Travel Vaccinations

[MrsBxxx]

Hi everyone! I have been to my doctors surgery this afternoon and seen a nurse who has given me the Hepatitis A & Typhoid vaccines, despite the medical leaflet saying not to give to persons with a weakened immune system. She spoke with a GP at my request who "didn't know"! Her opinion was that by 'weakened immune system' the leaflets were referring to patients who have NO immune system (i.e. Those with hiv or receiving radiotherapy/chemo) and went ahead with the vaccinations. I have SLE and take hydroxychloroquine. I have seen some contradicting info online as to whether vaccinations are safe and if you should seek advice from your rheumy before receiving them. Has anybody had these vaccinations or know of advice from a rheumy regarding them?! Obviously it's a bit late now but I'm concerned! Thank you!

[Fennella02]

I was in your shoes a month ago leading up to a holiday in the Dominican Republic. My immune system is weakened due to the mycophenolate that I take and my very low WBC. Hep A and Typhoid were considered ok for me although I was actually too unwell for the Typhoid jab so went without it. Live vaccines are the main concern such as Yellow Fever. Have you considered anti-malarials? They caused me and my GP the greatest concern and I never did get an answer. Where are you going?

[MrsBxxx in reply to Fennella02]

Hi! Thank you! You have somewhat put my mind at rest! I am going to South Africa with my husband to stay with friends we met on our honeymoon in Mauritius last year! I did read that yellow fever was one to avoid but fortunately it's not a listed country where you are at risk and we won't be stopping at any other destinations in between. I have an appointment with my haematologist in a couple of weeks as I have ITP so hoping that he will have some knowledge as to anything else suggested. Cape Town is in the "low-no risk" of maleria area of South Africa which is where I will be but I will definitely ask advice! Thanks again!

[Sara_A]

It would only really be if u were on immunosuppressants or if it were a live vaccine such as yellow fever.

[Paul_Howard Partner LUPUS UK]

Hi MrsBxxx ,

The hepatitis A vaccine is not a 'live' vaccine so cannot cause hepatatis. If the typhoid vaccine was given as an injection, then you will also have received the non-'live' version of that. In most cases, people with lupus should have the same vaccines as everyone else, but they just need to take caution if they are immunosuppressed and needing a 'live' vaccine. The biggest culprits for immune suppression are methotrexate, mycophenolate mofetil, cyclophosphamide, prednisolone (20mg or more), rituximab and belimumab (I may have missed some). Hydroxychloroquine doesn't have a strong immunosuppressive effect, but in some people, lupus itself can attack the neutrophils and reduce the immune response. If anyone is unsure, they should check with their doctor.

We covered a little bit about travel vaccinations in our blog post about going on holiday with lupus - lupusuk.org.uk/going-on-hol...

You may find the rest of the article helpful too.

I hope you have a lovely trip.

[MrsBxxx in reply to Paul_Howard]

Thank you Paul. Unfortunately the GP at my surgery knew no more information than the manufacturers leaflet that was enclosed with the vaccinations and I was asked if I was happy to have them and told "it should be ok"!

This information is really useful so thank you! Kerry

[Paul_Howard Partner LUPUS UK in reply to MrsBxxx]

In cases when GPs do not, we would hope that they would refer to your consultant for their expert opinion. Obviously this didn't happen here.