I have received a letter from my surgery re having the shingles vaccine. I had shingles about 15 years ago and not sure if i should have the vaccine, I'm reducing Pred on the slow method and at 7mgs.
Has anyone else had the vaccine whilst taking Pred. ?
bowler
bowler, as a live vaccine, the shingles vaccine is generally contraindicated for those on long term steroids. Here is an extract from Public Health England's most recent advice for healthcare professionals:
"those who are receiving or have received in the past 3 months immunosuppressive therapy including i) short term high-dose corticosteroids (>40mg prednisolone per day for more than 1 week); ii) long term lower dose corticosteroids (>20mg prednisolone per day for more than 14 days) iii) non-biological oral immune modulating drugs e.g. methotrexate >25mg per week, azathioprine >3.0mg/kg/day or 6-mercaptopurine >1.5mg/kg/day."
From the above, it would appear that they consider the vaccine to be less risky for those on lower Pred doses. I would think it all depends on the state of your immune system especially after having been on Pred for such a long time as in your case, I believe.
Important to mention here that if anyone suspects a new rash could be shingles, the earlier you get in with the anti-viral medication the better as this will reduce the length of illness and reduce the risk of long term nerve pain.
Thank you Celtic
I have taken Methotrexate and Azathioprine but that was several years go,
When I did get shingles it was caught and treated quickly, it was in the days when we could pop into our village surgery and be seen by our Dr. if it was in surgery hours, no appointment needed, not so these days, 2 weeks if I'm lucky, I have had no problems/nerve pain since.
I don't think my immune system is that good after all these years on Pred.
Don't really know what to do re the shingles jab,
bowler
Oh bowler, I feel for you in your quandary over what to do about this vaccine.
Like you, I, too, had a bout of shingles (unusually on an arm!) that resolved very quickly on the anti-viral medication, and apart from a slight ongoing nerve reaction to the touch for some months on my inside wrist area, the recovery was plain sailing.
I guess the decision for me is simple in that the shingles vaccine isn't an option as it contains Neomycin to which I am allergic!
If you have confidence in the opinion of your Dr then perhaps chat it over with him or, better still, your rheumy if you see one.
The main hope with the shingles vaccine is to reduce the risk of post-herpetic neuropathic pain which I'm sure you know can be horrendous! The general opinion is that it is safe for patients on below 10mg pred. However the effect seems to be less in people in their 70s than people in their 50s because their immune system is on the wane anyway because of ageing - but I haven't seen how taking pred to suppress the immune system impacts on the effect.
Another personal decision I suspect...
Thank you PMRpro
As I said to Celtic, I don't know what to do. Its like the flu jab, some years I have a reaction and some I don't, I will have another think about the shingles jab.
I'm feeling reasonably well at the moment considering my other ailments, and getting to 7mgs. Pred, is an achievement as it's the lowest I've been in several years, I don't want to upset the apple cart.
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