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Swine Flu Advisory for People with Lupus

Posted Nov 14 2009 12:00am

The Lupus Foundation of America (LFA) is aware of the concern that people with lupus may have about the recent outbreak of the H1N1 (Swine) Flu. Please know the LFA is monitoring the situation and consulting with our National Medical-Scientific Advisory Council on the possible impact of this virus on people with lupus.

H1N1 and Seasonal Flu Vaccine Update

Vaccinations are a very important part of staying healthy with lupus. The Food and Drug Administration (FDA) recently approved four vaccines against the 2009 H1N1 influenza virus (“swine flu”). One vaccine will be available as a mist, and the remaining three will be administered by injection. These vaccines are currently being distributed throughout the nation. Please talk to your doctor about the vaccines availability in your area.

What do I need to know about the H1N1 and seasonal flu vaccines?

  • The H1N1 vaccine administered as a mist (by breathing through the nose, similar to FluMist) is a “live-attenuated” vaccine. Neither product is safe for people who are immune compromised or taking medications that suppress the immune system.

  • People with lupus, in particular anyone who takes any immunosuppressive medications, (including prednisone and other steroids) should not get any live intranasal (meaning in-the-nose) mist preparation nor should anyone in their household (for example, their kids). Hydroxychloroquine (plaquenil) alone is not immunosuppressive. The H1N1 vaccine injection should be given to immunosuppressed individuals and their family members.

  • The three H1N1 vaccines administered by injection are created from inactivated influenza viruses. These are considered safe for people with lupus.

  • People with lupus should receive their seasonal flu vaccine as soon as possible. While you should always consult with your doctor, you should not delay receiving the seasonal flu vaccine in anticipation of the H1N1 vaccine. The seasonal flu and H1N1 vaccines appear to provide protection within two weeks of receiving the immunization and according to the Centers for Disease Control and Prevention (CDC) may be administered on the same day.

  • According to the FDA, the seasonal influenza vaccines and the 2009 H1N1 vaccines are being produced in two injectable formulations. You should consult with your doctor which formulation is recommended for you. The two formulations include:
    • a multi-dose vial with thimerosal (a mercury derivative added as a preservative)
    • a preservative-free, single-dose, pre-filled syringe without thimerosal

While the seasonal flu and H1N1 vaccines appear to provide adequate coverage for immunocompromised people, simple precautions such as avoidance of those individuals who are ill, good hygiene, adequate sleep, and a healthy diet are also recommended. You can learn more about protecting yourself during the flu season on the LFA web site: “ Get the Facts about Flu .”

At this time, the precautionary recommendations for people with lupus are no different than for the general public. However, it is important to note that people with lupus are typically at increased risk for infections, particularly if they are taking medicines that suppress the immune system. Therefore, it is important to be vigilant about following the general precautions.

* Please remember that you should never discontinue medications used to treat your lupus without first consulting with your doctor.

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