Living With CLL During Flu Season: What Vaccines Are Recommended?

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Andrew Schorr:

Now let's go back to the basics before the end, Jeff, and this that is flu season coming up.  

Dr. Sharman:

Yes.   

Andrew Schorr:

And there's also a shingles vaccine.  And also some people related to hepatitis B.  

What are you telling your patients about vaccines?  My friend Jeff Folloder said somebody at MD Anderson had them maybe getting two flu shots. 

Dr. Sharman:

Yeah.  

Andrew Schorr:

So first of all, flu shots, and do we need more than one?  And what about these other shots?  

Dr. Sharman:

Yeah, so starting with flu I would encourage all my patients CLL patients to get flu shots.  The response is nearly universal.  Everybody always says, well, I got a flu shot and I still got sick.  A flu shot does not prevent all illness.  Flu prevents flu.  And patients with CLL get more complications from flu, because their immune system has a cancer in it.  So CLL is a cancer of the immune system, so to whatever extent you can give yourself a head start to fight off flu I would encourage patients to do so.  

Andrew Schorr:

More than one shot?   

Dr. Sharman:

Well, so I will say that patients with CLL generally have less of a response to a flu vaccine than somebody without CLL.  

So you don't get as much protective benefit if you have CLL as somebody without it.  I don't think, at least, I'm not familiar with data that says two flu shots are better than one.  It may be out there and I'm not aware of it, but I mean I could understand why you might.  It at least biologically makes sense.   

Andrew Schorr:

And the shingles vaccine? 

Dr. Sharman:

Yeah, so very few clinic days go by where I don't curse shingles at least once.  For anybody who has had shingles you know it can hurt really badly, and there is this condition called post-herpetic neuralgia, which is a sort of a lingering pain syndrome that can go on for years for patients who have had shingles and can be a life altering pain.  And so, again, I think whatever head start you can give your immune system it's worth doing.  

And I guess the reason why I curse shingles so frequently is because it does seem to go part and parcel with lymphomas and CLL.  Again, you have a cancer of the immune system.  The immune system doesn't work as well, and, boy, I can't count the number of times where somebody gets shingles just as their CLL is acting up and then it delays treatment, or somebody is going through treatment with a lot of pain as a result.  

Andrew Schorr:

So you're not worried about the vaccine?  

Dr. Sharman:

No.  Not only am I not worried I highly encourage it.  But I would point out that the old vaccine was a live virus, and there were problems giving that to patients with CLL.  There is a new dead virus, Shingrix, that's in short supply.  

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.