Live Vaccines

[Beaver]

I suffer from GAP(Granulomatosis with polyangiitis) but luckily I have been in remission now for 2 years. Still taking methotrexate but no steroids.

I am investigating a holiday to Singapore, New Zealand and Australia but obviously may need some vaccinations like Hepatitis A, Diphtheria etc.

I think this would be unwise, as I don't want a flare, or this awful disease to cause further complications to my health. But I really want to do the holiday, before I can't!

Anyone any comments, thoughts or experiences

Thanks

Beaver

[Nadine99]

Don't know which vaccines in particular, but we were told my husband should not take 'live' vaccines. We were just looking at Yellow fever I think. My husband has GPA (Wegener's) Check with your doctors when you know which you might need.

[Beaver in reply to Nadine99]

Thanks Nadine

Saw Doctor yesterday, who told me I am seeing the wrong person, best to see a nurse at the practice. Filled in a form and now may have to wait 6 weeks for an appointment with her. Doctor was very helpful though she felt that the places I am intending to visit were low risk.

[RichardE Volunteer]

There's quite a good page here for information on travel vaccines. There's a section towards the end that talks about the different live and inactivated vaccines.

traveldoctor.co.uk/vaccines...

But as Nadine says, you are best checking with your GP and/or consultant as to what vaccines might be required for your trip and whether it's safe for you to have them.

I think that Yellow Fever is the main one that immunocompromised people shouldn't have. But I think that diphtheria, hepatitis A and others are inactivated and should be ok. But check !

I think that there is also a difference between being immunosuppressed and immunocompromised.

If you have recently had Cyclophosphamide or Rituximab etc and are perhaps on high dose steroids then you will be immunosuppressed and be extremely susceptable to infection. Having a live vaccine at this stage would be very risky as you would most likely develop the disease. And whilst you'd be ok with an inactivated vaccine, I think that your immune system would not respond and so you'd not get any protection from it.

I suspect you should only be thinking of vaccines when you're in a relatively good remission and are on low levels of steroids, possibly alongside an immunosuppressant like Azathioprine, Methotrexate, Mycophenolate, etc. You should still not have a live vaccine but the inactivated ones should generate some sort of immune response that should protect you. But just be aware that the evidence suggests that for a few immunocompromised people, vaccines are not always effective.

[Beaver in reply to RichardE]

Richard

Thank you for the information saw Doctor yesterday see comments to Nadine. Spoke to Rheum consultant who has said as long as the live vaccine is dead! then I should be alright. Needs a lot more research before I make the final decision. My other worry is if I decide not to go ahead with Hepatitis A will my specialist Insurance cover still be valid. Its a minefield. Really want to do this trip but won't put my health/condition at risk, as we are all aware its along road to get back to anything like normal. Its taken me some 7 years with a great deal of help from wife who makes sure I have a healthy diet and life style. Although she would tell you I still could do better.

Thanks again

Beaver

[DevonLottie]

I have GPA and am on methotrexate. I went to india earlier this year and had all those vaccinations with no problem. None are live so should be ok. I was told the only areas I needed to steer clear of were those needing a yellow fever vaccine.

[monikagoyal in reply to DevonLottie]

I have a GPA too. I didn't get what type of vaccines you are talking. Can you tell me from where did you get that vaccine from india because i am going to India in few weeks.

[DevonLottie in reply to monikagoyal]

Hi, I went to the practice nurse at my surgery who sorted the vaccines out - diphtheria, hepatitis etc. I don't know which part of India you are going to but requirements vary across the country and there are parts it's inadvisable to visit as yellow fever (live vaccine) is required. The nurse at your surgery should be able to advise you further. Enjoy your visit, it is an amazing country. Charlotte

[monikagoyal in reply to DevonLottie]

Thanks!for your reply actully i belong to India and i am visiting my parents who lives in northern part of India. I know its a wonderful country. I love my India.

[DevonLottie in reply to monikagoyal]

You lucky thing - my husband is dead jealous, he'd move there like a shot!

[Compo34]

Be careful! I was going to Swaziland and went to GP to see about vaccines - I was in remission of MPA, he said see nurse who said you are ok got the lot. Within a few months I had a flare, eGFR had gone from 52 to 23 ! I looked into it and discovered that 2 of the vaccines had been 'live' and that I should not have had 'live' vaccines. However, no- one would say that the vaccines had caused the flare - doctors support each other!

[Chris-Bromsgrove]

Hi, I went to Singapore and New Zealand 18 months ago and had the necessary vaccines at my surgery. I can't remember what I had but because I am on immunosuppressants I did check that there were no live vaccines. The nurse at the practice confirmed they were not. Hope this helps.

Chris