Live vaccines

[Pickzie]

Hi all. I’m Considering a holiday tour for hubbys special birthday but destinations likely require live vaccinations eg yellow fever, typhoid etc. I have lupus and APS with medication including methotrexate and rituximab. I’m waiting to hear back about this from rheumatologist but wondered if others have had advice / experience if live vaccines

[Penguintaz]

Hi Pickzie,

I know that methotrexate specificly mentions to avoid live vaccines if you are on it. I would wait to hear back from rheumatologist but in general I know live vaccines are a no go for immune compromised patients.

[I814u24u in reply to Penguintaz]

I am immune compromised last year I was on methotrexate and did not get the flu shot even though my rheumatologist suggested it. I ended up with the worse case of the flu and that subsequently turned into pneumonia and I ended up in the hospital

[PMRpro in reply to I814u24u]

Apart from the nasal flu vaccine used for children which is live, all flu vaccines are made with what is called "killed" virus and they are safe for patients on immunosuppressants. Live vaccines however are a very different matter and do have the potential to give the recipient a mild case of the disease - and obviously this isn't a good move for patients who are immunocompromised who are likely to develop a much more severe case.

[AgedCrone in reply to I814u24u]

I had the flu vaccine in early November2017...January 2018 had flu for the first time ever.

Can't win can you?

[awareness75]

Hi. I've just come back from Cape Verde. The travel advisor mentioned typhoid as a precaution.

I discussed my holiday with my consultant and the recommendations. His answer was it depends on how high the warning is where you're going and what you're doing there.

If you're staying in an inclusive hotel, or high rating accommodation, then it's usually safe to not have the live vaccines, as this can aggrevate your Lupus and it might not have been necessary to do that, if the need wasn't high. I did have a tetnus booster, but nothing live.

Again, if you do need a live vaccine, I would take it a good month before travel if possible and again, your health must be reasonably good; no colds/antibiotics. This is key really for all jabs and vaccines.

End of the day, it depends on how you feel within yourself and just weighing up all your holiday destination options.

🙂

[PMRpro in reply to awareness75]

Even when you travel and stay in a high end hotel which may reduce the risk of such diseases - mosquitoes don't read the signs! And the problem arises when you return to your home country or must travel via another where you may be told you can't enter the country BECAUSE you don't have the requisite vaccination documentation.

[AgedCrone in reply to PMRpro]

You can find a list of countries that won't allow entry if you haven't had certain vaccines on the FCO website.....& believe me these countries want sight of your proof of vaccination certificate.

No certificate & you are on the next plane out of there.

[AgedCrone]

Think you might be well advised to search for destinations that do not need live vaccines. I'm sure your husband would not want you to take the chance...if you could find anyone to give it to you once they know your medical history.

Prior to being diagnosed with any AI disease I had both Yellow Fever & Typhoid immunisations,& every time the YF made me really poorly. Of course because I hadn't been diagnosed it may have been coincidence, but no medical practitioner will give you the YF if they know you have Lupus.

Regarding the Rituximab, I suggest you speak to the Biologic nurses where you have the infusions. I have just been told if I have the FLUAD infuenza vaccine I will not be able to have my RTX infusion.

[Pickzie in reply to AgedCrone]

Thank you AgedCrone - sound advice.

[Pickzie]

Thought I’d send an update on my live vaccines post. The upshot of my saga triggered by wanting to go to South America is that live vaccines like yellow fever is a no go especially if you’re on immunosuppressant drugs. But ... if absolutely necessary it is possible but only if you stop all drugs for a 3 month window! Not a good idea if your condition isn’t absolutely stable and your trip isn’t essential - who wants to cause themselves to have a bad flare! But all non- live vaccinations are fine. You just need to plan well in advance eg allowing at least a month before immunosuppressant treatments like rituximab. So I’ve now had my rabies, Japanese encephalitis jabs etc, ahead of rituximab this month and a trip to S Korea/ Japan in April 😊