Tell them, repeat, then tell them again
That was a mantra I learned a long time ago in graduate school regarding the art of effective teaching.
I have written several times on the subject of swine flu, its complications and its special impact on people with immune system related diseases. You qualify automatically for the high risk group since you have CLL. Additional factors that can put you in an even higher risk category are
- Advanced CLL
- Chemotherapy treatment (including monoclonals)
- Steroid use
- Autoimmune disease
- History of chronic pulmonary inflammation, sinusitis
- Asthma
- COPD
- Pulmonary fibrosis
- History of pneumonia in recent past
- Low T-cell counts
- Low immunoglobulin levels
- Stem cell transplant
- Secondary cancers
The list is long and I am willing to bet most of our guys have more than a couple of these additional risk factors on top of the CLL. See, I am not being overly alarmist – I did not bother you about the risk of being pregnant.
There is only so much we can do to avoid catching the flu this fall. You can wash your hands raw, bathe in alcohol gel, become a hermit for the duration and so on, but it is impossible to avoid all avenues of infection. When / if a vaccine rolls out for this novel pandemic swine flu bug, chances are CLL patients will mount a puny response to it and therefore will be poorly protected.
But there is one thing you can do to reduce your risk of dying if you do catch the bug. And that is talk to your doctor about getting a pneumonia shot. Please get your spouse protected as well – for a change love and self interest point in the same direction.
Will the pneumonia shot guarantee you will not get pneumonia this fall? No, it does not. The vaccine works only on certain types of pneumonia and not on viral versions of it. But as I pointed out in a recent article, one of the complications following influenza infection is opportunistic infection with bacterial pneumonia. Every little bit of protection helps and I strongly urge you to act upon this sooner rather than later.
The LA Times article (below) discusses many of the issues clearly. Also, below are links to several of our earlier articles on this site as well as on our flagship website www.clltopics.net
Pandemic 6 Declared: What it Means to CLL Patients
Infectious Complications in CLL
Role of pulmonary inflammation in CLL
The weather outside is hot, 100% humidity and the mosquito swarms are large and very blood-thirsty. I will be here in India for several more months. The good news is that I have broadband internet access and that means I can continue doing what I do here. Send me photographs of snow, pristine landscapes with no sign of people! It feels like a different world here. I have been away for far too long and feel a stranger in the land where I was born.
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Pneumonia vaccine may help limit swine flu deaths
http://www.latimes.com/features/health/la-sci-pneumonia4-2009aug04,0,6872284.story
Most of the serious consequences linked to the H1N1 virus are the result of pneumonia, but the Pneumovax vaccine is underused.
By Thomas H. Maugh II
August 4, 2009In years past, the nation’s attempts to prevent flu-related deaths have focused on limiting transmission of the virus through widespread vaccination programs. This year, with school starting up well before a vaccine for the pandemic H1N1 influenza virus will be available, there will be little that can slow the spread of the virus for the next few months.
But there may yet be something that can be done to reduce hospitalizations and deaths associated with the virus, commonly known as swine flu, public health authorities say.
Most of the serious consequences linked to the virus are the result of pneumonia, and an underused vaccine called Pneumovax can prevent, or at least limit, such complications in many patients.
“We would certainly like to see the vaccine used more extensively,” said Dr. William Schaffner, chairman of the preventive medicine department at Vanderbilt University School of Medicine and president-elect of the National Foundation for Infectious Diseases. Schaffner was a member of the Centers for Disease Control and Prevention advisory committee on vaccines that in early June strongly affirmed current recommendations for who should receive the vaccine.The normal target population for the pneumonia vaccine is a microcosm of those groups most likely to die or suffer serious complications from flu, so most experts say that eligible people should receive Pneumovax independent of its ability to affect the current pandemic.
But those recommendations have apparently slipped by largely unnoticed, Schaffner said.
U.S. sales of Pneumovax have not increased since June, according to John D. Grabenstein, senior director of Adult Vaccine Medical Affairs for Merck Vaccines and Infectious Diseases. Sales in Europe have risen, however, in response to similar recommendations by health authorities there.
“Unfortunately, I think too much emphasis has been placed on inappropriate administration of [the antiviral drug] Tamiflu, which has its own side effects and, aside from that, may create resistance,” said Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in New York. “Most of my pulmonary patients are already getting [Pneumovax], but I am broadening my recommendation to other patients, since it is such a relatively harmless thing to do.”
Further, the vaccine provides protection against pneumonia for up to 10 years, meaning one vaccination provides at least some safeguard not just this year but for future flu seasons as well.
Some physicians are more skeptical about the pneumococcal vaccine’s potential to limit flu deaths.
“I think that the pneumococcal vaccine is a very important vaccine that should be taken by all for whom it is appropriate,” said Dr. Aaron Glatt, president and chief executive of New Island Hospital in Bethpage, N.Y., and a spokesman for the Infectious Diseases Society of America. “Whether it could play a role in preventing complications from swine flu . . . I don’t think that is known.”
The problem is that there are many causes of pneumonia, an inflammation of the lungs that interferes with breathing and can be fatal. The influenza virus itself can cause pneumonia, as can many others. Or the lungs can be invaded by a bacterium such as Streptococcus pneumoniae or Staphylococcus aureus when the patient is weakened by a viral infection. Pneumovax protects against 23 strains of S. pneumoniae.
It is not yet clear what proportion of swine-flu-related pneumonia is caused by S. pneumoniae and thus could be prevented or ameliorated by immunization.
But preliminary results presented to the CDC vaccine committee in June by Dr. Matthew R. Moore, a medical epidemiologist at CDC, indicated that about 40% of swine-flu-related pneumonia had an unknown cause — and that about 30% were caused by S. pneumoniae. This suggests that at least a third of flu-related pneumonia deaths could be prevented by vaccination.
At least 70 million Americans are in groups that the CDC recommends receive the vaccine, according to Moore. That includes about 22 million people ages 2 to 64 with chronic underlying conditions, such as diabetes and heart disease; about 3.5 million with asthma; about 30 million smokers; and all people over the age of 65, about 15 million.About two-thirds of the elderly have been vaccinated, Moore said, but fewer than a third of the other groups.
“It’s really a good idea to take it,” said Dr. Peter Gross, an infectious diseases expert at Hackensack University Medical Center in New Jersey. “I don’t know why it is not pushed more.”
The committee has not recommended the vaccine for pregnant women, who are about six times as likely to die from complications of swine flu as the population at large.“I am not aware of any data suggesting that . . . pregnant women are at increased risk of pneumonia, whether during a pandemic or not,” Moore said. In fact, most of the pregnant women who have died from pandemic flu have suffered viral pneumonia, for which Pneumovax offers no protection.
The vaccine is relatively inexpensive. Merck charges $33 for the necessary one dose, and physicians who administer it typically charge the patient $50 to $75, which is covered by Medicare and private insurance.
Grabenstein said the company has “millions of doses” on hand and can ramp up production fairly quickly to produce more.
The side effects “are mostly local, including swelling and tenderness,” Horovitz said. “Significant side effects are rare unless you are dealing with someone who has a problem with vaccines in general.”
Most physicians would probably give the vaccine to patients who are not in one of the high-risk groups, but who ask for it anyway.
Dr. Linda Rosenstock, dean of UCLA’s School of Public Health, speculates that Pneumovax has not been promoted more heavily because the H1N1 pandemic has so far been perceived to be milder than seasonal flu. If the virus mutates to become more deadly, then the recommendations will become stronger, she believes.
But she argues that increased efforts should be made to vaccinate more people. “As a public health measure, it makes sense to target the groups we would be most worried about, independent of the pandemic.”
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43 comments on "Call me a nag…"
You may be a nag – but keep at it! Some of us will survive longer because of you. Thank you for the suggestion.
Chaya – my husband was given a pneumonia shot when he was first diagnosed with CLL (8 years ago). Would it be prudent for him to get another shot this year? He will be starting his fourth month of FCR in about two weeks…(don’t know if that makes a difference).
Thank you so much for all you do for CLL patients!!
SueD
My first blush guess is that after 8 years it may be worth re-vaccinating. But you should discuss with his doctor first.
The sad fact of life is that our guys have puny response to vaccinations – especially when they are in the middle of aggressive chemotherapy regimen. This is something you should discuss carefully with your husband’s physician.
You, on the other hand, are a totally different story. If you get a pneumonia shot not only will you be better off, it means that much less risk to your husband as well. Think “herd immunity”. Also, there will be someone to take care of him! I think the role of the caregiver is seriously undervalued. Our patients will fare a lot worse if there is no loving spouse or family member watching and worrying about them.
From what I’ve read about this Pneumovax shot, it is usually only ever given once to a person, except in unusual cases. Is that what you understand? Please comment, Chaya! Thanks.
From the Mayo Clinic site:
Precautions
If you have more than one doctor, be sure they all know that you have received pneumococcal vaccine polyvalent 23 so that they can put the information into your medical records. This vaccine is usually given only once to each person, except in special cases.
JudyW
No, I do not believe there is no once-in-a-lifetime restriction to getting a pneumonia shot. (But I could be wrong, so correct me if someone has firm information to the contrary). I believe most manufacturers suggest a 7 year interim between re-vaccinations. But this fall is a sufficiently high risk period that it may be worth discussing it with your doctor if you have had a pneumonia shot 5 or more years ago.
I got my pneumonia shot last month. The previous shot was 6 years ago. I am not considered high-risk (even though I have diabetes and Crohn’s disease). What clinched the case for my GP was that I would be traveling and living in India for several months.
I really appreciate this update, Chaya. Tom received his pneumonia shot at dx, 6 years ago. I have never gotten one. I understand “herd immunity”, but had not put puneumonia in the herd category. I always get a flu shot and make sure that our son’s and friends get one also. Sometimes, being repetitive really works—-I think it got through loud and clear to me!
Be well in your homeland and breathe it all in. You will find that when you come home to us, you will miss many things that are surrounding you right now in India.
Jenny Lou
Here is the official word on when to vaccinate and who may be re-vaccinated with Pneumococcal Vaccine PNEUMOVAX® 23. The link below is to a very detailed and long PDF. I have aslo abstracted several quotes from the PDF.
Polyvalent
Following pneumococcal vaccination, serotype-specific antibody levels decline after 5-10 years. A more rapid decline in antibody levels may occur in some groups (e.g., children). Limited published data suggest that antibody levels may decline more rapidly in the elderly (greater than 60 years of age). These findings indicate that revaccination may be needed to provide continued protection.
Pneumococcal vaccine should be given at least two weeks before elective splenectomy, if possible. For planning cancer chemotherapy or other immunosuppressive therapy (e.g., for patients with Hodgkin’s disease or those who undergo organ or bone marrow transplantation), the interval between vaccination and initiation of immunosuppressive therapy should be at least two weeks. Vaccination during chemotherapy or radiation therapy should be avoided. Pneumococcal vaccine may be given several months following completion of chemotherapy or radiation therapy.
Revaccination of immunocompetent persons previously vaccinated with 23-valent polysaccharide vaccine is not routinely recommended.
However, revaccination is recommended for persons ≥ 2 years of age who are at highest risk of serious pneumococcal infection and those likely to have a rapid decline in pneumococcal antibody levels, provided that at least five years have passed since receipt of a first dose of pneumococcal vaccine.
The highest risk group includes persons with functional or anatomic asplenia (e.g., sickle cell disease or splenectomy), HIV infection, leukaemia, lymphoma, Hodgkin’s disease etc.
——————————
So, JudyW, I guess we are both right. Our guys fall into the “special circumstances” category I think.
It is discouraging to report that my SLL was diagnosed as a result of hospitalization for pneumonia 6 months after my pneumonia vaccination. I am not looking forward to this flu season but I will get whatever flu/swine vaccines are available… and hope.
SCM
qb
Your story is not all that uncommon.
One of the intriguing leads unearthed (by NIH researchers, if memory serves me right) is that a significant percentage of newly diagnosed CLL patients have had one or more episodes of pneumonia in the prior couple of years.
My husband PC had a case of “walking pneumonia” one year before CLL diagnosis. When he died last year the active cause of death was pneumonia (brought about as a complication following a stem cell transplant).
My mother died from leukemia in 1980 (no idea what subtype) when she was 49. The *official* cause of death was pneumonia. I took your advice, MANY thanks, and got my vaccine last week. I’ve been on W&W for over 2 years now, so no chemo, but was unwilling to take the chance. Now I’ll have to bug my husband about getting one. Wish me luck on THAT one!
Here are some fabulous pictures of the Hawaiian surf. I find the ocean to be a healing force, not to mention the peace and relaxation. Hope this helps a bit. I know it did me. What a fantastic photographer!
http://www.clarklittlephotography.com/
Thanks so very much for all you do! Peace, Jennifer
Chaya, nag all you want – it’s needed and appreciated.
Correct me if I’m wrong, but it seems like I recall reading there are two types of pneumonia vaccines – if so, should both be taken?
John, excellent question!
John:
The two different types of pneumonia vaccines, relative merits etc were reported earlier in my article “Pandemic 6 Declared: What it Means to CLL Patients” (link given above in this article).
You should also read the excellent member discussion that followed the article.
How appropriate to be reading this from the 14th floor of UCSF Medical Center, where I have just been treated for pneumonia. The fever started last Thursday and luckily I will be released tomorrow. It came on like the flu (quickly rising fever, body aches), but they eliminated that possibility after a couple of days.
I answered yes on 6 of the high risk factors on your list. After reading your article I looked up when and what my last vaccine was. It was the pneumococcal polysaccharide vaccine and I had it seven years ago. Before my release tomorrow I will try to get revaccinated. Thanks for the timely reminder.
Chaya
Again, thanks for the timely update. I had my last pneumonia shot 5 years ago in October. I will get another one as soon as I can get to my doctor.
Rita
Chaya:
Thanks for keeping this in front of us. One thought – I am currently going through chemo FCP and as a precaution against pneumonia they have put me long term on trimethoprim antibiotic. Perhaps this in conjunction with the vaccine would be better then either by themselves.
Your thoughts on long term use of this antibiotic as a precautionary measure would be helpful. In any case I shall ask my oncologist about continuing this usage against H1N1.
Mike
As a result of CLL and the treatments which I received, my immune system (igg, iga, igm) was “wiped out” and continues to be very suppressed. As such, I routinely have my (igg, iga, igm) levels tested and I receive IVIG treatments every 4 to 6 weeks. I am also very susceptible to: respiratory, upper respiratory, ear and other infections.
I have received the “usual” flu vaccine in the Fall of each year. Previously, I was told that since I am immune suppressed and the pneumococcal vaccination is a “live virus” that I am not a candidate to receive this vaccination. (is this accurate?)
Questions:
• Am I a candidate to receive the “swine flu” vaccine this year – in addition to the the “usual” flu vaccine that I receive each Fall?
• Am I a candidate for the pneumococcal vaccination, even though it is a “live virus”?
Thank you for your comments!
CLL:
Pneumonia vaccine is NOT a live vaccine. You can get it without worry. The problem is that as a long standing CLL member you probably will not have a robust response to the vaccination and it may not do you as much good as it would an otherwise healthy person.
As for the fall pandemic H1N1 flu vaccine, I do not have enough information yet on what its components are going to be. When I have a better fix on it I will be sure to comment on it.
I expect the generic annual flu shot will continue to be quite safe and you should get it when it becomes available.
Deepgreen:
You should continue on any prophylactic antibacterials they have you on for as long as they tell you to keep taking them. Taking long term antibiotics is not fun. For starters, they kill all the friendly (good) bacteria in your gut and that can lead to GI tract inflammation and irritation. I suggest you eat a goodly amount of yogurt (the variety that has live probacteria in it) each day in an attempt to repopulate your gut. But it is important that you keep taking the prophylactic medications they have you on. Better safe than sorry, right?
Just to clarify one thing…while I agree that many people who might not otherwise consider it should receive the Pneumovax vaccine, it will NOT meaningfully produce “herd immunity” as most of the cases of bacterial pneumonia that it hopefully will prevent are not terribly “communicative” the way that viral infections such as influenza are.
Patients stricken with influenza and the resulting inflammation of their respiratory tract succumb to secondary infection with their own bacteria which are quite prevalent in the environment.
I broke my own rule and didn’t fully research things before I made the above comment. There is some evidence of a ‘herd immunity’ benefit when the conjugated pneumococcal vaccines (eg, Prevenar) are used. This is more easily demonstrated in children than in adults and most of the benefit seems to accrue in prevention of otits media and meningitis, but there is a possibility that use of Pneumovax or of the conjugated peumococcal vaccine might provide some herd immunity against pneumonia in adults.
Sorry,
Rick
thanks for eveyone’s comments. as the saying goes: “nothing is easy, or as it may initially appear”! My oncologist indicated to me that he is researching the swine flu vaccine, As Chaya indicated, not enough objective information and data is yet “out there”.
i have another question re: vaccines:
what about the shingles vaccine? I believe that this IS a live vaccine and as such, people with suppressed immune systems should not receive this. Is my information correct?
CLL’s mentioning shingles made me think of this question: should those of us whose immunoglobulins are still in the normal range get a shingles vaccine?
Tim
CLL, Tworrall:
No. Cll patients should not get the shingles vaccine – in my opinion. It is a “live” vaccine, but a weakened one. Some physicians seem to think that it is OK to give it to immune compromised folks (that is us chickens) because the virus is weakened. There is healthy controversy about it and Terry Hamblin has a good review of the pros and cons.
If you ask me, I would tell you not to get the new “live” shingles vaccine. But that is just my two cents since there is no definitive answer in this case.
After Dorene was heavily treated for sinusitis & bronchial problems by her pulmonolgist with antibiotics he recommended Florastor (good bacteria) It did a great job keeper her regular and feeling OK, stomach wise. PS it is an over the counter item. tcd111
Because of the reduced efficacy of pneumovax for CLL patients, the ‘protection’ will be far less than one would like. Recent studies have shown great promise in using first a dose of the conjugate vaccine followed by a booster of pneumovax a year later. CLL and AIDS patients seem to have a much better response to the conjugate vaccine offering some hope in improved efficacy by the two shot approach. See a recent review by Jackson and Janoff, “Pneumococcal Vaccination of Elderly Adults: New Paradigms for Protection”, Clin. Infect. Dis., Vol 47, pp 1328-1338, 2008.
As an aside, the conjugate vaccine covers only 7 of the 90 or so serotypes of s. pneumonia. A new conjugate vaccine, which covers 13 serotypes, is being fastracked for USDA approval.
As to the Zoster vaccine, a heat killed version is in clinical trials and the recruiting cohort includes CLL patients but it may be some time before we know about the efficacy. Remember that the current vaccine has about a 50% efficiacy.
I had a pneumovax shot in January 2007. I recently asked my GP if I should have another, and he said no. I forget how long he said I should wait, but he did say that you can only have 2 such shots during your lifetime and that if you get any more than that, their effectiveness is decreased.
Regarding shingles, I had a very bad case of them in ’07 that left me with permanent neuropathy and memories of weeks of horrible pain. I’d consider the vaccination under close supervision of my doctor, as 1 in 5 over 65 will get the shingles. There are three antivirals that I can think of that can be taken at the onset of shingles to mitigate the severity of disease. When I travel, at the recommendation of my doctors, I carry with me Valtrex, one of the antivirals, should the shingles come back, Somethng to consider if you travel, as once shingles gets started you have about 48 hours to start the antiviral treatment for it to be effective.
many thanks for providing a forum for an important timely well informed debate.
I am wondering what does the current best available evidence / experience suggest:
while recognising the potential meagre response for someone with chronic lumphocytic lymphoma (NHL) possibly only 3-4% should they still have the pneumococcal and flu vaccines?
Does the evidence suggest that if you are on chem there is no point in such vaccines till 4 to 6 weeks after completeion when there will be a meagre response even if one opts to have it then?
what is the best available evidence / experience please?
The above referenced article “Pneumococcal Vaccination of Elderly Adults: New Paradigms for Protection”, can be found at
http://www.journals.uchicago.edu/doi/pdf/10.1086/592691
should you want to read it.
Chaya
Is it okay for your partner to have the shingles vaccine? I have asked my oncologist, and my husband asked his doctor and the answer seems to be yes. But I am concerned about the live virus. I know that my friend who has lymphoma could not be around her grandchildren when they received live vaccinations. Does this apply to the shingles vaccine too? Thanks for helping us understand these issues. Enjoy India.
I am a 57 year old diagnosed 9/2008, Stage I with all the good prognostic stuff and otherwise very healthy! I received the pneumonia vaccine right away. My problem is I am a nurse working full time on a residential mental health unit at a VA hospital. The veterans on my unit are mostly homeless substance abusers with chronic medical problems. I love my job but am concerned how I can best protect myself. Would appreciate any input.
Thanks,
Pat
Chaya,
I am indebted to you for this “Nagging Information”.:) I will pass this onto my sister and her husband who also has CLL and is in treatment at the present. I also had the pneumococcal polysaccharide vaccine PPV on 11/20/07 at my work place. In my paperwork that I saved there is a question of How many doses of PPV are needed?
It says: a second dose is recommended for those people aged 65 and older who got their first dose when under 65,if 5 or more years have passed since the last dose. A second dose is also recommended for the people who have damaged spleen or none,sickle cell disease,HIV infection or AIDS,cancer,leukemia,lymphoma,multiple myeloma,kidney failure,nephrotic syndrome,organ or bone marrow transplant,taking medication that lowers immunity(chemotherapy or long term steroids).
So, I guess I am not able to get this again for another 3 years. I am not certain as to when my husband had his last pneumonia shot. SO I guess he ought to get one.I do get the flu shot every year though. They aren’t due out till October or November though are they?
Chaya et al
I have just returned from Dr. Byrd’s Clinic at OSU having finished Cycle ! of Concurrent RF protocol. My WBC at time of first infusion was 319+ with bulky-profuse nodes and 91% bone marrow infiltration. As of this writing my WBC is 15+ and signs of red cell recovery are underway.
Allopurinol has and is working well for me and there was not a hint of TLS or any first infusion related reactions. I did however suffer from edema, bloating, heartburn & constipation which had to be addressed as they appeared. Given my huge tumor burden everything has gone very well indeed. Care at OSU was great and responsive to changing conditions.
While it is proper to focus on the preventive vaccines for infections I would urge patients to act swiftly when symptoms arrive. The advice from OSU nursing staff was to monitor temperature at times of chills and flushing. If I recorded a temperature of 100 degrees for over one hour or a temperature of 101 degrees to go to the emergency room ASAP. Granted this was advice given to me following immunosupressive treatment but since many CLLers begin their journey by acquiring infections, this guide is of practicle value.
Chaya, I know of your concern for me at the Niagara CLL conference so take extra pleasure in your well deserved vacation, for your efforts in my CLL education were instrumental in my path of many decisions. True, I am not out of the woods yet but all is well and grateful for me right now.
WWW
Chaya: I’ve read everything twice. I can’t remember where or from whom I read something about receiving more than two regular pneumonia shots. “Burke” above mentions the doctor said more than 2 pneumonia shots in a lifetime reduces effectiveness. I’ve read that too. Sorry if I’ve missed something you’ve written, but would you comment on the foregoing, and if “pneumovax” is still in order for us who’ve had two shots already. This is complicated stuff. Ch
Yes, it is complex, made more so by inaacurate information and urban myths that circulate in patient communities – such as the one several comments above that suggested pnuemonia vaccinations use “live” virus vaccines. They do not.
As for a rule that there is a two shot life time limit on getting pnemonia vaccinations, that too is less than accurate. Please click on the link below to get the official word on polyvalent pneumonia vaccinations:
http://www.csl.com.au/docs/218/654/Pneumovax%20PI%20-%20approved%20Apr2007.pdf
In an earlier comment above I abstracted relevant portions from this link about when it is appropriate to revaccinate.
Hello Chaya, Please comment on using the “jab” and “dab” technique when receiving any of these vaccines. Thank you, Stan W.
“Jab & Dab” is an experimental concept we proposed for improving vaccination efficacy – based on solid leads in related fields of oncological vaccines. We funded and sponsored a trial (in cooperation with our sister patient organization UK CLL Support Association) to explore this concept at the Royal Bournemouth hospital. In a fit of unwarrented optimism I wrote an article titled “We have lift off!” in October 2007. Links to that article and other related articles are given below.
http://www.clltopics.org/SponsoredProjects/LHF.htm
http://www.clltopics.org/SponsoredProjects/JabNDab.htm
http://clinicaltrials.gov/ct2/show/NCT00596336
To my chagrin and regret, this project has stalled. The researcher in question has been hard to contact and when I finally managed to reach her told me she had trouble recruiting patients for this patient sponsored trial (with local patient group support to boot!)
I chalk this one as a failure on my part. A good concept (Dr. Terry Hamlin thought so and so did Dr. Ken Foon of FCR Lite fame), hard earned money to fund it, generously given local support and we have nothing to show for it. Sometimes you get the bear, sometimes the bear gets you.
I still think the concept has merit. But I am a scientist. Nothing is proven until it is proven. I wrote in an earlier article “a boatload of anecdotal evidence based on individual patients and what they do with the permission of their doctors will carry no weight. We absolutely need the results of a well-documented, well-conducted and officially sanctioned clinical trial before anyone will take this concept seriously.” Unfortunately we are no closer to getting results from a well documented and well conducted clinical trial, two years after the false start. The last business PC conducted before he died was infuse a further amount of funds into this trial in the forlorn hope that would jumpstart it – again. No such luck.
Will Jab & Dab work in improving efficacy of flu and/or pneumonia vaccinations? How can I advise you? I do not know the answer. No clinical data exists on the subject.
You are welcome to read the articles we wrote, refer to the references we cite in coming up with the concept, discuss the pros and cons with your doctor and make your own choices. Given the seriousness of the present situation (swine flu pandemic) and our particular concerns regarding lack of our guys mounting a robust response to flu and pneumonia vaccinations, what a blessing it would have been to have some solid clinical trial results to consider! I regret this more than I can tell.
“Revaccination of immunocompetent persons previously vaccinated with 23-valent polysaccharide vaccine is not routinely recommended”.
This is quoted from Chayas 8/6 attachment…http://www.csl.com.au/docs/218/654/Pneumovax%20PI%20-%20approved%20Apr2007.pdf
I hope this helps all who are contemplating a revist to their pneumoccal shot.
elcaringo
8/12/Swine flu vaccines
i was told that this new vaccine has immune boosters and alumin.Do you think it is dtill worth taking this very quickly tested shot?
thanks
ondrea
Ondrea:
There are a lot of rumors milling around, but no one knows for sure (yet) what the formulation of the new pandemic flu vaccine will be. When the information becomes available I will be sure to review it on this site – for what it is worth.
Well .. here we are, in the midst of the pandemic. Has anyone been able to be H1N1 vaccinated? None of my doctors or my husband’s doctor will be getting the vaccine. They say, “Get it from the county”. The county says, “You’re over 64 so you aren’t at risk .. we won’t give it to you. Get it from your primary care physician.” Of course, we know there isn’t much of the vaccine because of production problems as well. So, I’m curious to know how and where other CLL-ers are finding the vaccine. Are those with cancer center docs doing better?
I live in Louisville and it has been available for over three weeks now everywhere around town.There has not been a shortage for any age group. I was able to get mine at work. Good luck…
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