Shingles Vaccine (Shingrix): Is it advisable for transplant patients?

Posted by azdan99 @azdan99, Jul 31, 2020

Is it advisable and safe for a transplant patient to get the new shingles vaccine, Shinglex?

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@rosemarya

I would like to Re-direct this discussion back to the original question: Is it advisable and safe for a transplant patient to get the new shingles vaccine?

Shingles a viral infection that causes a painful rash. It is caused by the varicella-zoster virus — the same virus that causes chicken-pox. Vaccines can help reduce the risk of shingles. Here is information about the causes, risk factors, complications and prevention (vaccine) for shingles. Shingles - https://www.mayoclinic.org/diseases-conditions/shingles/symptoms-causes/syc-20353054

Shingrix was approved by the FDA in 2017 and is the preferred alternative to Zostavax. Studies suggest Shingrix offers protection against shingles beyond five years. It's a nonliving vaccine made of a virus component, and is given in two doses, with two to six months between doses.
Shingrix is approved and recommended for people age 50 and older, including those who've previously received Zostavax. Zostavax isn't recommended until age 60.
Zoster Vaccine Recombinant, Adjuvanted (Intramuscular Route) - https://www.mayoclinic.org/drugs-supplements/zoster-vaccine-recombinant-adjuvanted-intramuscular-route/description/drg-20406737

I had the original shingles (live) vaccine right before I was placed on the transplant list because my Mayo team knew (in 2009) that I would not be eligible for the live vaccine after a transplant. My first transplant team did not even mention it to me. When the new Shingrix was approved by FDA in 2017, Mayo okeyed it for me when I inquired about it. My transplanted organs are a liver and a kidney and my age fit the standard requirements.

@jodeej, @gaylea1, @jolinda, - Have you any update about asking your doctor?
@azdan99, We look forward to hearing from you after your appointment.
@estrada53, How are you doing? Did you get the 1st shot?

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@rosemarya my husband has an appointment this coming Thursday the 20th at the Portland transplant center at Samaritan Hospital. I have asked him to write down a list of questions, as he will be getting established there. One thing is to ask if he is eligible for a shingles vaccine. Unfortunately I will not be with him, like I normally am for transplant center appointments. I will be visiting my specialist in Eugene which is 200 miles away from him.
Ginger

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@gaylea1

My doctors have not recommended for me to get the shingles vaccine even though I've had it once post transplant (1 year)

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@gaylea1 My transplant team told me not to get it, it has immunity boosting ingredients.
JK

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Last week i had a person to person appointment with my transplant cardiologist at the VA. I had posed this question to him weeks earlier.
He does NOT recommend me getting either of the shingles vaccines. He referenced the suggestions from 2 transplant physicians groups that do not recommend either shingles vaccine for heart transplant patients. Maybe it is my age (73) or my drug protocol. My health is generally good for my age and health history. We also discussed the Covid-19 vaccines, which is too early to recommend.
My guidance, ask the doctor that is most knowledgable of your transplant case.

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@azdan99 This response is a bit late but I just found this out yesterday in an article in my email.
Shingrix OK'd For Immunocompromised Adults | MedPage Today
https://www.medpagetoday.com/infectiousdisease/generalinfectiousdisease/93760
I had been upset that my transplant hospital, Mass General (MGH), would not yet approve the Shingrix vaccine for immunocompromised patients but apparently it had not been approved yet by the FDA!

I expect that I will hear from MGH very soon telling me that I can get it. That will be a huge relief. My sister-in-law has been feeling the effects of shingles since she first got it in March. Shingles put her in the hospital two times due to extreme pain. At this point she has even tried acupuncture. I want to get the vaccine and be less concerned about it. I realize not everyone gets an extreme case of it as my sister-in-law has, my husband has had shingles two times and both times it was just a minor nuisance that cleared up in less than a month.
JK

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@contentandwell

@azdan99 This response is a bit late but I just found this out yesterday in an article in my email.
Shingrix OK'd For Immunocompromised Adults | MedPage Today
https://www.medpagetoday.com/infectiousdisease/generalinfectiousdisease/93760
I had been upset that my transplant hospital, Mass General (MGH), would not yet approve the Shingrix vaccine for immunocompromised patients but apparently it had not been approved yet by the FDA!

I expect that I will hear from MGH very soon telling me that I can get it. That will be a huge relief. My sister-in-law has been feeling the effects of shingles since she first got it in March. Shingles put her in the hospital two times due to extreme pain. At this point she has even tried acupuncture. I want to get the vaccine and be less concerned about it. I realize not everyone gets an extreme case of it as my sister-in-law has, my husband has had shingles two times and both times it was just a minor nuisance that cleared up in less than a month.
JK

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I'm a bit surprised. Since Mayo Phoenix oked it quite a while ago. Interesting how different Transplant centers see things differently. But like @azdan99 said maybe there is more in the decision than just age.
Blessings

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@danab

I'm a bit surprised. Since Mayo Phoenix oked it quite a while ago. Interesting how different Transplant centers see things differently. But like @azdan99 said maybe there is more in the decision than just age.
Blessings

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@danab I realize that Mayo had Ok'd it previously so I was very upset that MGH had not but I see why they hadn't. They tend to be conservative and without FDA approval I'm not surprised that they held off.
JK

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@contentandwell

@danab I realize that Mayo had Ok'd it previously so I was very upset that MGH had not but I see why they hadn't. They tend to be conservative and without FDA approval I'm not surprised that they held off.
JK

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Hi all,
I am a transplant patient. My question is how much immunity can we expect from vaccinations taken AFTER transplant with immune suppression drugs? Are the results similar to the covid-19 vaccine (50% chance of developing antibodies) or the results better for the pneumovax 23, Hep A and B, Shingrix vaccines?

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@hello1234

Hi all,
I am a transplant patient. My question is how much immunity can we expect from vaccinations taken AFTER transplant with immune suppression drugs? Are the results similar to the covid-19 vaccine (50% chance of developing antibodies) or the results better for the pneumovax 23, Hep A and B, Shingrix vaccines?

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@hello1234 That's a good question. I wondered about that also but I read somewhere that the other vaccinations do provide immunity. Perhaps they provide less immunity but some immunity is better than none.

Transplant patients have always been advised to get flu shots so I presume that they must feel the flu shots do give us similar immunity from the flu that patients not on immunosuppressants get. I would love to see this answered by someone with real facts though.
JK

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@contentandwell

@hello1234 That's a good question. I wondered about that also but I read somewhere that the other vaccinations do provide immunity. Perhaps they provide less immunity but some immunity is better than none.

Transplant patients have always been advised to get flu shots so I presume that they must feel the flu shots do give us similar immunity from the flu that patients not on immunosuppressants get. I would love to see this answered by someone with real facts though.
JK

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“Protective immunity to the flu virus is driven mainly by antibodies (Fig. 1) made by B cells.” - https://www.nature.com/articles/d41586-020-02556-2#ref-CR2

There are different types of B cells. Including the memory ones from pretransplant day flue shots we have received. So, to me that seems to be our hope. But, I don’t see how getting the Covid vaccine or any additional vaccines will help those of us on immunosuppressants, since our bodies are now not producing B cells to repel viruses we are newly exposed to. 😷

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@athenalee

“Protective immunity to the flu virus is driven mainly by antibodies (Fig. 1) made by B cells.” - https://www.nature.com/articles/d41586-020-02556-2#ref-CR2

There are different types of B cells. Including the memory ones from pretransplant day flue shots we have received. So, to me that seems to be our hope. But, I don’t see how getting the Covid vaccine or any additional vaccines will help those of us on immunosuppressants, since our bodies are now not producing B cells to repel viruses we are newly exposed to. 😷

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Thanks@athenalee.
I think the question of the viability of t and b cells helping us out is the next topic if research at JH. We'll see what happens but I am not super hopeful. My hope is more of a wish. 🙂

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