Monday, December 17, 2012

Enbrel and the Shingles Vaccine

In early 2009, I finally decided to try Enbrel for my psoriasis.  This was not an easy decision for me and it wasn't a quick one, either.  I spent weeks, months, and even years coming to the decision to do this--and I didn't start without a great deal of anxiety.  But, my skin was getting to the point where I couldn't handle it anymore, so I thought I would try.  I chose Enbrel because of the fact that I could use a self-injecting SureClick syringe.  There is no way I can imagine EVER getting a regular syringe even close to my body, much less CONSCIOUSLY deciding to inject a needle in to myself!  Surprisingly, I have had little to no problems with doing the injections.

My skin cleared up remarkably well using Enbrel.  I came very close to being completely clear after a year on the medication and continued to stay clear-ish for two years.  And I praise whoever came up with this medication--it made my life SO much better.  I am one of the lucky ones, though, as we have very good insurance and don't have to pay big money out-of-pocket.  This is one of the only reasons why I am able to continue to use this very expensive medication.

A year or so after beginning Enbrel, my best friend got shingles.  She continued--and still does, to a certain extent--to suffer side effects for quite some time.  Finally, the medical community decided that the shingles vaccine should be given to younger people and The Husband and I became eligible for this.  With K's kidney problems, it was highly recommended that he get the vaccine and my friend BEGGED me to get it, also.  I do know that it is not a good thing to come down with shingles while using Enbrel, so I decided to go through with it.  And this is where my life became 'interesting,' to say the least.

I did know that someone using Enbrel cannot get a live-virus vaccine, of which the shingles vaccine is.  What I did not know, is how long does a person need to be off of Enbrel before getting the vaccine and  how long do you have to stay off before going back on Enbrel.  I called my dermatologists office and they had NO answer for me, but said they would see if they could find one.  I went on the internet and got no answers.  I even called the manufacturer and had no luck.  My specialty pharmacy was a little better, as they had some anecdotal stories, but nothing more than that.  After a LOT of research, phone calls, and 'gut-feelings,' I decided--with some reluctance on the part of physicians--that four weeks off before and four weeks off after the vaccine was sufficient.  My primary care physician has NEVER been happy with me being on Enbrel, but she reluctantly agreed--as long as I understood the risks.  So, after being off of Enbrel for FIVE weeks, I went and got my shingles vaccine.  I stayed off of the med for another four weeks before I went back on and had NO side effects or any other detrimental effect from any of this.

As of today, I am one+ years removed from having the shingles vaccine and continue to do well.  I have been on Enbrel for almost four years and still have reasonable results in terms of clear skin.  The Enbrel does seem to be a bit less effective today than it was during the first couple of years I was on it, so I don't know what will happen in the long-term.  I am seeing my first new lesions in almost four years and what never went away are slowly growing in size.  I think I may need to change meds at some point in the future, but that remains to be seen.

So, for anyone on Enbrel trying to make the decision as to whether or not to get the shingles vaccine, I have only one thing to say:  it worked for me.  The time frame of being off of Enbrel for five weeks before getting the vaccine and staying off for another four weeks before going back on, was within all of the few guidelines I was able to find.  (While doing all of my research, I found out the half-life of Enbrel and calculated how long it takes to leave your body.  After five weeks there should be so little left that it is as if you are almost Enbrel-free.  So, I felt pretty safe.)  Some people feel as if the longer you stay off of Enbrel on either side of the vaccine, the better, but there IS being TOO conservative, also.  As long as one goes into this with eyes wide open and all of the facts available, I don't feel as if this is something that can't be done.  Getting shingles is NO walk in the park--whether you are or are not on Enbrel--but it is potentially life-threatening while using Enbrel, so that needs to be considered.  I hope this helps in making the decision.

***For all of my posts regarding my psoriasis, search for 'psoriasis' up there ^ to the left.


Cruiser said...

I too have psoriatis Arthiritis and have been on Enbrel for 4 yrs. before that I was taking Methotrexate tablets they worked for about 2 years then the Arthiritis came back with a vengeance I was unable to cut up food lift a kettle get out of the bath and my toes were that painful I couldn't walk. So the Arthiritis special is recommended Enbrel to me and I had to go and have a check up as I'd had TB in the past, the hospital put me on tablets for a few weeks to make sure the TB would not flare up again after that I was started on Enbrel injection , I take one every week but must also keep taking the methotrexate tablets as well. Since a month after I started Enbrel I was and still am pain free and my skin is also clear now that is since I started them 4 yrs ago. I go for check ups every year and the specialist is very pleased that I can now live a normal pain free life. Whoever came up with those I Enbrel injections deserves a medal. And thank God for the Dr recommending them to me.

chrkos said...

That is unbelievably wonderful news! I certainly hope things continue to go well for you.