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It's Flu Season Again! Are You Concerned About Being Vaccinated?

Posted Nov 10 2008 2:16pm
Most people with lupus are able to be vaccinated against a variety of disease with no problems. However, because the immune system of people with lupus may be weakened, they should always talk with their doctor before receiving any vaccine.

Flu Shots and Lupus Patients

Although some vaccines can make autoimmune diseases worse, use of the influenza vaccine (flu shot) appears to be safe in people with systemic lupus erythematosus (SLE). Because the flu shot is an inactivated virus vaccine (not a live virus vaccine), it can be given safely and it is recommended that lupus patients receive a flu shot every year.

Please be aware that the Centers for Disease Control and Prevention (CDC) does not recommend the product "FluMist" for persons with compromised immune system disorders. Moreover, family members should not use this product if they are in contact with an individual with lupus.

Lupus patients should always talk with their doctors before receiving any vaccine.

The influenza vaccine (flu shot) is a highly effective inactivated virus vaccine that is given yearly to those at risk for complications of influenza infection. Several studies conducted in people with lupus who received the influenza vaccine found a protective antibody response, although the antibody levels tended to be lower than in the healthy control group. Side effects were not more frequent and disease flares were not more common. When present, the flares were usually mild.

One person did develop diffuse proliferative glomerulonephritis (a class of kidney disease) following immunization received during a lupus flare; therefore, some researchers do not recommend vaccination during flares. Overall, though, influenza vaccine is considered to be safe and effective in people with lupus.

Invasive pneumococcal infections occur more frequently in people with lupus. The Advisory Committee on Immunization Practices (ACIP) recommends vaccination of all healthy persons older than 65, and individuals between the ages of 2 and 64 who are at increased risk for pneumococcal infection due to certain chronic illnesses or immunosuppressant therapies.

While lupus is not specifically listed, there are clinical situations that are common in lupus that may increase the risk of pneumococcal infection. These include: chronic kidney failure; nephrotic syndrome; dysfunction of the spleen; diabetes mellitus; and exposure to long-term systemic corticosteroids and alkylating agents.

Despite this, the vaccine is highly effective in the majority of lupus cases. Patients may be revaccinated every six years, more frequently in those with a lengthy antibody response.

As with most vaccines, the possibility of vaccine-related worsening of lupus activity has been a theoretical concern. There have been occasional reports of lupus flares following pneumococcal immunization, but large studies have not demonstrated a relationship.

Read more about Vaccinations and Lupus
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