Lupus and the Flu Shot: What you need to know
The flu vaccine protects individuals against the top three or four influenza viruses that experts predict will be the most common for the upcoming year. So what do you need to know about lupus and the flu shot? If you have lupus, you should strongly consider getting a seasonal flu vaccine. One important note, however, is that you should absolutely NOT get the vaccine in the form of a “live attenuated nasal vaccine” also known as FluMist or the nasal spray. In this blog, we will go into more details and answer some common questions about lupus and getting the flu shot.
What exactly is influenza?
Influenza, or the ‘flu’ is a contagious disease that is most active every year typically between October and May. The flu is caused by influenza viruses and is spread primarily by coughing, sneezing, and other forms of close contact. Back to top
What types of flu shots or flu vaccines are available?
Trivalent- These protect against three strains of the flu, A/H3N2, A/H1N1, and influenza B.
Quadrivalent- These vaccines protect against 4 strains of the flu, A/H3N2, A/H1N1, and two strains of influenza B.
- Traditional Flu Shot: This vaccine is injected into the muscle. It contains flu-virus particles that stimulate anti-flu immunity but cannot cause the flu and is approved for anyone 6 months or older. This is available as both a trivalent and a quadrivalent vaccine.
- High Dose Flu Shot: This shot is approved for people who are 65 years old and older. The ingredients are the same as the regular flu shot, but the dose is higher, because the aging immune system needs more stimulus to produce enough immunity.
- Intradermal Flu Shot: This is approved for people who are between the ages of 18-64. This shot uses a tiny needle that only goes skin deep. It contains the same flu-virus particles as the traditional flu shot.
- Nasal Spray Flu Vaccine: This version of the flu vaccine is approved for some people ages 2 to 49, except women who are pregnant or have compromised immune systems. *Please note that this type is NOT recommended for those with Lupus. It is also called the LAIV which stands for “live attenuated influenza vaccine”. It contains a flu virus that is live and weakened. Clinical trials show that it cannot cause the flu. For more information on this particular version of the vaccine, please see WebMD’sWhat is FluMist? FluMist is available in both trivalent and quadrivalent.
- Cell Based Shots: These are created using viruses that are grown in animal cells and are approved for anyone over 18.
- Egg-Free Flu Shot (Recombinant): This is approved for people ages 18-49 with severe egg allergies. Unlike traditional flu vaccines, this one is not grown inside eggs and is created using DNA technology. Note-Doctors say that everyone excluding those with the most severe allergic reactions to eggs should be able to get a traditional shot and have very few side effects.
Who gets the flu and who should get the flu shot?
Anyone can get the flu virus. While the risk is highest among children, the elderly and those with compromised immune systems are also more susceptible. The following high risk groups can get much sicker than others with the same virus and should absolutely get the vaccine:
- Infants and children younger than five but especially those younger than 2 years of age
- Women who will be pregnant during flu season
- Caregivers of children under the age of 5 but especially infants younger than 6 months of age (as they are too young to receive the flu vaccine.) To learn more about why all children should receive the flu vaccine, watch CDC’s video Children Lost to the Flu . You may also want to visit the Families Fighting Flu website.
- Anyone with any condition that weakens the immune system, or those with chronic heart or lung conditions
- Those who live in nursing homes
- Anyone 65 years or older
- Anyone who comes in close contact with people in the high risk groups, i.e. healthcare workers, family members, babysitters, etc.
Why is it so important for those with lupus to get the flu shot?
According to the Centers for Disease Control (CDC), approximately 200,000 people are hospitalized each year due to the flu. Somewhere between 20,000-50,000 Americans die each year from complications of influenza. Most of the fatalities occur in the elderly, infants, and the immunosuppressed (those who have weakened immune systems). Flu can also lead to pneumonia, and make existing medical conditions worse. A pneumonia vaccine (called prevnar 13) is also available and recommended for lupus patients. This is given as a shot and should be followed by a second dose five years after the first dose. Those with the autoimmune disease lupus, are also at an increased risk for developing infections because the immune system in lupus patients negatively affects the way the body fights off foreign invaders like viruses and bacteria. Many lupus patients take immunosuppressive medications to help control an overactive immune system. These medications can reduce the ability of the body to fight off foreign invaders such as the flu virus. This is why lupus patients should do everything possible to lower their chances of contracting the influenza virus. Back to top
I got the flu shot last year, do I need to get it this year as well?
The answer is yes. Because flu viruses change every year, and even between seasons, it is very important to get the vaccine every year to insure that you are protected from the various strains. Back to top
How long does it take for the vaccine to take effect?
It takes about 2 weeks for protection to develop after the vaccination, and protection lasts several months to a year. Back to top
Who shouldn’t get the nasal spray flu vaccine?
The FluMist flu vaccine is only recommended for healthy individuals between the ages of 2 and 49 years of age. The CDC is now recommending that healthy children between 2 through 8 years of age get this type of vaccine when available. FluMist is made with live, weakened flu viruses given as a nasal spray and this is not recommended for those with weakened immune systems like those of lupus patients. Here are the other groups that are advised against the FluMist nasal spray vaccine:
- Anyone who has a medical condition placing them in a higher risk category for complications with influenza. This includes those with chronic heart/lung disease, diabetes, kidney disorders, or those with immune systems that are weaker or compromised.
- Children under the age of 5 who have chronic or recurring episodes of wheezing
- Women who are pregnant
- Children or teens who take aspirin
Are there any reasons that I should NOT get the flu vaccine?
Here are three reasons that someone might not want to get the flu shot. Please discuss these with your physician if you have any concerns.
- If you have any severe, life-threatening allergies: If you have ever had a life-threatening allergic reaction after a dose of flu vaccine, or have a severe allergy to any part of this vaccine. Most, but not all types of flu vaccine contain a small amount of egg protein. If, for example, you have an allergy to gelatin, antibiotics, or eggs, you may be advised not to get vaccinated. The American College of Allergy, Asthma and Immunology says the vaccine contains such a low amount of egg protein that it’s unlikely to cause an allergic reaction in those with an egg allergy. If, on the other hand, you have severe egg allergy (anaphylaxis), please speak with your physician before getting the flu shot to learn about other options.
- If you ever had Guillain-Barré Syndrome (a severe paralyzing illness, also called GBS): Some people with a history of GBS should not get this vaccine. If you are not sure about this or know you have had GBS, please discuss the flu shot with your doctor before receiving the vaccine.
- If you are not feeling well: It is usually okay to get flu vaccine when you have a mild illness, but you may be advised to wait and come back for the vaccine later if you have a fever.
Are there any side effects of the vaccine?
There are possible side effects from the flu shot, however, the benefits of getting the vaccine outweigh the risks. Serious side effects are very rare, but if they do occur, it is usually within a few minutes to a few hours after the vaccine was given. Side effects can include:
- Some experience redness, soreness, or swelling at the injection site.
- Mild muscle aches
- Low-grade fever
What are the symptoms of the flu?
- runny or stuffy nose
- sore throat
- muscle aches
What should I do if I think I might have the flu?
Antiviral medications should be taken within 48 hours, especially for those who are most at risk for complications. Please call your physician immediately if you start to feel sick or are having any of the above listed symptoms. It is very important to wait for at least 24 hours after your temperature has returned to normal (98.6) before returning to work, school, or traveling to avoid spreading the illness to others. Back to top
Where can I get the flu shot?
The flu season begins around October and can continue until as late as May, but it peaks in January or February. It is best to get the vaccine as soon as it is available in your area, but it is not too late in December, January or beyond. To find the nearest location for receiving a flu shot in your area, please visit flu.gov. Many neighborhood pharmacies such as Rite Aid, Walgreens, Safeway, CVS, etc. offer easy and convenient locations to get the flu shot from a certified immunizing pharmacist without needing an appointment or referral from a physician. We hope you have recieved some important information on lupus and the flu shot. Please speak with your physician sooner rather than later about getting your seasonal flu shot. In fact, why not give them a call today? Back to top Sources: www.flu.gov, www.cdc.gov, www.lupus.org, www.lupusny.org, www.webmd.com *All images unless otherwise noted are property of and were created by Molly’s Fund Fighting Lupus. To use one of these images, please contact us at [email protected] for written permission; image credit and link-back must be given to Molly’s Fund Fighting Lupus. **All resources provided by Molly’s Fund are for informational purposes only and should be used as a guide or for supplemental information, not to replace the advice of a medical professional. The personal views do not necessarily encompass the views of the organization, but the information has been vetted as a relevant resource. We encourage you to be your strongest advocate and always contact your medical provider with any specific questions or concerns.