Vaccinations and Vasculitis

[Tambo7]

Hello again!

I am travelling on holiday (guided tour) to Vietnam next month for 2 weeks. I have both lived abroad and travelled extensively in the past and am not always in favour of vaccination.

There is a list of recommended jabs: Diphtheria, Polio, Typhoid, Hep A. None are compulsory. I would rather not. I am part of an organised group (good hotels, organised travel). I have no idea if my diagnosis of Churg Strauss and daily pred makes a difference here? I am certain that you guys will know far more than if I ask my GP? WOuld appreciate advice please!

Many thanks!

[John_Mills Volunteer]

We went to Vietnam in 2005 about 3 years after I was diagnosed with WG. I don't recall having any special vaccinations but it was a long time ago. Certainly, as ours was an "adventure" holiday, staying in village houses & small hotels, we took anti-malarials. The big cities - Hanoi, Ho Chi Min (Saigon) & Hue are quite modern.

It was a fantastic holiday and I we are green with envy. It is a wonderful country with delightful people.

Do go to see your GP or practice nurse. They have a guide to the recommended vaccines, as you know.

The most important thing is to avoid having live vaccines.

Please don't regard this as advice. Just a comment. Have a wonderful time.

[Tambo7 in reply to John_Mills]

Thank you John. Hoping to be well for the trip!

[PMRpro]

If you are on pred there are some vaccinations you cannot have - anything that is "live" is a no-no. Those that are done with "dead" vaccine are fine. Pred is an immunosuppressive medication so even the vaccines that are safe to use may not result in a successful immunity reaction.

This may help: (from the Uni of Michigan education site)

"Problems with LIVE VACCINES (planning ahead)

Many vaccines work better if they are alive but weak. They cause a better immune response. However, if you are taking an immunosuppressive medicine, these vaccines can cause infections. It is VERY IMPORTANT to avoid active virus vaccines while taking immunosuppressive medicines. The five vaccines that only come in live forms should be given at least 2 months before starting to take an immunosuppressive medicine (for example, prednisone, azathioprine, methotrexate, Remicade®, Humira®, Cimzia®). Live vaccines should not be given while you are taking immunosuppressive drugs, or within 2 months after these drugs are stopped. The inactivated form should be used instead whenever possible.

Common live vaccines

Nasal spray (Intranasal) flu shot – the flu vaccine given as a shot not live

Varicella (chickenpox and shingles)

MMR (measles, mumps and rubella) – this vaccine is used in children only and as booster for healthcare workers who have negative titer

Rotavirus – this vaccine is used in children only

Oral polio – this vaccine is used in children only; the injectable polio vaccine, which is not live, is also good for children

Uncommon live vaccines

Smallpox

Yellow fever

Oral typhoid – can use injectable typhoid

So: injectable typhoid and injectable polio are OK, oral forms are not.

The primary problem with choosing not to have a vaccination is less that you might catch something - but the possibility that if there were to be an outbreak in the country where you are on holiday your home country can theoretically refuse you reentry without you being held in isolation for a suitable period. Possibly inconvenient!

If you want absolutely reliable advice - try calling either the London or the Liverpool Schools of Hygiene & Tropical Medicine. They are the experts!

[Tambo7 in reply to PMRpro]

Thank you for comprehensive response. Outbreak idea a little scary! Currently unwell so not sure I'd be able to have vaccines. I will follow up advice. Thanks again

[SueAshdown]

I would always recommend those vaccinations, you can get typhoid or hep A even in smart hotels. I know someone who got typhoid in the smartest hotel in India. You are relying on the hygiene of the staff! There is no problem from a Vasculitis point of view with having any of those vaccinations, only 2 jabs as diphtheria/Polio/Tetanus is one and there is a combined Typhoid/Hep A. The only thing about being immunosuppressed is your body doesn't always make as many antibodies. I would recommend malarial protection also. As you are immunosuppressed if you caught any of the illness you would be quite unwell. Hope that helps. Sue

[gibson100]

Hi

I was recently planning a trip to Southern India.I have had mpa for three years but have travelled a lot,mostly to disease free places .

My research suggested that injections for typhoid and hep are not always effective the first time and often need to be repeated.And then with blood tests to check the results and levels of immunisation.I don't. Like injections in the first place so I began to think again

I asked my V consultant about this and he said-Do you really want to clobber your your immune system any more.?You could always go somewhere else if you are worried about it.So I have just come back from a three week trip to the Carribbean which is pretty much disease free.The warmth light and sunshine are great medicines for me.Unfortunetly I couldn't persuade my doc to prescribe the trip on the NHS!