Re: Digest:new to risg - smallpox vaccine vs reiters

[Guest guest]

Hi to :

Welcome to the group. I am fairly new also. I have

undifferentiated spondyloparthropathy. In my

professional, non-patient life, your question would be

appropriate for me to address, so I looked up the CDC

recommendations on giving smallpox vaccine to people

with immune compromising conditions; here is the

relevant paragraph:

" Replication of vaccinia virus can be enhanced among

persons with cellular or humoral immunodeficiencies

and among those with immunosuppression (e.g.,

HIV/AIDS, leukemia, lymphoma, generalized malignancy,

solid organ transplantation, or therapy with

alkylating agents, antimetabolites, radiation, or

high-dose corticosteroids [i.e., >2 mg/kg body weight

or 20 mg/day of prednisone for >2 weeks]). Persons who

are taking or have taken high-dose corticosteroids

should not be vaccinated within 1 month of completing

corticosteroid therapy, and persons treated with other

immunosuppressive drugs within the previous 3 months

should not be vaccinated (37). Persons with

immunosuppression also include hematopoietic stem cell

transplant recipients who are <24 months

posttransplant, and hematopoietic stem cell transplant

recipients who are >24 months posttransplant, but have

graft-versus-host disease or disease relapse. Patients

with severe clinical manifestations of certain

autoimmune diseases (e.g., systemic lupus

erythematosis) might have a degree of immunocompromise

as a component of the disease (38). Although no data

exist to indicate that a person is at risk from

live-virus vaccines because of severe autoimmune

disease in the absence of immunosuppressive therapy,

persons with immunodeficiency as a clinical component

of their autoimmune disease should not receive

smallpox vaccine during the pre-event vaccination

program. "

I agree to ask the medical authority on your ship.

IMHO form reading the above paragraph, the criteria I

would use to not give this vaccine for a person with a

rheumatological condition woujld be being on steroids,

or being on methotrexate, or possibly being on one of

the TNF-alpha inhibitors. Unfortunately, most of the

treatments that might be of concern were unknown at

the time the vaccine was given routinely, so they

can't base these recommendations on any real data.

Best of luck and stay safe.

Ann (Seattle, USA)

____________________

Ann

__________________________________

for Good - Make a difference this year.

http://brand./cybergivingweek2005/

[Guest guest]

Thanks Ann

I do know what is up against and that is a legal command (order) of a

superior officer. The Armed Forces are not democracies and many folks have

faced court martials for refusing some immunizations that could have caused that

unfortunate side affect of death.

On a ship, could take his case to the ship's Captain but he would have to

go up the chain of command to do so. I do not know 's rank so I do not

know how high up the " pecking order " he is.

I like to think that someone would think twice about the possible problems a

crew member would have in an immunization. But given my military experience,

those that listen are few and far between.

+Dave