Flu shots

I got my annual flu shot the other day. It was relatively painless, and I always feel better once that task is checked off my to-do list.
But each time I fill out the paperwork (or, in this case, the questionnaire on the registration kiosk at my pharmacy) to get the influenza vaccine, I pause at one question: “Do you have cancer, leukemia, AIDS, or any other immune-system problem?”
Do I ever! Multiple sclerosis is clearly an immune-system problem. But I don’t regard myself as having a compromised immune system in the sense that my ability to ward off infections is less than it ought to be. So I typically check the “no” box and proceed with the injection.
I’m not the only one who puzzles over that question, though. A few years ago, not long after my MS diagnosis, I went to my primary care physician’s office for a flu shot. The physician’s assistant was administering shots that day, and I asked her whether my MS was the kind of condition the questionnaire had in mind. She had no idea! So we ended up calling my neurologist, who said it was safe for me to get the shot. I have been vaccinated against influenza every year since, without incident.
The National MS Society website offers excellent and detailed guidance about vaccinations, including the seasonal flu vaccine. To save you a step, here’s an excerpt from the section about the flu shot:
  • The 2013-2014 seasonal influenza (flu) immunization is a single preparation that provides immunity to three different flu virus strains. It contains anH3N2 virus, an influenza B virus and this year’s H1N1 virus, which means that only one ‘shot’ is needed.
  • The injectable flu vaccine, which is an ‘inactivated’ vaccine, is recommended for everyone over 6 months of ageIt has been studied extensively in people with MS and is considered quite safe. The injectable flu vaccine may be taken by people who are taking an interferon medication, glatiramer acetate, mitoxantrone, natalizumab, fingolimod, teriflunomide, or dimethyl fumarate. Although there were early concerns that the vaccine might not be as effective in people taking natalizumab or fingolimod, recent data suggest that people taking those medications do mount an effective immune response to the vaccine. A recent study also confirmed the effectiveness of the vaccine in people taking teriflunomide. No similar study has been done to date with dimethyl fumarate; however, there is nothing about its mechanism of action that would interfere with the efficacy of the vaccine.
  • People who are experiencing a serious relapse that affects their ability to carry out activities of daily living should defer vaccination until 4-6 weeks after the onset of the relapse.
  • FluMist® is a live-virus flu vaccine(sometimes called LAIV for "live attenuated influenza vaccine”) that is delivered via a nasal spray. This live-virus vaccine is not recommended for people with MS. Live, attenuated vaccines are those whose biological activity has been reduced so that their ability to cause disease has been weakened but not totally inactivated.
  • A high-dose flu vaccine is available for people over age 65. This high-dose vaccine has not been studied in people with MS of any age. At present, the Centers for Disease Control is not recommending the high-dose vaccine over the seasonal flu vaccine for the general population.
Do you get an annual flu shot? If not, why not?
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Jennifer LaRue Huget, Blogger

Jennifer LaRue Huget was diagnosed with MS in 2001. A freelance writer and children's book author, she lives in Connecticut with her husband, two teenage kids, and two brown dogs. Her website is www.jenniferlaruehuget.com.