Post op day 11
Today I went to get my shingles shot. With the impending start of my chemotherapy, I needed to make a very important decision- vaccinations. Cancer increases risk for infections especially for pneumonia, influenza, respiratory difficulties and Hepatitis B. Increased risk may be due in part to the cancer itself stressing our immune system and from chemotherapy or radiation therapy. Even though I know the risk of shingles is very small, that is my fear. I spoke to my oncologist and she reported she has not had any patient get shingles while getting chemo. However, I know too many non immunocompromised people to not be concerned. This is a point that feelings vs. statistics collide. I looked into the risk of getting the shingles vaccination prior to getting chemotherapy. Shingles is not recommended get while undergoing any immunosuppressive treatment. Shingles is a live attenuated virus vaccination- meaning the vaccination is made up of active virus that has been weakened to prevent an active infection but allow for the immune system to mount a defense. With a decreased ability to mount a defense for immunosuppressed a live attenuated vaccine can potentially cause the illness. For any live attenuated vaccination you need at least 4 weeks prior to the start of the immunosuppressive therapy and 2 months after the end of the immunosuppressive therapy. I was just within 4 weeks prior to the start of my chemo. Therefore I could safely get the vaccination now. The efficacy of the shingles vaccination is at 51%. This means that it will work to prevent shingles in about 51% of the time. While this isn’t as robust as I would like, it does help to decrease the possibility of me getting shingles and it will help to lessen the severity of shingles if I do in fact get shingles (it is 67% effect at preventing severe pain known as post herpetic neurologia). While the vaccination potentially may not help prevent shingles, the risk of an adverse affect vs. the stress and fear I feel from worry about shingles made me choose to get the vaccination. I will also get the Pnuemovax to prevent pneumococcal infection (one cause of pneumonia). Strange how I am not as concerned about pneumonia as I am for shingles, even though the pneumonia is more common for people undergoing immunosuppressant treatment than shingles, I went first for my shingles vaccination and am lackadaisical about the Pneumovax. A more detailed description of vaccines can be found here.
The shot was not more painful than any other vaccination. However, I have a 1-2 cm hard bump that developed and is really painful and difficult to move my arm. This can occur in just over 1% of people receiving the vaccine. It is not to the point that I regret getting it but it is an annoyance since I was finally able to have full range of motion post surgery. I hope that I do not get shingles but at least for now, one less stressor is welcome.