Vaccinations during XRT
Started by Gfunk6
I've never restricted a flu shot personally....didn't think it was an issue wrt to Radiation. My med oncs tell me that since it's a dead vaccine, they don't have a problem with it either
Viral and bacterial exposures occur "in the wild" with our rad onc patients; I can't see how a single attenuated viral exposure would be more harmful than those. The corollary to preventing a flu shot in a rad onc patient is that the rad onc patient is safer with... catching the flu? That can't be right.
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I usually advise that vaccinations may not "work" as well during / after treatment than with an intact immune system. Therefore I sometimes advise patients to carry out potential vaccinations before treatment commences. This is of course restricted to patients receiving rather extensive radiation therapy with larger fields. The immune suppression due to an RT of a vestibularis schwannoma or a limited prostate cancer is considerably smaller than what will happen if you perform adjuvant RT for breast cancer with complete ENI or an extensive pelvic RT.
We routinely have our patients get vaccines during treatment like shingles, flu, pneumonia and they do completely fine.
Patients always seem to ask about the flu vaccine about 1 week before treatment ends (n = 3). In that case we tell them to hold off until after RT is over.
It's voodoo but it's the voodoo that we do
It's voodoo but it's the voodoo that we do
+1
ACS has a nice summary about this - patients are usually relatively immunosuppressed during RT (mostly due to decreased lymphocyte count), and thus it is recommended to avoid live vaccines such as the intranasal flu vaccination.
The danger is not an exaggerated immune response, but that of either developing an infection due to the vaccination or of not mounting an adequate protective response to it.
ACS guideline here with specific recs about individual vaccines:
http://www.cancer.org/treatment/tre...ithcancer/vaccination-during-cancer-treatment
Article about blood counts & XRT. It would be interesting to do a study on vaccinating XRT patients. My theory is that 1) it's safe, and 2) they'd get immunized OK, despite a lymphocyte depletion. It's a testable theory and one of those kinds of questions we ought to have a data-based answer to.
http://www.redjournal.org/article/S0360-3016(00)01587-X/abstract
http://www.redjournal.org/article/S0360-3016(00)01587-X/abstract
