Shingrix vaccine - fitting it around rituximab infusions

[Gurberly]

Hi

I understand the Shingrix vaccine is given as two doses, 2 to 6 months apart.

I am under 60 and assuming I can persuade my GP of my eligibility, when should the vaccines be best scheduled around my 6 monthly rituximab infusions?

Should the first one be 3-4 weeks or so before an infusion, the second in a further 6 months i.e. before the next infusion?

Should they be at the mid point between infusions?

Or some other time scale?

My next infusion is due end of October so I think I have probably missed the boat for that one, but at least I can start getting it organised for next year.

Thanks

[PMRpro]

For rituximab I think the advice for vaccines is about 2-3 weeks before the next infusion.

With the new guidelines for Shingrix you should have no problems as someone with an a/i disorder and over 50, it is the only option now, Zostavax is no more, so shouldn't need to be ordered - it is still 4 weeks, Get on to it NOW!!! Carpe Diem!

[Investigator1]

Hi Gurberly, there isn’t a lot of information in the UK about that but the US have produced some guidelines (CDC) and they are saying to have the first part of the vaccine at least 4 weeks prior to treatment with the second part somewhere in between. They also say for immune suppressed the 2 x Shingrix doses can be as close as 4 weeks apart for those of us on treatment. To be honest I don’t think it’s been very well thought out over here, some Practices are referring patients over 50 who are immune affected and some haven’t a clue like my practice. Yesterday I popped in to tell them I didn’t need the Flu Vaccine because I have just had it at the same time as my Covid (I thought it was the decent thing to do) and considering I emailed them 3 weeks ago I asked about the Shingles Vaccine to be told sternly by the Practice Manager “you’ll be called when it’s your turn for the Zostavax” Clueless! I tried to explain but ………..total waste of time, this is what happens when you have so called practice managers who are not medically trained. She used to run a nightclub I think. I have just had the Covid and Flu and I am absolutely poleaxed.

[Gurberly in reply to Investigator1]

Thanks for your comments.

Flu last week and covid next week. for me.

It was a struggle to get past the opinion of the receptionist who was adamant that I did not qualify (computer says no) and get her to talk to the practice nurse who agreed that the guidelines for shingles vaccine had changed recently and that I should "probably" qualify. It seems the practice processes have not yet caught up.

I'll leave it now until after the next infusion but as I am seeing my consultant about that time, I shall mention it to them and see what they think or if they would be prepared to write to my GP practice requesting it.

[Investigator1 in reply to Gurberly]

Hi Gurberly jus to keep you updated. I spoke to the GP practice pharmacy today and he wasn’t sure but said he would find out. He rang me back at 2pm today to tell me I was definitely entitled to it (I am 62) and to ring the GP reception to book a Shingles jab. I have done and I am booked in for 4 weeks prior to my Rituximab.