Questions submitted by readers and answered by the CLL Society Medical Advisory Board
By Thomas E Henry III, MBA, RPh, CPh
Is there a nationwide shortage IVIG?
There was a shortage of some brands of IVIG that started about 6 months ago but there was never a shortage to the point where alternate products from other suppliers were not available. This situation seems to have improved over the past 1-2 months but select products may be in short supply so your provider may need to order an alternate product.
Is there a nationwide shortage of the new shingles vaccines? Should I get this vaccine if I already had shingles?
There had been a shortage of the Shingrix® vaccine that was caused by high demand for this product. Glaxo Smith Kline has ramped up production and this appears to have alleviated most of the shortages but there may still be some isolated shortages in some geographic areas.
With regard to the question about whether you should receive this vaccine despite having already had the shingles, the answer is a qualified yes. The primary qualification is that you should discuss any planned vaccinations with your CLL specialist first. The secondary qualification is that if you are currently receiving traditional chemotherapy such as FCR or BR then you should not receive this vaccine until your immune status improves. (Shingrix, is not indicated in non-immunocompetent patients.) The reason that the Shingrix would be warranted is that the Herpes Zoster virus remains dormant in the body from the initial introduction into the body in the form of chickenpox and repeat episodes of shingles are fairly common.
It should also be noted that Shingrix is warranted for adults over 50 even if they received the older shingles vaccine because this new formulation is far more effective. Neither shingles vaccine will eliminate the chance of a shingles outbreak, but both the severity and duration are lessened in vaccinated patients.
Thomas Henry is a Registered Pharmacist and CLL Patient. He is President and Senior Consultant for Burlington Consulting Associates, a company that provides consulting services to health systems nationwide. Tom is a CLL Society Medical Advisory Board member and strives to educate other CLL patients through his blog https//www.cllpharmacist.com. He has a forty-two-year career in pharmacy and has served as Chief Pharmacy Officer at two Top-15 Comprehensive Cancer Centers, Moffitt (Tampa, FL) and Roswell Park (Buffalo, NY).
Originally published in The CLL Tribune Q4 2018.