In February 2022, the CDC came out with its new vaccine recommendations. In this post, I will summarize the important changes for people who are immunosuppressed (such as people with systemic lupus erythematosus). I will make this short and to the point. I will only include those for adults aged 19 and older.
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Pneumonia shots against Pneumococcal Pneumonia
PCV13 (Prevnar 13) is no longer recommended
The Pneumovax every 5 year recommendation is also no longer recommended
Getting another Pneumovax after turning 65 if someone gets a Pneumovax before 65 years of age is no longer recommended (in other words, only one Pneumovax in one’s lifetime for those who receive a Pneumovax per the schedule below)
The pneumonia vaccine schedule is greatly simplified
Immunosuppressed patients (this includes all systemic lupus patients, including those who only take hydroxychloroquine) 19 and older should get one of the following:
PCV20 (Prevnar 20) and no other pneumonia shots after that, or get a…
PCV15 (Vaxneuvance) followed at least a year later by a PCV23 (Pneumovax) vaccine and no more after that
If someone accidentally gets Pneumovax initially, this should be followed by either a Prevnar 20 or a Vaxneuvance at least one year later
If someone has already received a Prevnar 13 shot (and no other pneumonia shots), they should get a Pneumovax at least one year later
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All immunosuppressed patients should get the Shingrix vaccine series against shingles (herpes zoster)
Shingrix (Shingles) vaccine recommendations
The FDA had already approved the use of Shingrix for the prevention of shingles in people aged 19 and older who have compromised immune systems. However, insurance companies were rarely covering it yet for people aged 49 and younger. In February 2022, the CDC formally added this recommendation to the adult immunization schedule.
Systemic lupus patients are generally three times more likely to get shingles (due to the chickenpox or herpes zoster virus) than older healthy individuals. I, and many other rheumatologists who specialize in caring for lupus patients, recommend that all of our systemic lupus patients get the Shingrix vaccine followed by a further booster shot 2 to 6 months later.
Now it is recommended that everyone 19 to 59 years old get hepatitis B vaccines
Hepatitis B Vaccine Recommendations
Previously, the CDC only recommended hepatitis B vaccines for high-risk individuals. Now, it is recommended for everyone who is 19 to 59 years old. People who are 60 and older should get it if they have risk factors for hepatitis.Â
Other vaccine recommendations for systemic lupus patients
There are currently no other big changes. I (and the CDC) still recommend the following (in a nutshell)
Flu shot (influenza) yearly, particularly in early September to mid October is preferable in the Northern hemisphere
Gardasil series against HPV virus associated cancers, before sexual activity is preferable.
Have you received your vaccines? How did you do? Did you have any reactions or did your lupus flare afterwards?
Hello Dr. Thomas : I’ve read that Daniel Wallace mentioned a future where a “Lupus Vaccine” would be used to prevent Lupus, what can it do for those already living with the disease? Will the malaria vaccine be therapeutic and show any benefit in controlling SLE symptoms? Is there any progress towards finding a “cure”?
MH: My good friend, Dr. Wallace… what a great guy! I hope his dream is reached some day. Since he made that comment, though, new lupus-related genes are being discovered all the time (now around 150), so one anti-lupus vaccine is appearing more difficult. Like him, I hope we find a cure sooner than later.
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