Question:

My doctor is suggesting having a pneumonia vaccination.  Is that safe to take if you have Sjögren’s Syndrome and is it a “one-time shot” or do you need it every year?

Answer:

Similar advice given about the flu vaccine also pertains to patients with autoimmune disease and the pneumonia virus vaccine.  This is not a live vaccine and it is recommended for all individuals aged 60 or older unless there are specific contraindications.

I advise my patients to have it if possible.  It is recommended to repeat the vaccine every 5 years.

I also recommend it for younger patients if they are going to need strong immunosuppression, for example, a biologic therapy in the case of rheumatoid and lupus patients particularly.  Rituxan also comes into this category and is more likely to apply to Sjögrens patients.

Whenever possible I try to give the vaccine at least one month and preferably 6 weeks before initiating treatment with the immunosuppression.

Question:

Can a person with Sjögren’s have the Shingles vaccine?

Answer:

This vaccination is a LIVE virus and so in contraindicated in patients who are immunosuppressed and who have severe disease.

All live vaccines are contraindicated in patients on biologic therapy.

I also have had patients who did have the shingles vaccine and still got shingles sometime after the vaccine so it needs to be reviewed on a case by case basis.

All vaccinations should be reviewed with your doctor taking into consideration the list of medications the patients are receiving, other immune abnormalities, for example, low levels of immunoglobulins should also be considered, and patients’ previous history, if they have had a problem with vaccines before, for example some vaccines contain egg products.

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