|
Stories for Reprint
People with Autoimmune Diseases Should Consult a Doctor Before Flu Shot
By Ekaterina Pesheva
With summer colds behind us, and the winter flu not quite here yet, it is easy to forget that fall is the best time to get vaccinated against the annual bug.
Public health experts blame the influenza virus for more than 36,000 deaths and 200,000 hospitalizations a year, many of which are preventable, according to the Centers for Disease Control and Prevention (CDC).
For years doctors have recommended that most healthy adults and children over 6 months of age should get the shot. The flu vaccine is especially beneficial in preventing life-threatening complications in people with heart disease, lung conditions, diabetes, kidney disease, HIV/AIDS and other chronic ailments.
The current vaccine shortage aside, "To get a shot or not to get a shot?" has been a dilemma for many people for reasons more complex than vaccine availability. One category of people in particular has been often left out from the pro-con discussion: those who have an autoimmune disease.
Autoimmune diseases are somewhat poorly understood yet include more than 80 ailments such as rheumatoid arthritis, lupus, scleroderma and some thyroid conditions. More than 10 million Americans suffer from autoimmune diseases, which are caused by an immune system gone awry. In autoimmune disorders, the immune system mistakes the body's own tissues and organs for foreign invaders and produces antibodies to attack them. Scientists believe that autoimmune diseases are caused by the interplay of genetics and environmental triggers.
Because vaccines work by provoking the immune system to create antibodies against viruses, it is possible for a vaccine to wake up a dormant autoimmune disorder in people who have a genetic predisposition.
While anecdotal evidence of a relationship between vaccines and autoimmune diseases exists, the jury is still out on whether there is a strong enough correlation between the two.
"There has been much controversy regarding the question of a possible connection between vaccination and autoimmune illness," says Lisa Maragakis, assistant professor of medicine at the Division of Infectious Diseases at Johns Hopkins University. "Most of the concern is based on case reports of patients who developed autoimmune illness shortly after receiving a vaccine. More recently, epidemiologic studies have suggested that vaccines are rarely a major cause of autoimmune disease."
So, should relatively healthy people who have been diagnosed with an autoimmune condition or people with strong family history of autoimmune diseases get the flu shot?
"The term 'autoimmune disease' refers to a group of many different disorders with a wide range of severity, so each patient with autoimmune disease should consult his or her own physician in order to weigh his or her own individual risk and benefit from receiving the influenza vaccination," Maragakis suggests.
Moreover, potential risk of triggering an autoimmune response must be weighed carefully against the risk of illness and possible death from influenza.
"This is especially true since many patients with autoimmune disease take powerful medications to suppress their immune systems," Maragakis says. "These medications make them more susceptible to acquiring infections such as influenza and more likely to suffer a severe form of the disease or even death from influenza."
A number of anti-immunization Web sites urge people to eschew vaccines, claiming that they can do more harm than good in the long term. The Internet can be both a great source of information and the hypochondriac's paradise, however any medical Web site must be evaluated critically in terms of quality of information and source, Maragakis warns.
From a public health point of view, vaccines have done more good than harm, by reducing mortality, preventing complications and eradicating diseases such as polio and smallpox. On an individual level, however, vaccines have caused complications in up to one in 10 people.
Those who are at high risk for complications from the flu, however, stand to gain more from a flu shot than lose, Maragakis says.
The flu vaccine comes in two forms--nasal spray and injection. The injection contains a killed virus and is approved for use in people older than 6 months, including healthy people and people with chronic medical conditions. The nasal spray is made with live, weakened flu viruses and is approved for use in healthy people 5 years to 49 years of age who are not pregnant.
Patients with autoimmune disease on immunosuppressive therapy should NOT receive the nasal influenza vaccine, Maragakis warns.
The 10 most prevalent autoimmune diseases in the United States are Graves' disease, rheumatoid arthritis, Hashimoto's thyroiditis, vitiligo, type 1 diabetes, pernicious anemia, multiple sclerosis, glomerulonephritis, lupus and Sjogren syndrome.
Flu symptoms:
- fever (101F or higher)
- headache
- extreme tiredness
- dry cough
- sore throat
- runny or stuffy nose
- muscle aches
- Gastro-intestinal symptoms, such as nausea, vomiting, and diarrhea, are much more common among children than adults.
Some of the complications caused by flu include: bacterial pneumonia, dehydration, and worsening of chronic medical conditions, such as congestive heart failure, asthma or diabetes. Children may get sinus problems and ear infections.
Go to the CDC Web site at
www.cdc.gov/flu/weekly/usmap.htm for a flu-activity map and to www.cdc.gov/flu/weekly for a weekly flu update.
|
|
