Vaccinations are one of the best ways to protect someone’s health. Those with Duchenne muscular dystrophy (DMD) are no exception. Though there are some precautions around the timing of certain vaccines, in general vaccinations are safe and recommended for children and adults with DMD — and are crucial when it comes to protecting respiratory health.
Why are vaccinations important in Duchenne?
Respiratory diseases pose an extra threat to those with DMD. As Duchenne progresses, lung function decreases. Since people with DMD have weaker coughs, they are less able to clear viruses and bacteria from their airways. This increases the risk of developing serious respiratory infections, such as pneumonia.
Staying up-to-date with vaccinations helps protect people with DMD from influenza (the flu), COVID-19 and other respiratory diseases that can be especially dangerous to their health.
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What precautions need to be taken?
There is one main precaution regarding vaccines in DMD: In general, children and adults taking steroids should not have live vaccines.
There are two types of vaccinations: non-live and live. Non-live vaccines contain a version of the virus or bacteria that has been destroyed. Live vaccines, on the other hand, contain a weakened version of the virus or bacteria. While these are safe for the general population, they carry a risk for those on corticosteroids. This is because steroids can suppress the immune system, increasing the risk that the weakened version of the disease causes illness.
Corticosteroids are usually started when children with DMD are around the age of 4. When possible, the childhood vaccination schedule should be completed before treatment with corticosteroids starts, to avoid any issue with live vaccines. If this is not possible, the inactivated or non-live version of the vaccine should be administered.
If corticosteroids are discontinued, patients will need to wait at least three months before receiving any live vaccinations.
Which vaccinations are recommended in DMD?
Since no two people are exactly alike, your DMD care team is the best point of contact for any questions you may have about the recommended vaccinations. But in general, it’s recommended that people with DMD receive vaccinations following the Center for Disease Control and Prevention (CDC) vaccination guidelines. In addition, the annual flu vaccine and the COVID-19 vaccine are also recommended.
The vaccinations that are usually recommended include:
- MMR vaccine: This vaccine protects against mumps, measles and rubella. A live vaccine, it should be given before starting corticosteroids.
- Varicella vaccine: This protects against chicken pox. It is also a live vaccine that should be given before starting corticosteroids.
- Pneumococcal vaccine: This protects against invasive pneumococcal disease, a serious bacterial infection.
- Flu vaccine: This yearly vaccine protects against the annual strain of flu. Patients with DMD should avoid the nasal spray, as it is a live vaccine.
- COVID-19 vaccine: This protects against the latest strain of COVID-19.
- Meningococcal vaccine: This protects against meningococcal disease, a bacterial infection that can infect the blood.
- HPV vaccine: This protects against human papilloma virus, which can cause warts or cancer.
- Hepatitis B vaccine: This vaccine protects against hepatitis B, a serious liver infection.
- Polio vaccine: This protects against polio, a viral disease that attacks the nervous system.
- Tdap vaccine: This protects against adult tetanus, diphtheria and pertussis (whooping cough).
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