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The details and recommendations listed below are for a guideline only, if you are in any doubt ALWAYS check with the Coordinators first as with new drugs becoming available circumstances may change.
Vaccination advice for patients regarding Chicken Pox, Shingles.
Following your transplant it is important for you to stay as healthy as possible and free from infection. If you intend travelling abroad you should also ensure you have the appropriate immunisations if required.
You may need vaccines for several reasons. It is suggested that you do not have any vaccines for the first three months after your transplant. However, after three months you may need vaccines to travel, prevent flu, or a ‘booster’ to update you or your families’ immunity.
Your GP will probably offer you the winter vaccinations which include the flu and pneumonia jab. If you want to have those you can. As your immune system is weakened due to the anti-rejection drugs it is recommended that you do have them.
It will be recommended that you have Hepatitis A and Hepatitis B vaccinations if you are not already immune to these viruses. You will normally be asked to start the vaccination course when you go on to the waiting list for the transplant.
If you do not complete the course before your transplant, you will be asked to continue it three months after your transplant.
Your GP or practice nurse or the International Travel Section of the Department of Health (0800 555 77770800 555 7777) will be able to tell you what vaccinations are needed if you travel abroad.
Listed below are vaccines that you MUST NOT receive;
Those who have had liver Transplants CAN safely be given.
Inactivated polio vaccine
Hepatitis B vaccine
Hepatitis A vaccine
Meningococcal polysaccharide vaccine
Pertussis (whooping cough)
Cholera (in patients over 6 months old)
Typhoid (in patients over 1 year of age)
The varicella-zoster virus which causes chicken pox and shingles can make a transplant patient very unwell,.
Here are some guidelines;
The risk of chicken pox infection is negligible if you are sure that you have had the disease in the past.
A test to check for immunity to chicken pox is often done as part of the assessment and if in doubt it can be checked from your notes.
However, if you have direct chicken pox contact (being in the same room) and have never had chicken pox or cannot remember having it in the past, you should have a blood taken to test for chicken pox immunity.
This can be done by your GP, but it will take a few days to get the results back.
If you have never had the virus in the past, then you will need some protective treatment. This can be started within 10 days of the contact.
A drug called acyclovir can be used which is in the form of tablet medication and can be taken whilst at home, however, Varicella Zoster immunoglobulin (VZIG) can be the preferred choice but is given by doctors.
This drug is given intra muscularly as a single dose, and it can be given by a district nurse or at the GP surgery.
It does not always mean an admission to the liver unit.
If you have been in contact with someone who has in turn had a chicken pox contact (indirect contact) the risk is negligible.
You are only at risk if you come into direct contact with a chicken pox patient.
The risk of getting chicken pox from contact with someone with shingles is less than if the contact is with chicken pox.
In the majority of cases you are only at risk if you come into contact with the skin lesions (for example by touching them) but you should seek advice from your GP or doctor in these circumstances.
If you come into contact with someone with shingles, as long as you have had chicken pox, the risk is very low.
However, if you come into contact with someone with shingles and have never been exposed to chicken pox, you should then follow the same guidelines as above.
If you have any further queries then please get in touch with the liver unit or transplant co-ordinators.
The liver support group is unable to give any advice regarding vaccinations, all enquiries must be referred to the liver unit or the transplant co-ordinators.
This information is correct as of May 2009 but if in any doubt it is always advisable to check.
All the information contained above has been taken from a leaflet that is available from the liver outpatients department should you need a copy.
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