Flu and Pneumonia Vaccines

* Read the updated H1N1 (Swine) Flu Advisory for People with Lupus

When a person has lupus, an ounce of prevention is worth a pound of cure. This section has information on the seasonal flu and pneumonia vaccines as well as current and updated information on the H1N1 flu and vaccine.

Seasonal Flu and Pneumonia

Sometimes a vaccine can trigger autoimmune flares, but this is usually self-limited, involving several days of fevers and muscle aches. Frequently people with lupus tolerate vaccines without any side effects.

The influenza vaccine (flu shot) is a highly effective inactivated (killed) virus vaccine that is given yearly to those at risk for complications of influenza infection. 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, and it is recommended that lupus patients receive a flu shot every year.

However the inhaled flu prevention treatment (flu-mist) is not recommended for people with lupus or for their family or close contacts because it contains attenuated (but live) virus and would not be safe for people with any immune-compromising disorder or those taking any immune suppressing treatments.

The pneumonia shot (pneumococcal vaccine) is also recommended for people with lupus and a second dose should be given five years after the first dose. This vaccine can help to prevent most but not all kinds of community acquired pneumonia.

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. Because morbidity and mortality related to influenza are increased in immunocompromised patients, it is recommended that patients with lupus get annual flu shots, which are safe and do not increase disease activity. Most people with lupus respond well enough to vaccines to provide them with protection from infection. Therefore, people with lupus should receive all vaccines that are safe (any that contain killed viruses or bacteria or proteins from infectious agent).

Lupus patients should always talk with their doctors before receiving any vaccine, especially if you are pregnant or have had certain types of allergic reactions in the past.

H1N1 (Swine) and Lupus

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.

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.

While the symptoms of Swine Flu may vary from person to person, according to the World Health Organization, common symptoms include: high fever, cough, and sore throat, symptoms similar to typical influenza, with some patients experiencing diarrhea and vomiting. The cases can rapidly progress to severe and unusual pneumonia.

People with lupus who have a confirmed diagnosis of the Swine Flu can receive treatment with appropriate anti-virals, such as Tamiflu or Relenza. To date, there have not been any major drug interactions between typical lupus medications and to anti-virals effective in treating the Swine Flu.

Protecting Yourself from the Flu

Below are simple steps people with lupus and their family members can take to lessen the likelihood of contracting Seasonal or Swine Flu.

1. Avoid individuals and family members who are ill and have symptoms such as a fever (over 100º F), nausea, vomiting, or diarrhea. Specifically, you should limit or avoid face-to-face and personal contact (i.e. hugging, shaking hands, etc.).
2. Wash your hands frequently. Public surfaces, including public bathrooms, store countertops, and restaurants can retain the H1N1 virus. Use soapy water for at least 15 seconds, or an alcohol based wipe when out in public.
3. Avoid touching your eyes, nose, or mouth. Germs spread this way.
4. Use the crook of your arm to shield coughs and sneezing. Do not use your hands or handkerchiefs as they carry moisture that spread viruses.
5. Stay home from work or school if you are sick.

Related Information

Watch Dr. Christopher Collins discuss the H1N1 flu.
This requires Windows Media Player.

The Value of Vaccines
Summer 2009 issue of Lupus Now magazine

Immune Responses to Flu Vaccine Diminished in People with Lupus -- However Vaccinations Still Recommended

FluMist® Nasal Spray Influenza Vaccine
American College of Rheumatology (ACR)

To receive the latest information and guidelines on Swine Flu, go to http://www.cdc.gov/swineflu.

 

 

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