shingles shot | Arthritis Information

 

Has anyone had a shingles shot?  I guess with our immune system that we should have it.
Anybody?
I think the Shingles vaccine is live virus and if you're on dmards and/or biologics you shouldn't have a live virus.  Best to talk with your RD about this.  LindyGood question!  ~ Bump!It is a live vaccine and not recommended for anyone under 60 years of age.

From http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5515a1.htm

[quote=CDC]Because the risk of morbidity and mortality from herpes zoster is heightened in immunocompromised persons, eligible patients who are scheduled to begin immunosuppressive therapy should be immunized at least 14 days (preferably a month, according to some experts) before such therapy is initiated. Otherwise, immunization is contraindicated in immunocompromised persons.
...
The zoster vaccine is licensed for use only in persons 60 years and older. It is safe for those who are receiving blood products. Persons who already have been vaccinated against varicella-zoster virus should not be re-immunized; however, the ACIP stated that concern regarding unintentional re-immunization in persons 40 years and older was slight because varicella vaccination did not begin in the United States until 1995. The ACIP also noted that there is no need to question older patients about a history of chickenpox or to conduct serological testing for varicella immunity before administering the vaccine. Persons who have had an episode of herpes zoster in the past can receive the vaccine, but it should not be used to treat acute herpes zoster or PHN or be used as prophylaxis against PHN. In the absence of contraindications and precautions related to health status, persons with chronic renal failure, diabetes mellitus, rheumatoid arthritis, chronic pulmonary disease, or other chronic conditions can receive the vaccine.

Persons on immunosuppressive therapy, including high-dose corticosteroids (>20 mg/day of prednisone or equivalent) lasting two or more weeks. Zoster vaccination should be deferred for at least 1 month after discontinuation of such therapy . Short-term corticosteroid therapy (<14 days); low-to-moderate dose (<20 mg/day of prednisone or equivalent); topical (e.g., nasal, skin, inhaled); intra-articular, bursal, or tendon injections; or long-term alternate-day treatment with low to moderate doses of short-acting systemic corticosteroids are not considered to be sufficiently immunosuppressive to cause concerns for vaccine safety. Persons receiving this dose or schedule can receive zoster vaccine. Therapy with low-doses of methotrexate (<0.4 mg/Kg/week), azathioprine (<3.0 mg/Kg/day), or 6-mercaptopurine (<1.5 mg/Kg/day) for treatment of rheumatoid arthritis, psoriasis, polymyositis, sarcoidosis, inflammatory bowel disease, and other conditions are also not considered sufficiently immunosuppressive to create vaccine safety concerns and are not contraindications for administration of zoster vaccine.[/quote]

Like most decisions facing us, this one needs to be discussed with both RD and PCP and the pros and cons carefully weighed.

Cheers!
Thank you so much Spelunker  - great info! Thank you Lindy and Shug.  I will print this info and discuss it with my Doc's.  I will be starting remicade soon so perhaps I should have it.  
I have been informed that medicare will pay 80% for remicade, but not Enbrel or Humira.  I will keep you posted.

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