Commencing on a re-vaccination programme is a normal part of post transplant care. This involves repeating the vaccines you were given as a child with some additional ones such as the ‘flu vaccine.
As a child the reason we have vaccinations is twofold –
1) To protect against serious preventable infections.
2) From the public health point of view it is essential not to have increasing numbers of individuals vulnerable to serious diseases.
Why do I need vaccinating again?
The transplant process causes loss of the immune memory that has built up over many years of exposure to infectious agents and vaccines.
After transplant you are, therefore, vulnerable to all types of infection some of which are preventable by vaccine.
Studies have shown that antibody levels (showing protection to specific diseases such as diphtheria) fall over a number of years after transplant even if your immune system shows recovery.
What is a vaccine?
Vaccines stimulate the immune system of an individual to develop immunity to a specific disease.
I have had vaccinations but they have not worked?
Many patients with prolonged reduced immunity are unable to mount a protective immune response when they are vaccinated.
The more immunosuppression you have received the less likely you will be able to respond to vaccines.
Also many patients remain immunosuppressed for a long time due to GvHD.
Chronic GvHD unfortunately reduces immunity to some pathogens particularly pneumococci.
Immune deficiency is caused by a combination of:
- the conditioning regime given before the transplant
- immunosuppressive therapy given after the transplant
Reconstitution of the immune system can differ greatly between patients. Why this should be is still unknown.
When will I start my vaccinations?
Once you are 6 months post transplant as the vaccine response is usually poor before this time.
If my response to vaccination is poor what else can we do?
A way to reduce the risk for vaccine preventable infections is to reduce the likelihood of exposure. This can be achieved by vaccinating family members, with the ‘flu vaccine for example and ensuring that childhood vaccines have been given.
If you feel that your relative is at risk please speak to your transplant team.
How do you know that they have not worked?
Testing for antibody levels can be used to determine the need for vaccination or to assess the response to vaccination. This is a blood test and will be performed at least yearly to assess on-going response to the vaccinations.
Will there be any side effects?
Like any medicine, vaccines may cause side effects, but receiving one is far safer than getting the disease it prevents. The most common reactions include soreness, redness and swelling in the area of the injection or a low grade fever. The healthcare professional administering your vaccines will explain all of this before you have your injections.
If you are worried about anything or feel that you do not wish to have vaccinations please speak to your clinical team.