Vaccinations: What You Need To Know

By Leslie Spry, MD, FACP, FNKF

VaccineIn light of the recent news about measles outbreaks in the United States, you may be wondering what you should be doing to protect yourself. Are you in need of a booster vaccine? Have you already been immunized?

Vaccinations, usually given as a shot, protect you from serious diseases. Some common diseases that are preventable with vaccination include the common flu, polio, diphtheria, tetanus, whooping cough, hepatitis B, hepatitis A, shingles and pneumococcal pneumonia. Some of these diseases can make you very ill and have no cure. You may even risk dying from certain diseases if you have not received a vaccination. Recent reports show small epidemics of whooping cough starting in communities as a result of inadequate vaccination.

Vaccines usually contain parts of the dead or weakened bacteria or virus. Once you have received the vaccine, your body begins to produce antibodies to protect you as though you had actually been exposed to the disease. Should you actually come in contact with the disease, these antibodies will work to protect you.

Vaccinations not only protect the people who receive them, they protect others around you. The more people that get vaccinated, the less likely an epidemic can be started in any community. Your vaccination may prevent someone in a very weakened state from getting the disease. This is known as “herd immunity.”

In the case of the measles, if you received both doses of the vaccine for measles, mumps and rubella (MMR) during childhood, you should still be immunized against these diseases for the rest of your life.

Your doctor is the best person to ask about which vaccinations you and/or your child with kidney disease should receive, but it’s important to know that kidney patients and others with compromised immune systems may be at greater risk for contracting certain illnesses or may need a different form of vaccine. Certain vaccines made with live particles should not be given to kidney transplant recipients.

Live virus vaccines include:

  • Influenza nasal mist vaccine (Flu Mist)
  • Varicella (Varivax, Zostavax, “Shingles-vaccine”, “chicken-pox vaccine”)
  • Measles, Mumps, Rubella (MMR)
  • Yellow Fever
  • Oral Polio

Here are 4 to-dos before receiving a vaccine:

  1. Get your ducks in a row. Gather your immunization history and keep all the documentation in one place. Pediatricians typically give out charts to help keep track of children’s immunization schedules. For adults, this can take a little more legwork since you may have received vaccines from different healthcare practitioners and specialists over the course of many years.
  2. Share your medical history. Make sure that any healthcare practitioner offering you a vaccine knows the medications you are taking and whether you are a transplant recipient. Ask your transplant physician or pharmacist if you ever have questions about vaccines you should or should not receive. You may be asked if you take steroids or immunosuppressants, and transplant recipients generally fall into these categories.
  3. Ask questions about frequency. How often do you need to receive a particular type of vaccine? Some vaccines, like tetanus, require a booster every 10 years to remind your body how to fight off the bacteria again. Whooping cough vaccine (pertussis) is contained in some tetanus vaccines (Tdap) and should be boosted once in a lifetime. Other vaccines, like the flu shot, are different each year based on the scientific likelihood that certain influenza particles will be the ones most likely to spread and make people sick. Vaccines that kidney patients, including transplant recipients, should receive regularly include: Influenza (flu) vaccine injection, pneumonia vaccine. Pneumonia vaccines such as Pneumovax-23, and a new vaccine known as Prevnar-13 should both be given to kidney patients but you should consult your physician as to the appropriate timing of these vaccinations. Other vaccines should be determined by your healthcare practitioner. Transplant patients should not be vaccinated against shingles (Zostavax). All other kidney patients should be vaccinated with Zostavax at age 60 or above.
  4. Contact people in the know. Possible resources for vaccinations include your health care provider, your local pharmacist, the school nurse and your local Health Department. Your local Health Department is responsible for monitoring infections in the community. Your local Health Department will have the latest information about epidemics in your community and has the responsibility to investigate epidemics and design community responses to those outbreaks of infection. If you have an organ transplant, you should contact your transplant center for recommendations about your vaccination needs. For children, pediatricians have long been recognized for comprehensive care including vaccination.

The Centers for Disease Control and Prevention (CDC) has a resource for vaccination of adults. The CDC also has a resource page for vaccination in children.

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