Can I Get the Chickenpox Vaccine with an Autoimmune Disease?

Diseases and Vaccines

Hello, doctor.
A year ago, I experienced general fatigue and joint pain, and after undergoing tests at a large hospital, I was diagnosed with an autoimmune disease.
The doctor prescribed me medications including quinine, aspirin, and Celebrex.
I have also had pre-pregnancy check-ups and found that I do not have varicella (chickenpox) antibodies.
I would like to ask if, given my autoimmune condition and current medications, I can receive the varicella vaccine? Since I am over 36 years old, I want to conceive as soon as possible.
I consulted with an immunologist who said that the current medications are safe for pregnancy, but I still feel a bit anxious as this contradicts my belief that medications should not be taken during pregnancy.
Can you please confirm if these medications are safe? I apologize for my many questions due to my lack of knowledge.
Thank you, and I wish you joy and fulfillment.

Jiajia, 30~39 year old female. Ask Date: 2011/12/30

Dr. Gao Jiankai reply Internal Medicine

Hello, Jia-Jia, thank you for your question.
The varicella vaccine is a live attenuated vaccine, and in patients using immunomodulators, such as quinine and salicylates, there is indeed a possibility that their immune function may be suppressed, which could increase the risk of contracting varicella.
Additionally, the body may not produce sufficient varicella antibodies, potentially reducing the effectiveness of the vaccine.
However, these are possibilities, and there is limited definitive data in the literature to reference.
Moreover, since the immunomodulatory effects of quinine and salicylates are relatively mild, we generally do not oppose patients receiving the varicella vaccine, although we do inform them of the potential issues mentioned above.

Regarding the safety of quinine and salicylates during pregnancy, salicylates are considered safer and are documented as safe for use in pregnant women.
Quinine, on the other hand, is more controversial; literature suggests it is not recommended during pregnancy, but many physicians have observed that numerous pregnant women who had to continue using quinine did not have children with adverse outcomes.
Therefore, some believe that quinine can also be safely used during pregnancy.
In this regard, your physician may consider the control of your condition when deciding whether to continue medication, rather than solely relying on literature findings.

Best regards from the Allergy, Immunology, and Rheumatology Department at Changhua Hospital.

Reply Date: 2011/12/30

More Info

When considering vaccination, particularly with a history of autoimmune disease, it's essential to consult with a healthcare provider who understands your specific medical history and current treatment regimen. In your case, you are interested in receiving the varicella (chickenpox) vaccine while being on medications such as quinine, aspirin, and salicylates for your autoimmune condition.

1. Vaccination with Autoimmune Disease: Generally, live attenuated vaccines, like the varicella vaccine, are not recommended for individuals with certain autoimmune diseases or those on immunosuppressive therapy. This is because these vaccines contain a weakened form of the virus, which could potentially cause disease in individuals with compromised immune systems. However, if your autoimmune disease is well-controlled and you are not on immunosuppressive therapy, you may be eligible for vaccination. It is crucial to have a thorough discussion with your healthcare provider to assess your specific situation.

2. Current Medications: The medications you mentioned—quinine, aspirin, and salicylates—are typically not contraindications for receiving the varicella vaccine. However, aspirin is not recommended for children and teenagers with viral infections due to the risk of Reye's syndrome, but this concern does not apply to adults. Your healthcare provider can give you the best advice based on your overall health and the specifics of your autoimmune condition.

3. Pregnancy Considerations: You mentioned wanting to conceive soon. It is important to note that the varicella vaccine is a live vaccine, and it is generally advised that women avoid becoming pregnant for at least one month after receiving the vaccine. If you are planning to conceive, it may be advisable to get vaccinated before trying to conceive, provided your healthcare provider agrees that it is safe for you to do so.

4. Safety of Current Medications During Pregnancy: The safety of medications during pregnancy can vary widely. Some medications are considered safe, while others may pose risks to the developing fetus. It is crucial to discuss your medications with your healthcare provider, who can provide guidance on which medications are safe to continue during pregnancy and which may need to be adjusted or discontinued.

5. Consulting with Specialists: Given the complexities of autoimmune diseases and pregnancy, it may be beneficial to consult with both a rheumatologist (or your primary care physician) and an obstetrician who specializes in high-risk pregnancies. They can work together to create a plan that ensures both your health and the health of your future child.

In summary, while it may be possible for you to receive the varicella vaccine, it is essential to have a detailed discussion with your healthcare provider about your autoimmune condition, current medications, and plans for pregnancy. They can provide personalized advice and ensure that you make informed decisions regarding your health and vaccination status.

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