Shingles vaccination

[cathie]

I'm thinking of pressing to get this as I'm just on methotrexate so I'm checking you can have a live vaccine with mtx. My father suffered terribly from shingles and it'd be good to avoid it. See all the publicity in papers today

[helixhelix]

Mmmm, no harm in asking - and do tell us what you are told - but live vaccines are not recommended for us as far as I've been told. Apparently it's both as we could end up getting an infection from it, and also as they may not work the way they're supposed to because our immune system won't respond to build up the immunity. As v pissed off about it as has ruled out visiting friends in Algeria, which is a v beautiful country that I used to go to, but asks for yellow fever vaccine certificate. Pxx

[earthwitch in reply to helixhelix]

I discovered years ago when I was going to visit Malaysia and malaria treatment was recommended, that it really pays to get travel medical advice from a specialist service or travel advisory, as they are far more aware about not only what the actual risks are right now, but also which areas of any country are risky. For example even though I'd been advised about malaria and it was on the list the travel agent gave me, when I did more research I discovered there was absolutely no risk in the areas that I was going to be travelling in, and it was only in one small area of the country that there were problems. If immigration requires the certificate, but you aren't going to be in at risk areas, you may be able to get away with a medical certificate stating you can't have the vaccination, but that would need checking with the appropriate embassy I would think to make sure you didn't get turned away at the airport. I'd also contact a specialist travel medicine clinic just to make sure that there weren't any alternatives to live vaccines. A specialist clinic might be able to access things your GP or the NHS can,t, though you might have to pay a lot more for it.

[cathie]

Hello Polly. Are you sure about needing yellow fever for Algeria? That must be new as I went there a lot during the 90s and never needed it. Last visit was in 1999. Wonderful place though my RA prevented me from going much into the countryside.

On shingles - my father had it and it blighted the last few years of his life. I'm going to find out whether while I"m on methotrexate I can get it, because I know you cant with biologics. There's an interesting piece in the current NRAS magazine about it. Shiingles involves a very painful rash and used to stop my father sleeping. It was quite horrible pain, so anything we can do to prevent it, would be good. I think you're in France, arent you - but the NHS has just accepted to give the shingles injection to everyone over 70.

Now I'm horribly rapidly approaching that birthday, but aware that I may be back ono the biologics by then I'm thinking it might be worth paying £150 for a private shot which would help me avoid this. Still doing the research.

Hope you get to Algeria

XX

[cathie]

The oracle:

nras.org.uk/about_rheumatoi...

I think what they're saying is that mtxate would be ok, but definitely not biologics.

[helixhelix]

para 5 says that people on MTX should avoid live vaccines...?

But thanks re Algeria, I'll look again as although haven't been back since diagnosed did briefly look and was told it would be needed, but could easily be wrong. My whole attitude to illness and risk has changed since getting RA as I used not to worry much about things like vaccinations, and not really bother much but just make sure I didn't hug too many Mosquitos or drink dirty water. But now I feel much more cautious about being exposed to any serious illness/infection. And my Mother has had bouts of shingles, and yes it's a nasty thing, so as well to avoid if you can. Px

[cathie]

All I had to do for my visa was to queue up in Knightsbridge with a filled form, photos and some cash. I needed an invitation but I was working at one of the unis in Algiers so that wasnt a problem. And addresses there.

Mosquitos not a problem in the cities and I tended to be very careful with water. But few problems for me. Do message me if you want to discuss. Well worth a visit, the security situation was a bit dodgy but that can be a problem anywhere!

algerian-consulate.org.uk/V...

[helixhelix in reply to cathie]

We've been a few times...as have friends there since OH works on stuff to do with the disappeared. Lovely place (apart from a few aspects of course...) so would like to go back and see more of it. I mustn't let RA dominate my life! Px

[Hidden]

If you have already had shingles would you still need this vaccine, both my husband and I have had shingles in the past and have assumed that he will not require it, he reaches 70 this August. I have not read the article so not sure.

As to other vaccines, I understood although you are not allowed to have a live vaccine whilst taking your ant-tnf, it would be allowed if you came off it for the period required to get the vaccine if you had to have one for any particular reason. I am sure that I read this somewhere in my many readings but I could be getting my memory muddled up!

[Hidden]

live vaccines. these are yellow fever, polio are not allowed with mtx and anti tnf, shingles vaccine is at moment for over 70 year olds only.. and unless you look incredibly young you arenot 70??!! plus it5 is another live vaccine..

[Hidden in reply to Hidden]

It would not affect me for another ten years! Just wondered if you had already had shingles you would still need it.

[Hidden in reply to Hidden]

my reply was to cathie, georje, you should have immunity if you have already had shingles..shinlges virus lies dormant hidden somewere on a nerve ending.. it is usually present in the bodyfrom intitial exposure to the chicken pox virus.

[cathie in reply to Hidden]

Thanks for this. Sadly I am nearly 70 and would really like to have the vaccine if it isnt going to mess things up. I didnt find the NRAS guidance crystal clear, but will try to get to the bottom of it.

I'm sure I had yellow fever vaccine in 2002 to go to my daughters wedding in Dar so am quite confused!

[Hidden in reply to cathie]

You look much younger xx

have done a blog to clarify disclaimer applies

[cathie in reply to Hidden]

Thanks! Don't feel it often! I think it's not clear cut and I will ask consultant. It sounds as tho if I left off mtxate for a while before/after I might've ok but will do nothing without talking to drs. But I remember vividly my fathers repeated attacks on shingles. Blighted the last years of his life.

[Hidden in reply to Hidden]

oral polio was given to some one on the site,, this is a live vaccine .

thr combined injection vaccination with diptheria (non live) is alo available

[Hidden]

I wouldn't have it on MTX. Not sure why you think it's any different to when you're on anti-tnf - MTX is an immunosuppressant and therefore not appropriate to have any live vaccines while taking it? The injections are even more quickly absorbed so it will be like a higher dose too. Tilda x

[cathie]

All I had to do for my visa was to queue up in Knightsbridge with a filled form, photos and some cash. I needed an invitation but I was working at one of the unis in Algiers so that wasnt a problem. And addresses there.

Mosquitos not a problem in the cities and I tended to be very careful with water. But few problems for me. Do message me if you want to discuss. Well worth a visit, the security situation was a bit dodgy but that can be a problem anywhere!

algerian-consulate.org.uk/V...

[Victoria-NRAS Partner Moderator NRAS]

Hi Cathie

I took a helpline call about the shingles vaccine today, so will share some links I found. Live vaccines are not generally recommended for people on any immuno-suppresant medication, including MTX, though you could always ask on thr grounds that your father had it so severely, so they may determine that the risk of shingles is greater in your particular case than the risks of having a live vaccine. However, for most people with RA I think it would not be recommended until more research is done.

Here is a link to an NHS choices article about the vaccine:

nhs.uk/news/2010/02February...

and the following is a study that had positive findings, but concluded that more research would be needed before this vaccine could be offered to people with lowered immune systems:

webmd.com/skin-problems-and...

Kind regards

Victoria

(NRAS Helpline)

[cathie]

That's v helpful and clear. I will talk to my rheumy about this.