Are you getting a flu shot?

[Beth36]

My mom was told not to get once, since she is having a transplant soon.  The donor coordinator told her that it raises antibody levels and she has high PRA anyway.  I need to get one and make my hubby get one, too.  Our son won't like it but oh well, a sick toddler isn't fun and if I can avoid it I will!


Beth

[Roxy]

Has anybody heard of the flu mist? or gotten it? I ask because I remember seeing a poster in my transplant neph's office about it and I looked it up and I guess it is the flu vaccine through a nasal spray instead of using needles. I'm not sure if dialysis patients are recommended it since they have a weakened immune system as well as transplant patients but I thought I would bring it up. To my knowledge it is a live virus, so anyone who has had a transplant or anybody in close contact with someone who has had a transplant shouldn't get it because the transplant patient would get the flu.

[Laurie]

My mom was told not to get once, since she is having a transplant soon. The donor coordinator told her that it raises antibody levels and she has high PRA anyway.
Beth

Thanks for mentioning that Beth, I was planning on getting one, but now I'm not so sure. I am on the transplant list and I surely don't want to do anything that will raise my PRA  

[brenda]

I got one once and got the flu, so, no thankyou! They can only immunize you anyway from the strains that have already gone around, they can't immunize you against the new one's that seem to come every year.

[mcjane]

I'm getting mine tomorrow, wouldn't be without it the flu can be a killer.

The shot is killed vaccine & you ABSOLUTELY CAN NOT get the flu from it. The nasal spray is weakened live vaccine & it's said you cannot get the flu from that either.

I'm playing it safe & am going for the shot.

[Ken Shelmerdine]

I get one every year but this year for the first time I had a reaction. Sort of mild flu symptoms for a couple of days.

[paddbear0000]

None of my doctors recommend the nasal spray one. They've all said it doesn't work as well as the shot.

[Bill Peckham]

The CDC has a great deal of vetted information available on the seasonal flu vaccine. http://www.cdc.gov/flu/professionals/acip/shouldnot.htm discusses Persons Who Should Not Be Vaccinated; the information distinguishes between TIV ( trivalent inactivated influenza vaccine) and LAIV( live, attenuated influenza virus ... aka FluMist®). My take away is that dialyzors should not take the LAIV version.

However, in all the recommondations scattered across the site I did not see mention of dialyzors (or even dialysis patients). I sent the following note to the CDC email address listed:

Looking at your web site regarding the seasonal influenza vaccine - specifically these two pages:
Persons Who Should Not Be Vaccinated  http://www.cdc.gov/flu/professionals/acip/shouldnot.htm
and
Persons for Whom Annual Vaccination is Recommended  http://www.cdc.gov/flu/professionals/acip/persons.htm

I noticed that there is not specific information for people with stage 5 chronic kidney disease. These would be people who are on dialysis or living with a kidney transplant; I believe each group has a specific recommendation. My understanding is that people on dialysis should get the TIV vaccine and should not receive the LAIV vaccine. Specific information for people waiting for a transplant would be very helpful.

I note that on table five of the page:
Influenza Vaccination Coverage Levels http://www.cdc.gov/flu/professionals/acip/coveragelevels.htm
it is noted that Persons with high-risk conditions"   include those told by a physician they have ... weak or failing kidneys. This discribes those with stage 1 to 4 chronic kidney disease, seeming to exclude those with stage 5 chronic kidney disease.

Please issue guidance for those living with stage 5 chronic kidney disease.

Sincerely,
Bill Peckham

[paddbear0000]

 

[goofynina]

YOU GO BILL    Thank you    Keep up the great work 

[willieandwinnie]

I took my husband for he's weekly post-transplant appointment yesterday and the nurse said no flu shot for him just yet. She said they had patients have rejection episodes that received flu shots. I called my GP this morning about getting one and they said they won't even have them until the end of Oct.

willieandwinnie

[MyRenalRomance]

Absolutely, yes.  I get a flu shot every year, and even got the pneumonia shot, last year.  Better safe than sorry. 

[KT0930]

My mom was told not to get once, since she is having a transplant soon.  The donor coordinator told her that it raises antibody levels and she has high PRA anyway.  I need to get one and make my hubby get one, too.  Our son won't like it but oh well, a sick toddler isn't fun and if I can avoid it I will!


Beth

I got mine yesterday at the doc's office, and he's well aware of my high PRA (we discuss it EVERY time I'm there). No one's said a word to me about that. Doc told me to start calling and bugging my transplant coordinator anyway, so I guess I can ask him - though it's a little late for this year.

[skyedogrocks]

Rob got one last week.  This was the first year he had a mild reaction to it.  Just a couple of days of feeling very blah and nauseous. 

I read that those living with someone who has kidney disease & diabetes should get the shot too.  So, me and our son will get the shot too.  I never got one before.

[Bill Peckham]

Nice - I received a reply from the CDC. I have not had time to look through the links. Here is their reply:

Thank you for your inquiry to CDC-INFO.  In response to your request for information on the recommendations for influenza vaccination of people with end stage kidney disease or for those who have received a kidney transplant, we are pleased to provide you with the following relevant information. 

The following document on the CDC website gives health professionals guidance on recommendations for vaccination of people with kidney disease:

Guidelines for Vaccinating Kidney Dialysis Patients and Patients with Chronic Kidney Disease
http://www.cdc.gov/vaccines/pubs/downloads/b_dialysis_guide.pdf

These guidelines are not meant to apply to kidney patients who are recently post-transplant. These patients are considered more significantly immunosuppressed than those who have only chronic kidney disease, with or without dialysis.

Recommendations for vaccination of immunosuppressed persons, including those who have received a solid organ transplant and are on chronic immunosuppressive therapy and/or corticosteroids can be found in the following documents on the CDC website:

General Recommendations on Immunization
Recommendations of the Advisory Committee on Immunization Practices (ACIP)
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5515a1.htm

The Pink Book
Epidemiology and Prevention of Vaccine Preventable Diseases
http://www.cdc.gov/vaccines/pubs/pinkbook/pink-chapters.htm

TABLE 11. Vaccination of persons with primary and secondary immune deficiencies
National Immunization Program
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5515a1.htm?s_cid=rr5515a1_e#tab11

Live vaccines can cause severe or fatal reactions in immunosuppressed persons due to uncontrolled replication of the vaccine virus. Live vaccines should not be administered to severely immunosuppressed persons for this reason.

Both diseases and drugs can cause significant immunosuppression.  Oral Polio Vaccine should not be given if an immunosuppressed person is in the household. However, Measles,Mumps and Rubella, varicella vaccines, and live attentuated influenza vaccine (the nasal flu vaccine) may be given when an immunosuppressed person lives in the same house. Household contacts of immunosuppressed persons may receive zoster vaccine if indicated. Transmission has not been documented from a person who received herpes zoster vaccine.

Persons receiving large doses of corticosteroids should not receive live vaccines. For example, this would include persons receiving 20 milligrams or more of prednisone daily or 2 or more milligrams of prednisone per kilogram of body weight per day for 14 days or longer.  Corticosteroids used in greater than physiologic doses can also reduce the immune response to vaccines. Vaccination providers should wait at least one month after discontinuation of high dose systemically absorbed corticosteroid therapy, administered for more than two weeks, before administering a live-virus vaccine

Aerosolized steroids, such as inhalers for asthma, are not contraindications to vaccination, nor are alternate-day, rapidly tapering, and short (less than 14 days) high-dose schedules, topical formulations, and physiologic replacement schedules.

Inactivated vaccines may be administered to immunosuppressed persons. Certain vaccines are recommended or encouraged specifically because immunosuppression is a risk factor for complications from vaccine-preventable diseases (i.e., influenza, invasive pneumococcal disease, invasive meningococcal disease, invasive Haemophilus influenzae type b disease, and hepatitis B). However, response to the vaccine may be poor depending on the degree of immunosuppression present. Because a relatively functional immune system is required to develop an immune response to a vaccine, an immunosuppressed person may not be protected even if the vaccine has been given.

For more information about influenza vaccination, please visit the CDC website:

Primary Changes and Updates in the 2007 Recommendations
National Center for Immunization and Respiratory Diseases
http://www.cdc.gov/flu/professionals/acip/primarychanges.htm

Key Facts About Seasonal Flu Vaccine
National Center for Immunization and Respiratory Diseases
http://www.cdc.gov/flu/protect/keyfacts.htm

Questions and Answers: Seasonal Flu Vaccine
National Center for Immunization and Respiratory Diseases
http://www.cdc.gov/flu/about/qa/fluvaccine.htm

Questions and Answers: Seasonal Flu Shot
National Center for Immunization and Respiratory Diseases
http://www.cdc.gov/flu/about/qa/flushot.htm

Questions and Answers: The Nasal-Spray Flu Vaccine (Live Attenuated Influenza Vaccine LAIV)
National Center for Immunization and Respiratory Diseases
http://www.cdc.gov/flu/about/qa/nasalspray.htm

Vaccines and Immunizations
National Center for Immunization and Respiratory Diseases
http://www.cdc.gov/vaccines

Thank you for contacting CDC-INFO Contact Center. Please do not hesitate to call 1-800-CDC-INFO, e-mail cdcinfo@cdc.gov or visit http://www.cdc.gov if you have any additional questions. 

CDC-INFO is a service of the Centers for Disease Control and Prevention (CDC) and the Agency for Toxic Substances and Disease Registry (ATSDR).  This service is provided by Vangent, Inc. under contract to CDC and ATSDR.

[BigSteve]

Thanks for the research, Bill. I'm glad I got the flu shot.
Also, the CDC says that revaccination of the Pneumonia
shot should be after 5 years for adults.

[angela515]

Thanks for the research, Bill. I'm glad I got the flu shot.
Also, the CDC says that revaccination of the Pneumonia
shot should be after 5 years for adults.

I was just going to mention that. I got my phemonia shot in 2005, so I won't get it again until 2010.

[KT0930]

I checked with my transplant coordinator about the shot raising your PRA, and he said that it's a temporary thing, similar to if you were to get the flu itself.

[thegrammalady]

what most people get that they call flu really isn't. i'm getting my shot, the flu can kill you. it is really important for children, the elderly and those with compromised immune systems (all of us) .

[Jannie]

I got my flu shot Saturday at my Dialysis Center. I also got the Pneumonia shot. As long as they don't bill me for them,I'm cool with it.

[Krisna]

I got mine last Wednesday at dialysis.  I get it every year and never have any symptoms from getting the shot.  I did however, used to get sick enough to land in the ER via ambulance before I started getting the shot every year!  I swear, I think I'm the only dialysis patient who was ever hospitalized with dehydration!  lol 

[donnia]

I got mine today at dialysis.

[Sunny]

Yes, got my flue shot today.My renal doctor tells me I must get it every year. I've got to admit, last winter when the people around me were falling like flies with flue,I didn't get it. My renal doctor also suggest my husband and teenage children get the flue shot as well.

[Jannie]

I got my flu shot Saturday. I was nervous about it because my last flu shot in 2005 I got a reaction 2 days later-headache,fever and very lethargic for a day. This year I had no problem, just a slightly sore arm and a dime-size black and blue mark. My other arm was infiltrated during dialysis a month ago, so it's black and blue all over. Now I can proudly state I have two sore arms. But I won't get the flu. Actually, I haven't been sick with the flu since the 1960's. I've been very lucky!

[Jill D.]

Got mine today. I think I am now immune to needle pokes because I didn't even feel it. And to think when I was a kid i was wiling to forego summer camp because I would need a shot....