admin Vaccines

Shingrix: The new shingles Vaccine

The new and more effective vaccine against the dreaded disease of shingles has been eagerly awaited in Spain, and has finally become available since August of 2022.

So what is it and what is better about the new shingles vaccine?

The disease

About 99% of people over the age of 40 have had chicken pox at some time, even if they do not recall getting the disease. The virus can hibernate for many years until, in about 1 in 5 people, it is reactivated, causing a burning sensation in one area of the body, followed by a rash of extremely painful blisters. If the rash is around the eye or ear it can damage vision or hearing. It can be triggered by advancing age, stress, illness, certain medications or anything that reduces immunity. 

The rash itself will usually clear after 3-4 weeks, but 1 in 5 people will develop post-herpetic neuralgia.

This is a persistence of the pain which can last months, even years and is a cause of great distress as it is often difficult to treat the pain successfully.

The older you are, the more likely you are to develop post-herpetic neuralgia, and the more severe it is likely to be.

The Shingles vaccine

The Shingrix vaccine prevents shingles 97% of the time, while Zostavax, the previously available vaccine is effective 51% of the time (and is even less effective with increasing age).

Who should receive the vaccine?

It is indicated for anybody over the age of 50, including those already vaccinated with Zostavax or those who have had shingles already. (Having shingles once doesn’t protect you from having it again).

It can also be given to those over 18 who are vulnerable because of low immunity.

How is it given?

It is given like a flu shot in the muscle of the shoulder. A 2nd dose is needed after 2 months. This single course will protect you for the rest of your life.

It is not a live vaccine and can be given at the same time as other vaccines.

If you have had the Zostavax vaccine already you should wait at least 8 weeks before having Shingrix. 

If you had the Zostavax under the age of 70 years and are not at high risk you could wait 5 years before having the Shingrix vaccine.

What about side effects?

These are usually mild and short-lived. The most common are soreness at the injection site, aching muscles, fatigue and headache. Rarely, some people can have an allergic reaction. 

How much does it cost?

Each dose of Shingrix costs 247 euros.

If you would like to book your vaccine please call Atlantic Clinic on 952 81 7425

Vaccines need to be paid for in advance as once ordered they cannot be returned. 

Dr Anthony Crichton-Smith

admin Vaccines

The pneumonia vaccine: should you have it?

The pneumococcal pneumonia vaccine protects against a serious and potentially fatal infection which can cause pneumonia, blood poisoning (sepsis) and meningitis.

Babies up to 2 years old are routinely vaccinated with the Prevenar 13 vaccine to protect them.

There is a different vaccine, Pneumovax 23, for adults (and some children) which covers more strains.

Who should have the Pneumovax 23 vaccine?

  1. All adults over 65 years should have a single dose. It is normally given at the same time as the flu vaccine, but once only, not every year. 
  2. Those at higher risk (see below) may be given the vaccine at any age from 2 years onwards as a single dose. Higher risk includes:
    1. A long-term respiratory disease, such as chronic obstructive pulmonary disease (chronic bronchitis), smokers
    2. Heart disease
    3. Chronic liver disease such as cirrhosis or alcoholism
    4. Diabetes
    5. Reduced immunity e.g. caused by HIV, radiotherapy, chemotherapy or steroids
    6. A cochlear implant (hearing device)
    7. A history of a leak of cerebrospinal fluid (the fluid that surrounds the brain and spine, often following an accident or surgery)
  3. These high risk conditions may need the vaccine given every 5 years:
    1. Chronic kidney disease
    2. If the spleen has been removed, is not working properly or is at risk of not working properly in the future (e.g. Coelic disease).
  4. These conditions usually require a single dose of Prevenar 13 followed by Pneumovax 23 2 months later:
    1. Severely reduced immunity due to conditions such as leukaemia, multiple myeloma, genetic immune disorders and after a bone marrow transplant.

Is it safe?

These vaccines are both inactivated or “killed” and do not contain any live bacteria, and cannot cause the infection they protect against.

Mild side effects of slightly raised temperature, redness or swelling at the site of injection sometimes occur. 

Severe allergic reactions are extremely rare. 

Is it effective?

In adults and older children, it provides 50 to 70% effectiveness at preventing pneumococcal disease.

I am not sure if I had the Pneumovax. What should I do?

It is safe to have the vaccine even if unknowingly you are repeating the dose.

You can book online your Pneumovax 23 vaccine together with the flu vaccine below or call the clinic on 952 81 7425.

Book here

Dr Anthony Crichton-Smith

admin Vaccines

Influenza (FLU) Vaccines 2021/22

What is New For 2021 ?

A few things are different for this year 2021:

  1. It is expected that this winter’s flu epidemic will be worse than usual because Covid-19 and the lockdown has meant that fewer people have developed a natural immunity to the virus.
  2. The composition of the Flu Vaccine has been updated
  3. All Flu Vaccines are Quadrivalent (four Components) This means they offer protection against 4 variants of the Flu Virus
  4. The Flu Vaccine and the COVID-19 Vaccines can safely be given at the same time. 

 

Why should you be vaccinated against the flu virus?

Influenza is a potentially dangerous virus which can not only lead to feeling very unwell, it leads to hospitalization and in some cases death. Millions of people suffer every year from the ever changing flu virus. People can be affected very differently; from feeling unwell for a few days requiring those days off work,  to more serious symptoms.

Complications of flu include bacterial pneumonia, ear and sinus infections, along with worsening medical conditions such as congestive heart failure, asthma or diabetes.

An annual seasonal flu vaccine is the BEST way to protect against the flu virus.

Vaccination has been shown to reduce the risks of illness, hospitalisation and flu-related deaths. Even if you get a flu-related illness it is likely that the severity will be significantly reduced after vaccination.

 

Who should be vaccinated against the flu virus?

1) If you are over the age of 50 

2) If you have certain health condition such as diabetes, asthma, COPD, heart disease, kidney disease, being very overweight (a body mass index of 40 or above) or reduced immunity (e.g. HIV, receiving cancer treatment, transplant patients)

3) If you are pregnant

4) if you are a Frontline Worker or caring for a vulnerable person. 

 

How quickly does it work?

It can take 10-14 days to provide full protection.

 

Can the flu vaccine give you the flu?

The vaccine does not contain live virus, so it cannot give you the flu. 

Some people have a mild temperature and muscle aches for a day or two after the injection.

 

How Much Does the Vaccine Cost ?

35 Euros Per Person 

 

How Do I Get My Vaccine?

1) Book online

2) Or call the clinic during opening hours (09.30-18.30 Mon-Fri) on 952 81 7425 to fix an appointment

3) Or visit Atlantic Clinic: Calle Califa 8, Nueva Andalucía, Marbella

 

OTHER VACCINES FOR ADULTS.

If you are over 65 years, or are at risk with some of the health conditions above, you should have the pneumococcal vaccine to prevent pneumococcal pneumonia. This is normally given once only, except in high risk patients, when a booster is given after 5 years. The cost is 50 euros

UPDATE 08/10/2021: There is currently a shortage of the pneumococcal 23 vaccine in Spain, and it is not available at present. As soon as it becomes available this blog will be updated to inform you.

 

If you are over 50 years you may be advised to have the shingles (herpes zoster) vaccine even if you have already had shingles or think you have never had chicken pox. You can speak to your doctor about the indications for this. The cost is 200 euros.

 

In Spain it is recommended to have a Diphtheria/Tetanus booster from the age of 65 years. The cost is 40 euros.

All these vaccines can safely be given at the same time, or at different times.

Dr Crichton-Smith (family doctor) Sarah Hartley (nurse)

 

admin COVID-19, Vaccines

Covid-19 vaccination for foreign residents in Andalucia

If you are a foreigner residing in Andalucia you are eligible for Covid vaccines even if you are not currently registered with the Andalucia Social Security health system. 

You will need to first ensure that you are empadronado or registered as a resident in the town hall for a minimum of 3 months, and obtain a certificate of empadronamiento (which is valid for 3 months). 

If you are a pensioner you will need the document S1 from your home country.

With these documents, and your passport and residence document you can obtain a tarjeta sanitaria or health card from your local ambulatorio (health centre). You will then be included in the vaccination programme and will be contacted (usually by phone) when your appointment is due.

The Junta de Andalucia (the regional government) recommends contacting the consulate of your country of origin for further advice on how to be included in the vaccination programme.

 

I am not a resident in Spain, can I get vaccinated here?

At present non-residents are not being offered vaccination. 

 

How safe is the vaccine?

To date more than 150 million doses of the vaccine have been given worldwide, and side effects have been very closely monitored.

The usual side effects common to most vaccines have been identified. These are generally mild such as a sore arm, tiredness, headache or aching joints for a few days. The very rare occurrence of a serious allergic reaction (anaphylaxis) is also a feature of all vaccines. No long-term complications have been reported.

 

Can I be vaccinated privately?

At present, the vaccines are exclusively controlled by the Andalucian Social Security health system and cannot be obtained elsewhere in Spain. 

During this season’s influenza vaccine program the flu vaccine was initially only available only through the Andalucia Social Security health system and later on was also made available through some private clinics.  

So far we have no information as to whether the same policy may be applied to Covid-19 vaccines. In the light of this it is recommended to have the vaccine through the Social Security health system if you are eligible. Should the situation change you will be alerted via this blog or by email if you are included on our waiting list.

 

Can I choose which vaccine I have?

Vaccines are given according to availability at the time, and you cannot choose. 

 

I have had Covid-19 infection. Do I still need the vaccine?

Most people who have had the infection will probably have some immunity for at least 8-10 months although it is not yet known if it may last longer. There have also been cases of reinfection after having recovered from the illness, so immunity is not guaranteed.

It is very likely that vaccination will provide a better and longer lasting protection than the infection itself and vaccination in these people seems to be equally safe.

The current guidelines in Spain recommend vaccination for those who have had Covid-19 infection (and do not have any contraindications) with the following conditions:

  1. Anyone over 55 yrs should receive the normal vaccination scheme after they have recovered from the Covid infection and at least 14 days from the start of the illness.
  2. Anyone in a high risk group such as health care professionals, carers of vulnerable people etc should receive the normal vaccination scheme after they have recovered from the Covid infection and at least 14 days from the start of the illness. 
  3. Those aged 55 or less (even if they have risk factors) need only 1 dose which should be delayed until 6 months after the diagnosis of the infection.

 

Once vaccinated do I still need to take precautions?

It is not yet known if vaccinated people could still become infected without symptoms and unknowingly pass on that infection to others. 

It is also not known if new variants of the Covid-19 virus could cause illness in those already vaccinated. For these reasons the same precautions should be followed as for those unvaccinated.

 

Does the vaccine protect against the new UK variant of the virus?

Based on the data available so far, the currently used vaccines are effective against this and other strains that are commonly circulating in Europe

 

After I get vaccinated will Covid-19 tests show up positive?

The PCR and antigen tests will not show positive due to the vaccine (but could be positive due to a new infection).

Antibody tests may show positive and indicate a state of immunity. The ELISA  antibody is recommended in this case. Click here for more information about Covid-19 tests

 

I suffer from allergies. Can I have the vaccine?

The only absolute contraindication (must never be given) to the Pfizer, Moderna and AstraZeneca vaccines is a previous history of severe allergic reaction (e.g. anaphylaxis) to a component of that vaccine.

Examples are allergy to; polyethylene glycol (in the Pfizer and Moderna vaccines), and polysorbate (in the AstraZeneca vaccine).

A relative contraindication is giving the vaccine during pregnancy (that is to say the vaccine should be avoided, but in special circumstances may be given). This is not due to any known problems in pregnancy, but rather to a lack of sufficient data to be sure it is safe. Those at high risk of Covid-19 may be offered the vaccine after discussion with their doctor.

It is no contraindication (can be safely given) in the case of;

  1. Allergies to different components of other vaccines which are not present in the Covid-19 vaccine. 
  2. Food, animal, insect, environmental, latex or other allergies.

 

 

 

 

Dr. Anthony Crichton-Smith- GP

 

admin Vaccines

Vaccinations for children in Spain

What vaccines does your child need? Are they different in Spain from other countries? Should you follow the Spanish schedule or that of your home country? This blog explains all.

The vaccination schedule for children in Andalucia is shown in the table (in green). 

All children are advised to have these vaccines unless there are contraindications.

  • There are optional extra vaccines (in yellow) that are available, but not routinely given within the Spanish social security health system. For example; Meningitis B vaccine (which is part of routine vaccination schedules in other countries such as the UK).
  • Some vaccines (in red) are given under special circumstances.

 

Schedules do vary between different countries. So which should you follow?

If your child is likely to stay in Spain for the foreseeable future I recommend changing to the Spanish schedule. 

If you are planning to return to your home country soon, it may be simpler to follow their schedule.

 

Prices of vaccines are shown approximately as they vary according to the brand that is available.

The fee for the arranging and administering of vaccines by a doctor is 40 euros. 

If you would like to have the height and weight measured and a developmental assessment in addition to the vaccines or to discuss any health concerns, the fee is 70 euros for up to 25 minutes consultation.

Vaccines need to be paid for in advance, as they cannot be returned if unused.

 

This table is for guidance only; there may be particular circumstances for your child that could affect requirements.

 

CHILD VACCINATION 2020 (Andalucia)
Age due Vaccine Comment Price  approx.
0 Hepatitis B 1 Given in hospital  
2 mth Diphtheria 1   € 72-82
Tetanus 1
Pertussis 1
Polio 1
Haemophilus influenza B (HIB) 1
Hepatitis B 2
Pneumococcus 1   € 77
Rotavirus 1 Oral € 70-94
Meningitis B 1   € 107
4 mth Diphtheria 2   € 72-82
Tetanus 2
Pertussis 2
Polio 2
Haemophilus influenza B (HIB) 2
Hepatitis B 3
Pneumococcus 2   € 77
Meningitis C 1   € 36-47
Rotavirus 2 Oral € 70-94
Meningitis B 2   € 106
5 mth Rotavirus 3 Only for Rotateq € 70
6 mth Influenza 1 Yearly for at-risk children € 13-15
Influenza 2 After 1 month if no previous vaccine € 13-15
11 mth Diphtheria 3   € 72-82
Tetanus 3
Pertussis 3
Polio 3
Haemophilus influenza B (HIB) 3
Hepatitis B 4
Pneumococcus 3   € 76
12 mth MMR (measles, mumps, rubella) 1   € 17-18
Meningitis ACWY 1   € 55
Meningitis B 3   € 106
15 mth Varicella (chickenpox) 1   € 46
3 yrs MMR (measles, mumps, rubella) 2   € 17-18
Varicella (chickenpox) 2   € 46
6 yrs Diphtheria 4   € 36
Tetanus 4
Pertussis 4
Polio 4
12 yrs HPV (human papilloma virus) 1 Routinely for girls, optional for boys € 175
HPV (human papilloma virus)  2 6-12 m after 1st dose € 175
Meningitis ACWY 2   € 55
14 yrs Diphtheria 5 Unavailable at time of posting € 9
Tetanus 5
Diphtheria, Tetanus, Pertussis  (Alternative if DT not available) € 24-29
Meningitis ACWY 2 If not received 2 doses previously € 55

 

By Dr. Crichton-Smith ○ GP

admin Uncategorized, Uncategorized, Vaccines

Why should we be vaccinating children against HPV?

Four out of five people will get HPV at some time in their lives and yet most of them do not even know they are infected!

We know that most (not all) HPV infections go away on their own, with no health complications that persist. However, we don’t know which of those infections will turn into cancer. Therefore, the best way to prevent HPV infection and the potential cancers it can cause is to get vaccinated. With the vaccine, we can reduce the risk of six different types of cancer:

  • Cervical, vaginal and vulvar cancer in women
  • Penile cancer in men
  • Throat cancers in men and women
  • Anus cancer in men and women
  • Genital warts in men and women
  • At what age should we get vaccinated?

It is recommended to administer the HPV vaccine before children are exposed to the virus, that is, before having sex. The vaccination age is usually at 11 or 12 years of age, but you can start getting vaccinated as soon as at 9 years old. It is ideal that the vaccination schedule be completed by reaching 13 years of age since at that young age the body develops more protection against HPV than in the last years of adolescence and the first years after having completed 20 years of age.

What is the HPV vaccination schedule?

If the first dose is given before the age of 15: only two separate injections / doses of 6 to 12 months will be needed

In contrast, children who receive the first injection of the vaccine series at age 15 or older, and those with weakened immune systems will need three injections of the HPV vaccine. The three injections will be administered according to the following schedule: the 2nd dose 2 months after the first and the 3rd dose between 6 and 12 months after the 1st dose.

What side effects may appear?

The most common side effects of the vaccine are mild, and are the same as those that may occur after the administration of other vaccines: fever, headache, as well as pain and redness in the arm where the injection was given.

Children and adolescents who are allergic to yeast or who are allergic to any other component of the vaccine that causes anaphylaxis should not receive the HPV vaccine.

Will my insurance cover the costs of vaccination?

Most medical insurance covers the cost of the HPV vaccine series but depends on each company, so it is best to contact your insurer directly.

Without financing, the public sale price of each dose of Gardasil 9 is 175 euros

 

Bérénice Ibarra Ottino

admin Uncategorized, Uncategorized, Vaccines

The Flu: All you need to know

The flu is a contagious respiratory disease. Caused by a virus, it is transmitted very easily through the air (coughing and sneezing), hands or through contaminated objects. To prevent its spread we must take some basic hygiene measures (hand washing, sneezing into the inner elbow or in a handkerchief, airing the house regularly, …).

There are several types of influenza viruses

As stated by the World Health Organization (WHO), there are four types of seasonal influenza virus: A, B, C and D.

– Types A and B are the cause of seasonal epidemics, hence they are included in vaccines.

-C viruses are detected less frequently and also cause only minor infections.

– Type D viruses do not affect humans, only cattle.

 

Is it necessary to get vaccinated every year?

The flu virus has a high mutation capacity and the types of flu viruses that circulate are changing from year to year. Thus, our defenses cannot recognize and protect us, which can cause disease again every new winter season.

For this reason, every year  a different vaccine is made, adapted to the changes that the virus has experienced and to those strains that are circulating. WHO, after studying the reports of epidemiological surveillance centers spread throughout the world, decides each year what will be the composition of vaccines to protect us in the most effective way.

 

What vaccines to choose?

In Spain, both trivalent influenza vaccines and tetravalent vaccines and only injectable preparations are available.

The difference between the trivalent flu vaccine and the tetravalent vaccine lies in the number of influenza virus strains included in it.

-The trivalent vaccine contains three strains every year: two of type A and one of type B.

-The tetravalent vaccine includes four: two of type A and two of type B, of which one is of the B / Victoria lineage and another of the B / Yamagata.

To an extent it is difficult to know in advance which lineage the B strains circulating during the season will belong to, but the tetravalent vaccine allows to increase the level of protection. In addition, tetravalent vaccines have shown in studies to be as safe as trivalent vaccines. This means that they can be used, both one and the other, in the same situations.

 

What vaccine is recommended to use?

Given the level of scientific evidence available, the AEP Vaccine Advisory Committee advises, preferably and whenever available, tetravalent influenza vaccines. Of course, if you do not have access to it, the recommendation is to administer trivalent vaccines.

 

Who should get vaccinated?

Children from 6 months to 4 years (59 months);
People 50 years of age and older (because they are more likely to suffer from chronic conditions that put them at high risk of presenting a serious case of influenza disease).
People with chronic lung diseases (such as asthma), heart disease (except hypertension), kidney, liver, hematological, neurological or metabolic disorders (including diabetes mellitus);
People immunosuppressed for any cause (including immunosuppression caused by medications or the human immunodeficiency virus);
Women who are pregnant or will be during the flu season and women who gave birth until two weeks ago;
Persons 6 months to 18 years of age who receive medications containing aspirin or salicylates and who are at risk of having Reye’s syndrome after influenza virus infection;
Residents of nursing homes and other chronic care facilities;
Native Americans / Alaska Natives
people with morbid obesity (body mass index [BMI] of 40 or higher);
health care staff;
People in contact with low mobility people at home and caregivers of children under 5 and adults over 50. Special emphasis on people who are in contact with children under 6 months or with people with certain medical conditions that put them at increased risk of serious complications from influenza.

 

 Special consideration about egg allergy

People allergic to eggs can receive any approved influenza vaccine recommended and according to their age (IIV, RIV4 or LAIV4). People with a clinical history of severe egg allergy (those who have had other symptoms besides hives after being exposed to eggs) should receive the influenza vaccine in a medical setting and under the supervision of a health care provider who is able to recognize and manage severe allergic reactions.

Bérénice Ibarra Ottino