Pneumonia vaccine : Been advised by rheumatologist to... - NRAS

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Pneumonia vaccine

Matilda_1922 profile image
47 Replies

Been advised by rheumatologist to have my flu and pneumonia vaccination this year as I am about to start a biologic. They said I will need to have it every 5 years and my last one was in 2004. So I explained to the nurse but she said I didn’t fall into their criteria to have it therefore I wasn’t given it.

The reason they gave was there is a national shortage as they had only 6 in stock and felt these should be for those who really need it. She asked if was on methotrexate I said yes said their reply oh that lowers your immunity. But I’m about to start a biologic which can decrease my immunity. I work in a hospital so exposed to infection. Recently been treated with 4 lots of antibiotics for a chest infection over the last 4 months.

Left it I would ask the rheumatologist to mention this in their next letter.

This tells me how much the practice nurse knows about RA and the effects of medication.

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Matilda_1922
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47 Replies
nomoreheels profile image
nomoreheels

I'm surprised working within the NHS you don't automatically qualify for the flu vaccine each year but that's not the issue here. Was it your Practice nurse who said there were only 6 pneumonia vaccine in stock? If so then I would double check with your GP if you should be allocated one of them, a tel consultation should be all it takes. I had to have the Pneumovax jab before I started leflunomide around this time last year at the request of my Rheumy, I was given it no question. I know my experience isn't current & stocks may be depleted now but even if they have to borrow one from another Practice in your area, it can be done, you're in the at risk category after all not only with starting a Biologic but with working within the NHS, you did mention that?

Matilda_1922 profile image
Matilda_1922 in reply tonomoreheels

Yes I mentioned all the above

She asked me if I had had pneumonia in the past which I said no although I’ve had this chest problem for the last 4 Months.

I have emailed rheumatologist so waiting for their reply.

nomoreheels profile image
nomoreheels in reply toMatilda_1922

Hopefully he'll send a quick email to your GP sanctioning/requesting you be allocated one of the 6 then.

Jonesburg profile image
Jonesburg in reply toMatilda_1922

What sorry this may seem stupid.. what is wrong with your chest

Matilda_1922 profile image
Matilda_1922 in reply toJonesburg

Been recently diagnosed with bronchiectasis in December after me trying to have pneumonia jab. I had it early December. GP sanctioned it

Matilda_1922 profile image
Matilda_1922 in reply tonomoreheels

I was given the flu vaccine but wouldn’t give the pneumonia one as I have had it in 2004 and said one is for life.

Lesley_1 profile image
Lesley_1 in reply toMatilda_1922

I am in Australia and was told that the pneumonia vaccine is good for five years.?

Jonesburg profile image
Jonesburg in reply toLesley_1

Sorry I knew it was around there

Jonesburg profile image
Jonesburg in reply toMatilda_1922

Not what they tell me when I was in the hospital with pneumonia they said 6 or7 yrs.

Jonesburg profile image
Jonesburg in reply tonomoreheels

At least get pneumonia shot it's know fullprofe .. but it will leason the sickness and it lasts I think 7yrs.

AgedCrone profile image
AgedCrone

I don't know if this applies to all Biologics, but I'm on RTX & was told I could not have the flu jab within 4 weeks before the infusion or 8 weeks after it.So check & find out - with RTX the flu jab lessens the effect of the Biologic.

Luckily I asked in time otherwise I would have had to wait over three months to get a flu jab.......& no doubt they would have run out by then!

You do know you can get a flu jab at pharmacies don't you? But if you are definitely starting a Biologic very soon you should phone your Rheumy to discuss what you should do. It can take up to six months to get approval for Biologics, so you may be able to get one in time.

Matilda_1922 profile image
Matilda_1922

Thank you for your replies

I asked the rheumatologist if I needed both vaccines said yes and before stating biologic. I had the flu vaccine but wouldn’t give pneumonia.

I’m off sick and have been for the last 2 weeks as I want to get rid off this chest infection. I’m on another antibiotic doxycycline. It’s very strong so hopefully it will work.

Matilda_1922 profile image
Matilda_1922

Had a call from Rheumatology nurse. They have spoken to specialist and asked them to add to GP letter from Monday’s appointment.

I’m not sure how long it will take as I’m scheduled to start Benepali soon.

Mhairi54 profile image
Mhairi54

I'm really confused about the pneumonia jag as have had conflicting advice about it - GP said it was a one off injection, whereas occupational health said I needed to get it every 10 years.Does anyone know the definitive answer on this?! I automatically qualify for the flu jag because I work for the NHS.

Matilda_1922 profile image
Matilda_1922 in reply toMhairi54

My Rheumatologist advised me to it every 5 years now I’m to start biologic. However the practice nurse says it’s one for life or more often if I fit the criteria which apparently I dont. They told me they need to have it in writing from the hospital before I can have it.

Yes all NHS healthcare workers are offered the flu jab but some choose not to. My colleague is one as they had a chesty cold recently which may have passed it to me. Now I’m off sick trying to get rid of a chesty cough. This will go against me because of my high level of sickness.

I feel their knowledge on Rheumatoid arthritis and it’s treatment is very limited. But when it’s to do with my health and history of chest infections it’s pretty concerning.

On diagnosis of RA my consultant said I needed to have flu and pneumonia vaccine due to the DMARDS that decreases your immunity. I’m asthmatic so have had the flu jab for the 15 years with pneumonia given in 2004.

nomoreheels profile image
nomoreheels in reply toMhairi54

It's dependant on your treatment & condition/s, the NHS Choices site states

People with a long-term health condition may need just a single one-off pneumococcal vaccination or five-yearly vaccination, depending on their underlying health problem.

I think you'd best ask your Rheumy, he/she is the one to determine if it's just a one-off or if not how often you'll need it.

Tessthomy profile image
Tessthomy in reply toMhairi54

Me too. Ditto! I have on numerous occasions been and called the gp and they won’t give me a booster. They say I don’t qualify even though I’m a coeliac have RA on embrel and sulphasalazine ALSO had pneumonia five years ago ... DO NOT want that again!!

Matilda_1922 profile image
Matilda_1922 in reply toTessthomy

I've gone back to rheumatology specialist to ask them to write to gp and also send me a copy too.

I wonder what would be cheaper having the pneumonia jab or treating infection.

I'm sure it's the jab!

Tessthomy profile image
Tessthomy in reply toMatilda_1922

Absolutely the jab ! as I was in hospital for 6 days. Was so ill. Had about 3 or 4 different antibiotics intravenously. They are shooting them selves in the foot by not allowing this vaccine to be available at least to people who need them! TT

Jules13 profile image
Jules13

You can go into any big pharmacist or chemists or any health centre and you can pay for flu jab yourself. It's usually about £8. Having rheumatoid arthritis means that you are vulnerable therefore your GP practice should give you one for free. And you should have one around September or October every single year.

Matilda_1922 profile image
Matilda_1922 in reply toJules13

Does the chemist offer the pneumonia jab

nomoreheels profile image
nomoreheels in reply toMatilda_1922

Yes they do but really, do you want to fork out £70 when you're eligible to have it free on the NHS?

Matilda_1922 profile image
Matilda_1922 in reply tonomoreheels

Hi Nomoreheels

No not £70 I will wait for the hospital to write to GP

X

nomoreheels profile image
nomoreheels in reply toMatilda_1922

Sensible girl!

Jules13 profile image
Jules13 in reply tonomoreheels

It was £8 in my chemist.

nomoreheels profile image
nomoreheels in reply toJules13

For the flu jab, we're talking about the Pneumovax (pneumonia) jab.

Jules13 profile image
Jules13 in reply tonomoreheels

Oh.

Lesley_1 profile image
Lesley_1 in reply tonomoreheels

So frustrating when you are trying to make informed decisions and trying to trying to take responsibility by working in partnership with your nurses and doctors.

It’s so confusing that there is no definitive answer when I think there should be .

Jules13 profile image
Jules13 in reply toMatilda_1922

Yes

sazlav83 profile image
sazlav83

I was given the pneumococcal vaccine in July just before I started mtx and got a phone call last week from my gp to offer me the flu vaccine on Saturday.

Hope u get sorted xx

Hobbits profile image
Hobbits

I’m on a biologic and about to start another. They said I can have flu shot 4 weeks before starting new biologic infusions or after my loading doses, once I am on 1/2 way into my 8 week maintenance program. So basically after 4 weeks.

With a self injected biologic every six Day biologic I can have the flu shot any time, but with infusions its only certain times. Not sure exactly why this is. That’s just what I was told.

I have had the Pneumovax and Prevnar 23 and the Zostavax live vaccine before starting any biologic. The Zostavax is a live vaccine for Shingles usually given at around age 60 in Canada, I’m 48, but my Rheumy told me to get it now cause once I’m on biologic I can’t have this live vaccine.

Lesley_1 profile image
Lesley_1 in reply toHobbits

I heard that live vaccines have to be thought and talked through with gp and Rheumatologist. While it may be more risky with Biologics I heard it was just as important when given with methotrexate.

All immune suppression drugs affect the body and there is a difference between a live vaccine (which can cause problems) and a regular vaccine.?

Somebody must have an answer to this

Hobbits profile image
Hobbits in reply toLesley_1

I found this curious too. When I was on Methotrexate I was never advised to get Zostavax, or Prevnar 13 or Pneumomvax but when I started biologics I was. Yes both Methotrexate and biologics both lower the immune. I think the reason may have to do with the half-life of the drugs ( how long they stay in the body after the last dose)

I’m sure someone on here will know the answer to this.

Hobbits profile image
Hobbits in reply toHobbits

I was never advised to get pneumonia shots again after 5 years but everything I read tells me that RA people should. I plan to ask my Rheumatologist about this.

For original poster. Every life is valuable and albeit a shortage surely RA people are at high risk and need this shot. I think the nurse may not be informed!

Matilda_1922 profile image
Matilda_1922 in reply toHobbits

I had heard this and asked rheumatologist and they agreed every 5 years.

Letter from rheumatology didn't mention pneumonia vaccination so due to see GP tomorrow so will ask them.

Vonnie10 profile image
Vonnie10

Can I bob in here do people on benepali get both injection ?

Matilda_1922 profile image
Matilda_1922 in reply toVonnie10

Answer to your question is yes!

Vonnie10 profile image
Vonnie10 in reply toMatilda_1922

Thanks

Matilda_1922 profile image
Matilda_1922 in reply toVonnie10

I've started benepali second dose last week. Since then have had a cold and chest cough and croaky voice.

Just hope it doesn't lead to pneumonia.

Lesley_1 profile image
Lesley_1

How irresponsible of the stupid nurse.

You are on immune suppression and considered vulnerable, same as babies and 90 year olds.

Stupid woman.

You do need to have the injections every year for flu etc and the pneumonia one when due. It's better to have the vaccinations before the biologics and you also have to take care with live vaccines such as tetanus? I think is one or Hepatitis.

You need to discuss with gp and rheumatologist.

Can you go to another practice or ring your rheumatology nurse or dr and ask them if they can ring the practice and insist that they give it to you. This makes me so wild for you.

Can the hospital give you the injections

Matilda_1922 profile image
Matilda_1922 in reply toLesley_1

Thank you for your reply. I have been in touch with Rhuematology department and they are going to write to GP. I had the flu jab with no problems but it’s the pneumonia one I couldn’t have as have already had it in 2004 and it’s for life. But I was told by consultant that I should have it every 5 years now that I’m starting a biologic. The nurse basically said I wasn’t in the criteria to have it and went on to say there was a national shortage and had 6 left so they needed a letter from hospital stating I need it.

My GP has shared care so their staff should be aware that RA medication can suppress your immunity. She asked if I was on Mxt and I said I was and about to start a biologic but she still said I couldn’t have it.

So waiting for Consultant to write to GP advising them I should have the pneumonia jab.

I’m back to work today after 3 weeks off sick with a chest infection.

Have a good day

Matilda x

Lesley_1 profile image
Lesley_1 in reply toMatilda_1922

My gp told me every five years for pneumonia shot. Glad you took it further, sometimes we have to persistent in seeking correct care for ourselves

Lesley_1 profile image
Lesley_1 in reply toMatilda_1922

Nurse needs ‘re educating’

Lesley_1 profile image
Lesley_1 in reply toLesley_1

I agree with you, this ‘assumption’ by nurses etc that because in most cases suffererers have an invisible illness for quite a while. You are not a ‘normal healthy person of your age group’ you are vulnerable like a baby or elderly people. This makes me so wild that we have to be so assertive

Life is hard enough

Deminem profile image
Deminem

Hia

I Just had my routine 3 monthly bloods done. I asked the health care nurse about the pneumonia jab. She checked my records(bcz apparently, I can't remember anything lately)She said I had it in 2010 and 2015 so every 5 years. I have AS and am on Enbrel don't know if any of this is useful to you though lol!

D

Matilda_1922 profile image
Matilda_1922 in reply toDeminem

Thank you

Hopefully my consultant will send a letter to my GP requesting I should have pneumonia jab.

Mpell41 profile image
Mpell41

I had both flu and pneumonia vaccine this year as I’m on methotrexate, nurse said pneumonia injection is for life unless they improve the vaccine to include more strains at the moment it covers 21 types the previous vaccine covered 7 types hope this helps

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