend you have the Shingrix series of two shots, which you'll need to arrange at a minimum of 1 month apart for maximum effectiveness. You should be able to have the pneumonia vaccination a few days after your first Shingrix vaccination - just to allow for possibly feeling under par.

Full details are provided on our pinned post on vaccinations. healthunlocked.com/cllsuppo...

Neil

[FreoSue in reply to AussieNeil]

Thanks Neil my numbers have been rising past 8 months and he pushed the button yesterday. That was my thoughts on Shingrix think it’s important so I’ll get the first one done along with the pneumonia and then I guess start taking the tablets.

[Skyshark in reply to FreoSue]

In the UK for the pneumonia vaccination there are 2 vaccines given 8 weeks apart. The first is PCV13, this is common for babies at 8 weeks and 1 year. UK GP's and haematologists don't know it should be given to CLL patients on Dx. The other is PPV23 which is for over 65's and over 50's if immunocompromised.

Both of these should also be given AFTER VenO and for patients undergoing chemotherapy leading to immunosuppression. When lymphs are >1x10^9/L or 6 months whichever is soonest.

Some counties now use PCV15 or PCV20 instead of PVC13.

[Walkingtall62 in reply to AussieNeil]

Oh heck, and I have just realised I haven’t had flu or Covid jabs and am due to start Zanubrutinib today. Just not been feeling great since breaking my leg. I can’t now work out which is more important to start