Autoimmune and Live Vaccines: What to Do??   

Here’s a big question: Should you or should you not get vaccinated with live vaccines before going to a developing country if you have an autoimmune disease? All the literature in the world pretty much says “No”. It’s contraindicated and could result in some negative consequences, all of which are pretty scary. But not getting vaccinated sounds scary, too.

To decide for myself, I met with my rheumatologist and a travel doctor at my university, and after going over my individual health history, my travel plans, and checking CDC recommendations, etc. they both told me that ultimately it is my decision to make. I struggled it with it, I really did. Do I risk getting really sick from the vaccination itself, or do I risk going into a country with known diseases having not been vaccinated? Being that I am in graduate school for public health, I was leaning more toward vaccination. And given that I am going to be in East Africa for 2 1/2 months, not getting vaccinated sounded terrifying. Yellow Fever was not something I wanted to play around with. Also given that I am not on any steroid medications or any immunosuppressants, I eventually opted to get vaccinated. I received one live vaccine (yellow fever), a flu vaccine, a Hepatitis A vaccine, and a typhoid vaccine. You can also take typhoid in pill form if you choose.

Here’s what the CDC has to say about the typhoid vaccine, including pill vs. shot.

On that note, CDC has tons of great information related to all vaccines you might be thinking about, depending on the country to which you are going.

When I went in for my vaccines, I received 4 vaccinations at once, including one live vaccination for Yellow Fever. My arms were incredibly sore for about two days. The site where the Yellow Fever vaccine was injected was sore and had a fairly large red mark which then turned into a bruise for about 2.5-3 weeks. The biggest reaction I had to the vaccines was just feeling kind of “blah” for a few days. Just not myself- really low energy. After about three days I got a pretty bad headache which eventually turned into a migraine, which lasted for about 2-3 days. But all in all, I didn’t experience any severe reaction to any of the vaccines I received. 

Please note: this is NOT a sweeping recommendation to get vaccinated!!! (sorry for yelling) As I said, it’s something you have to discuss at length with your doctor(s) and consider your personal history, your current health, your travel plans, etc. It ended up being the right decision for me, but that won’t always be the case. My recommendation? Talk to your doctor. Talk to all the doctors. Get second and third opinions, do research on the internet and then know that you are the one who has to advocate for your own care. You have to make your own decision and stick to it. I had two wonderful doctors and a very supportive family, boyfriend, and best friend to help guide me. But in the end, I was the one who had to make the call, and I was the one sitting in that chair in the vaccine clinic. But I know I made the right decision for myself in the end, and it was all worth it. (Especially if the typhoid inoculation actually protects me from typhoid!)