Vaccinations – What, When, and How

When I was first being evaluated for the pancreas transplant list, I answered a heap of questions. There were two in particular that I should have paid closer attention. I should have delved deeper and expanded the questions.

“Have you received a flu vaccine within the last 12 months?” “Have you received a pneumonia vaccine within the last 3 years?” The questions posed to me by my nurse coordinator were such innocent easy questions to answer. I answered in the affirmative, gave the dates of the vaccinations to the best of my knowledge, and gave the questions no further thought.

That is, until I saw my genius nephrologist, Dr. Siddiqui. He asked me had I received a Hep A and Hep B vaccine. I couldn’t recall whether I had. He being the fabulous and thorough doctor that he is, suggested that I have a titer blood test performed. A titer test checks for antibodies to a specific antigen in your blood. If your blood is positive for antibodies, then you have either had the illness or received a vaccine. He ordered the titer for Hep A and B and further suggested that I visit my internist for additional titer tests to be performed for routine vaccines.

Being the good patient that I am, I followed up with my pcp for the additional titer tests. In addition to Hep A and B vaccinations, I will need a Tdap booster, MMR, and meningococcal vaccine. I had already received a Prevnar 13 pneumonia vaccine, but due to the removal of my spleen, I required the additional protection of the Pneumovax 23.

Because my immune system is already suppressed due to Cystic Fibrosis and cystic fibrosis related diabetes, I am having to space the vaccinations. I received the Pneumovax 23 and Tdap last week and had a pretty intense response. My upper arms are still tender and slightly swollen.

I am glad that my nephrologist pointed me in the correct direction. It is better to be vaccinated now rather than risk getting these illnesses post transplant and most likely dying from them. I just wish that in the transplant evaluation process the importance of vaccinations had been reiterated to me. I could have been receiving these vaccinations during that process instead rushing to do them now while I am actively listed.

Ugh. Live and learn.