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After so many doctors’ appointments and hospital stays, agonizing waits for the results of tissue biopsies, and exhausting chemotherapy infusions, going to a primary care doctor or a walk-in clinic at a pharmacy is probably the farthest thing from your mind. Before your mesothelioma diagnosis, perhaps you used to complain endlessly when you got sick with a seasonal virus, but in retrospect, you didn’t even know what sick was. Unless you have already gotten them, though, you should probably get vaccinated against influenza and pneumonia this fall. Protecting yourself against infectious diseases for which a vaccine is available can make your recovery from mesothelioma surgery, chemotherapy, or both much easier and improve the quality of your life after you have finished your mesothelioma treatment.
How Vaccines Work
It is possible to treat almost any bacterial infection with antibiotics, as long as you choose the right antibiotic that is capable of killing the species of bacteria that caused the infection. Viral infections are much more challenging, from a medical standpoint. There is no drug that can single-handedly bring about a permanent cure for a viral infection. Antiviral drugs are available for certain viruses, but most viruses mutate so quickly that constantly developing new antiviral drugs to fight them would be futile, given the amount of work it would take. Instead, the best defense against viral infections is the immune system itself. With some viruses, the body’s immune response after a single exposure is enough to confer lifetime immunity, but with other viruses, your immunity fades after several years, or even sooner. For example, no one gets chicken pox more than once because of the long-term immunity that results from a patient’s immune response to the virus. By contrast, the common cold, which is caused by the rhinovirus, mutates so quickly that by the time your nasal congestion has cleared up, a new generation of rhinovirus has begun circulating, and it is different enough from your previous cold that it can make you just as sick as the first cold.
A vaccine is an intentional exposure to just enough of a virus to cause an immune response but not enough to cause a symptomatic infection. Vaccines are made from dead or weakened viruses so that they can trigger the production of antibodies by the immune system. Today, people in industrialized countries take vaccines against common infectious diseases for granted, but in populations that are not vaccinated, these diseases cause many cases of serious illness and death each year. If you were born in the 1950s or 1960s, you probably had chickenpox as a child, as did all your classmates. Today, few children in the United States get chicken pox, because vaccinating children against the varicella-zoster virus, which causes chicken pox, is routine. Two doses of the chickenpox vaccine are enough to give you lifetime immunity to the virus. Likewise, you have probably never met anyone who has had polio, but when your parents were young, polio was the scariest disease around. It was as contagious as a cold, and the symptoms started out similar to one, but it could cause serious complications, including paralysis; some polio survivors needed to use a device called an iron lung to help them breathe.
More recently, we have seen the effects of a new infectious disease with and without vaccination, namely COVID-19. The public was able to see in real-time the spread of the disease, with many cities and states reporting daily counts of new infections, often with data about the number of hospitalized patients, too. Even after patients got their vaccines, many reported breakthrough infections, which is when someone becomes infected with a virus for which they have already received a vaccine. Breakthrough infections can happen with any vaccine. Even if you get a breakthrough infection, your symptoms will be less severe than they would be if you had never received the vaccine; in other words, you have still gotten some immunity from the vaccine, just not enough to completely avoid infection.
How Mesothelioma and Its Treatments Affect the Immune System
Vaccines can help anyone stay healthy, but it is most important to get vaccines if you have a medical risk factor that increases your likelihood of becoming severely ill if you get infected with a virus. This is why people with health conditions related to immunity received priority when it came to the distribution of COVID-19 vaccines; for example, HIV-positive people and patients taking immunosuppressant drugs to help them manage autoimmune diseases or live with a transplanted organ have a greater risk than the general population of suffering severe symptoms and complications from infectious diseases.
Infections, especially those that affect the respiratory tract, are dangerous for people with mesothelioma for several reasons. First, if you have had part of a lung or an entire lung removed, then suffering lung damage due to an infection like influenza or pneumonia leaves you with less ability to breathe than the same infection would for a healthy person who was starting out with full lung capacity. Second, the impaired immune response is a side effect of chemotherapy. While you are undergoing chemotherapy, your doctor will test your white blood cell count to make sure that it is not dangerously low. Infections and dangerous levels of immunosuppression are among the main reasons that some patients must slow down their chemotherapy treatment. Therefore, being up to date on all the vaccines for which you are eligible is an important way to reduce the risk of getting an infection that could compromise your recovery from mesothelioma.
Flu Vaccine Guidelines
Influenza, commonly known as flu, is a rapidly mutating virus; it is much more common in the winter months when people spend more time indoors since the virus spreads through close contact and through respiratory droplets. In healthy people, an influenza infection can feel like a severe cold that lasts longer; another difference is that fever is more often a symptom of influenza than of colds. Although anyone can experience severe, or even fatal, complications from influenza, the risk is much higher in infants, elderly people, and people with compromised immune systems. The vaccine is available in several different doses; which one is right for you depends on your age and weight. The Centers for Disease Control and Prevention recommends that every person above the age of 50 receive one dose of influenza vaccine per year. Likewise, if you have additional risk factors, such as if you have had a mesothelioma surgery such as PD or EPP, or if you are currently undergoing chemotherapy, it is doubly important to get a flu vaccine. Because the flu virus mutates so quickly, last year’s vaccine is ineffective against this year’s strains of influenza.
Are You Eligible for Another Dose of the Pneumonia Vaccine?
Most currently available vaccines work against viral infections, but the pneumococcal vaccine works against infection by bacteria of the genus Pneumococcus. These bacteria can cause pneumonia, which is inflammation of the alveoli of the lungs; the symptoms of pneumonia include fever, cough, and shortness of breath. Pneumococcal infections can also cause meningitis, an inflammation of the membrane surrounding the brain; meningitis can have several causes, all of which are considered medical emergencies, but bacterial meningitis is the most likely to be fatal. It was once a common cause of infectious disease-related death in children, which is why doctors now begin the series of pneumococcal vaccine doses for infants at an early age.
Today, pneumococcal vaccines are part of the series of routine immunizations for children; today, most children receive four doses of pneumococcal vaccine by their first birthday, and this appears to be enough to confer lifetime immunity. Adults who received older versions of the vaccine should take a second dose of the pneumococcal vaccine if more than five years have passed since they received the first dose. If you have had more than two doses of a pneumococcal vaccine during your lifetime, then you are probably already immune to pneumonia-causing bacteria.
What About Vaccine Side Effects and Allergic Reactions?
Some people experience side effects from vaccines, including the vaccines for influenza and Pneumococcus, while others do not. Most people who receive these vaccines feel completely normal in the hours and days following the injection, while others feel a slight soreness in their arms near the injection site. Others experience side effects that feel more like a mild breakthrough infection as their bodies mount an immune response to the virus or bacteria, with symptoms such as fever and fatigue.
Allergic reactions are a possible risk with some vaccines. This is why the doctor, nurse, or pharmacist will ask you about your allergies to any of the components of the vaccine; for example, some vaccines are made from eggs and can cause allergic reactions in people who are allergic to eggs. If you have any known allergies, you should ask your primary care doctor or allergist which vaccines it is safe for you to take and what you can do to avoid a dangerous allergic reaction.
