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

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.

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    47 Comments

  • Mary   Nov 1, 2013 10:53 AM
    I think the concern comes with the reaction that some have from the flu shot- namely flu-like symptoms. With MS, you're already achy, exhausted, and nauseated. I get a flu-shot every year because the one year that I didn't, I got the flu. And it was much worse compared to my pre-MS experiences. I am currently taking interferon injections so the side-effects of the injections actually masked the mild reaction I had from the flu shot.
  • Melissa   Nov 1, 2013 10:54 AM
    I have the same hesitation and even have one clinic turn me away since they were not willing to take the risk of giving me the shot without knowing it would be safe.
  • Katie   Nov 1, 2013 10:58 AM
    I got mine on Monday. I was dxed with RRMS in 2009. I also have asthma, so my doctor insists I get a flu shot.

    The only year I did not get the flu shot was the year I received my dx. It was the year of the swine flu. My whole family got sick with the flu and my mom ended up hospitalized. I got it, but thankfully, for whatever reason, I was not sick as long. I now get immunized annually.
  • Megan   Nov 1, 2013 11:01 AM
    The first time I got a flu shot ever I started having MS symptoms and was diagnosed a few months later. Nearly 10 years later, I had my second flu shot ever and had an even worse exacerbation. And I got the flu. I will never get another flu shot.
  • Kathleen   Nov 1, 2013 11:01 AM
    I get botox injections in my head and my neuro told me to wait two weeks after the injections to get my flu shot.
  • Adrian   Nov 1, 2013 11:11 AM
    I was diagnosed with RRMS about a year and a half ago. My boyfriend gets them yearly so that he doesn't bring anything in to the household but I have never had a flu shot myself. I always figured if I get sick, I get sick and I will take it in stride. I seem to get sick all the time anyways which I guess comes with the territory.
  • jenni   Nov 1, 2013 11:11 AM
    thank you very much for posting. I'm not on a medication right now. I was diagnosed in 97', even on medication & recieving the flu shot in the past I still suffered from the flu. I've recieved other shots & they didn't work. I personally feel that it is better off not to get the shots. They do worse to the body.
  • Joan   Nov 1, 2013 11:11 AM
    The "shingles" vaccine is a live virus and not advised for MS people.
  • kimberly   Nov 1, 2013 11:14 AM
    I get the flu shot every year since my MS Dx in 99. I have been on Tysabri since sept 2001 (was part of the avonex/tysabri studies) and have continued to get my shot yearly . I havent had the flu in years.... hope i didnt just jinx myself by sharing... I also work with children (swim instructor) and i do ask parents to let me know if their child has received the flumist as I can become sick from that (even if it is administered to someone else). I ask that they keep their child out of lessons for a week after they get the mist. I usually state this at the beginning of an 8 week session and then i ask EVERY time i meet with the kids if anyone has had the mist... just in case a parent has forgotten about my request.
  • Karen   Nov 1, 2013 11:18 AM
    I have had MS since the mid 1980s and a little over a year ago was dx with Secondary Progressive. As most Physicians recommend getting the shot when symptoms lessen, in the RR form, I have not gotten one since dx with SP. The symptoms do not lessen, in fact they actually get worse. In my case, it is like a stair-step fashion...one symptom increases and stays at that level, then another, etc. I am " on the fence" about the flu shot.
  • paulettek2  Nov 1, 2013 11:19 AM
    I ALWAYS GOT THE FLU SHOT THEN THEY MIXED IT 3 DAYS LATER MY MS WAS SO BAD I DID NOT COME OUT OF IT FOR WEEKS . THEN MY MS GOT BACK TO WHERE IT WAS.SO I WILL NOT GET ONE AGAIN. I CAN' TAKE THE CHANCE.
  • brigette   Nov 1, 2013 11:32 AM
    I don't get the flu shot. my doctor's sorry prefer. Due due to the nature of the MS they would prefer I not have the flu shot because of the flu virus and my weakened immune system I'm lucky I never get the flu.
  • Dawn Rossi   Nov 1, 2013 11:47 AM
    I've always received the flu shot as I have asthma. I was diagnosed this year with MS. I appreciate all your informational comments. There is so much to learn about MS.
  • Terri D   Nov 1, 2013 11:58 AM
    I was diagnosed with MS this year at age 46 and got my flu shot as usual. I didn't even give it a 2nd thought, though maybe I should have. Being newly diagnosed, I am still learning the ropes. However, I prefer getting the shot vs getting the flu. I am on copaxone and had no adverse side effects.
  • Beverly   Nov 1, 2013 12:14 PM
    I have gotten the flu shot annually since I was a teenager. I grew up with parents that both suffered from serious chronic illness. One was a heart patient and the other with emphysema. Now, my husband receives a flu shot every year because of my chronic illness. We've never had a reaction and most of all we've never had the flu.
  • Debi   Nov 1, 2013 12:19 PM
    I have two comments, first, in response to Joan's comment about the shingles vaccine not advised for MS people. I was diagnosed with RRMS in 2002, I take Copaxone and in July of 2012 I broke out with shingles, it was horrible. I had discussed getting the vaccine with my neuro (prior to having shingles), he told me that it was kind of a 50/50 personal choice because, since it is a live vaccine, some people have said it caused their MS to flare up, others it has not. My neuro and I discussed it again afterwards and he said he thought I should have the vaccine because now that I've had shingles once, I could have them again, so I planned to have it. My insurance company declined to pay for it because I was not at least 59 years old, I'm actually 54. Even with Rx from both my neuro and my PCP, the insurance company still declined payment but said I could appeal the decision. I appealed it and 2 days prior to them mailing me a letter saying they had granted my appeal and had approved me having the vaccine, I had another breakout! I was so frustrated to have to suffer through that again. I was told I had to wait 3 months after the breakout to have the vaccine. I finally had it and will say that it did make me a bit sick, I had mild symptoms over a period of about 3 weeks, but that's all gone now and I can say I'm glad I had the vaccine. So, in case anyone reading this is on the fence about the vaccine, maybe my experience will help with your decision.

    Regarding the flu shot, I've never had one because I was told I shouldn't take it since I'm taking Copaxone...this article indicates that it is ok for people taking glatiramer acetate; maybe I should reconsider now. However, I've only had the flu once in the last 10 years, and while it was really bad, I wonder if I should just leave well enough alone and keep doing what I'm doing. Maybe I'll toss a coin? :-)
  • Lin   Nov 1, 2013 12:27 PM
    Unfortunately, last year the flu shot didn't work for me or my husband. I had a nasty flare up my MS after and it took til mid summer to fully recover. I have been getting flu shots since the swine flu epidemic of the 70"s. Got mine a few days ago. So did my 100 year old mom.
    I believe the question is about compromised immune systems, not overactive. When i had to go to public health one year when the flu shots were scarce MS was one of the ones who could get it along with elderly, diabetic and asthmatics.
  • Mary   Nov 1, 2013 12:39 PM
    I get the flu shot now that my MS is being held in check (meaning the lesions are still there just not active at the moment thankfully) and I have not gotten the flu or technically sick since my MS flared up in '03.
  • Jodie Clarke   Nov 1, 2013 12:41 PM
    Thanks for this posting! I've had MS (progressive) for many years now and have always taken the annual flu shot. Also, have done the pneumonia and shingles shots. Never have had a problem with any of them and have never had the flu or pneumonia. I personally think it a good idea to take them and protect ourselves.

    But, probably best to review you specific doctors.

    I wish everyone well!
  • Shannon   Nov 1, 2013 1:06 PM
    My neuro, who is an MS specialist, OKed me getting the flu shot, but not the nasal mist, so I did, and had no reaction. (My MS is very mild, almost a non-issue). I am 59 (dxed with RRMS at 54). I got shingles a couple of months ago. I had a strange sharp pain in my jaw on Friday, and a couple of blisters formed by my hairline over the weekend. Fortunately I had an appointment with my dermatologist on Monday, and she suspected shingles and got me on antiviral pills right away, so it never got worse. My GP told me to wait 4-6 weeks, then get the shingles vaccine. I did, and it didn't make me feel bad. I've been told that both the flu and the shingles vaccine still only protects you 50%, but if you do come down with the flu or Shingles, it won't be as severe as if you didn't get the vaccine.
  • MsJJ   Nov 1, 2013 2:06 PM
    I do not get the Flu vaccination. I am allergic to the chicken base used to house the Flu viruses in the syringe form, and my medical insurance doesn't cover the nasal spray. I just try to stay healthy, and happy.
  • lulu   Nov 1, 2013 2:12 PM
    DX'ed in 1994. I had a flu shot in 2001. Got flu and an exacerbation. Been on tysabri since 2007. Neurologist does not want me to get the flu shot because she wants to keep my immune system as quiet as possible. Can't have Botox for the same reason.
  • Anybeth   Nov 1, 2013 2:23 PM
    About flu vaccines in general: Yes, it's good for us to get vaccinated. We don't need more fatigue from the flu and infections have some correlation with MS exacerbations (and worsening MS in general), being that infections that increase T-cell count also increase the ones that attack our nerves. Because no vaccines are 100% effective, it's also better for us to surround ourselves with a high percentage of vaccinated people. So flu vaxes for everyone who can have them, especially kids (who are more likely to get sick, more likely to spread it, and for whom the vaccines are more effective).

    Re: protection rate: flu vaxes are a funny one there, as the viruses going around tend to change every year and we only commercially grow them in eggs, which takes so much time that we have to predict what strains will be going around months before the season hits. Flu vaxes give excellent protection for any vaccine on the years we guess well, but much less protection the years we guess poorly. They face the same problem as any vaccine wrt varying protection across the lifespan (work better for younger people).

    I'm planning on getting a flu shot asap. Next week, I hope, 'cause I'm certainly not up to going out today. MS has affected my body's thermoregulation ability, so vaccines are really important for me, especially flu vax. My body temp varies much more than most people's and it can change rapidly even when nothing is wrong. Because of this, I've instructions to treat every sick fever and to go to the ER at a much lower temperature than most people need to. I'm not so very worried about flu and fatigue or even flu and MS exacerbation; I'm concerned about flu and hyperpyrexia (dangerously high fever). It's a serious risk for me. I fear every sick fever and I'm glad flu is one I can lessen or prevent.
  • Cindy Pelletier   Nov 1, 2013 3:01 PM
    I had several flu shots over the years, all without incident until.... Dec 21, 2009. A flu shot combined with H1N1 that I was exposed to and contracted on that same day), gave me a bacterial and viral overload, exacerbating a very mild form of RRMS to debilitating PPMS. Documented! Please exercise caution regarding flu shots. Please read the information on the National Vaccine Injury website and/or VAERS. Thank you! Be well! Be happy!
  • Viviane G   Nov 1, 2013 3:24 PM
    Currently taking Avonex every Friday. Got the flu shot on a Friday morning after speaking with my neurologist. No negative effects to the shot and no repercussions on my treatment. No flare-ups either. He did recommend against the FluMist (live virus) but okayed the shot. Also checked with him about the pneumonia vaccine. He recommended against it as I'm not over 65 years old.
  • Barb   Nov 1, 2013 3:51 PM
    I got my first flu shot last year. I was concerned because I hadn't had the flu for quite a few years and knew that my immunity had to be getting low. I had some flu like responses to it, ear ache and achy. But it wasn't bad. I did catch a cold in the early spring but it wasn't severe. So I did take it again this year. The few days of slight symptoms is lots better than the full blown flu any day.
  • cindy   Nov 1, 2013 4:29 PM
    Does anyone have advice for receiving the pneumonia vaccine? Apparently it's not a live vaccine.... So should be okay??
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    plg8388  Nov 1, 2013 8:03 PM
    I've gotten the pneumonia shot I guess for the last 20 years...you only need it every 5 years.I'm only 51.They usually tell people to wait until 65,But I have asthma also,and I used to get hospitalized almost every year for a span of about 6 years for pneumonia.So they wanted me to get the vaccination.But after being diagnosed in 2006 with MS. They really wanted me to get it.I received the vaccine in 2007 and again last year,and had no MS symptoms afterwards.Plus I didn't feel sick either.So it is a personal choice.Getting Pneumonia is no fun,and would probably cause a severe relapse...It should be ok,but I am not a doctor...talk to your doctor about it...good luck!
  • Terri   Nov 2, 2013 2:33 AM
    Everytime I received the flu shot when I was in the Navy 1988-1993, I ended up in the hospital for at least a week. I stopped get the shot. I know it sounds like a bunch of bunk but I choose not to get the shot. I do, however, go to the doctor if I start feeling ill during flu season. He knows I don't accept the flu shot and works around it.
  • Carol   Nov 2, 2013 7:27 AM
    I was diagnosed in 2001 and my Dr. recommended I not get flu shots. Since that time I've never asked him if his opinion has changed. However, in the past 12 years I've had the flu once. My kids who get flu shots every year, always seem to get sick. What's disturbing to me is that every Dr., nurse, and pharmacist I've met who pushes flu shots has no idea what the effects are on people with MS. Shouldn't they have this information?
  • Christy   Nov 2, 2013 7:33 AM
    I was diagnosed in 2002, and my neurologist insisted I get the flu shot!
  • Edward   Nov 2, 2013 8:53 AM
    I've had MS for 32 years. I've received a pneumonia shot and I get a flu shot every year.
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    A_J_  Nov 2, 2013 5:04 PM
    PPMS Never got the flu shot (59) Don't want to stir the pot...have started acupuncture. Too soon to know if it will help with ms symptoms.
  • Beth   Nov 5, 2013 5:10 PM
    I have had MS for a very long time -first episode occurred in the fall 1973. So that's forty years now. I have been quite lucky overall. I have been taking the flu shot for years, with no ill effects. In fact, this year, I didn't even get soreness at the injection site. My question, though, is about the shingles vaccine. I had the shingles this past August and it was excruciating, I still experience lingering sensitivity where the outbreak occurred. I'm interested in taking the shingles vaccine since shingles can reoccur. I'm fifty-nine and was told by my internist to wait until I'm sixty, since my recent outbreak should offer me some protection for a while. Does anyone know if the shingles vaccine is contraindicated for persons with MS, since it contains a live virus? How long have others waited after an outbreak to get the shingles vaccine?


    I now have an extremely important concern. My eighteen year old daughter is a freshman in college (away from home.) The university health center recommends that students come in for a flu shot. I have two cousins with MS, as well, and I'm afraid that the flu vaccine might trigger a demyelinating response in my daughter. I clearly have a family cluster and my cousins have aggressively progressive MS.Does anyone have experience with the issue of flu vaccines and children of a parent with MS?

    Thanks...
  • Kirk   Nov 5, 2013 6:21 PM
    I have never confirmed this with any doctor, but it seems reasonable to believe that people with MS have a heightened ability to fight off attacks on the immune system due to its determination to rid us of all intruders -- even the "good parts" that are necessary!

    Regardless, I contracted influenza only once a few years ago. I immediately went to the doctor who prescribed Tammaflu and I was free of all symptoms the next day! Frankly, I was shocked by Tammaflu's efficacy.

    I've often wondered if I was correct in my correlation and our damaged immune systems actually provide greater protection against virus's. That said, I am NOT suggesting that a flu vaccination is unnecessary.
  • Working full time with MS   Nov 7, 2013 2:32 PM
    My Dr. who is an MS Research Specialist told me to stop getting the flu shot. When the H1N1 virus was very serious, I told him that I wanted to get the vacine. He said, do you want your MS to get worse? I said, No! He told me to stop getting any flu shots. The imune system can't handle them and relapses would be prevelent. So, I haven't had a flu shot in years.
  • Dan   Nov 20, 2013 1:35 PM
    I was diagnosed in 1998 at 28. There are Auto-immune diseases throughout my extended and immediate families. I do not get the flu shot for a few reasons. In 1976 or 77 I received the flu shot as a child and shortly thereafter was stricken with Guillen-Barre Syndrome. I was unable to walk, was hospitalized for several weeks until the condition reversed itself. When I was a Law Enforcement officer I received the first version of the Hepatitis B vaccine. The series of three shots, given two weeks or so apart, were supposed to be fairly routine. After two rounds I began to have Neurological issues like confusion, word finding, shakiness and such. I never got the third round. 5 years later I was diagnosed with MS, now in the Secondary Progressive category. Was it the Vaccines, the preservatives in the vaccines or just bad luck? I'll take the flu, which by the way I have never gotten, I just stay healthy. Good luck everyone.
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    cup_o_jo  Nov 22, 2013 11:48 AM
    About every three years I decide to get a flu shot. Those years I am sick sick sick. Last year after I got it. I was sick from October to May and had pneumonia twice. So basically this year I chose not to do it. We do have an auto immune disease. But just like everything else with MS. Everyone is different. If you chose it and it works for you AWESOME. I will have a slight jealous moment. It just makes me sicker. It could be a coincidence but. Considering making tshirts that say- "I have an immune disorder please go sneeze at home."
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    YOGA-BLISS-IN-MS  Nov 26, 2013 3:50 AM
    namaste,just go through this link and if possible please share it on facebook,whattsap. twitter and on your other social network. http://msrelief.com/namaste-yoga-and-multiple-sclerosis-2/
  • Joyce K   Jan 10, 2014 5:15 PM
    I have had RRMS since 1998. My doctor advises me not to get a flu shot.
    He says MS is due to an overly active immune system and that the shot would stimulate an already overlyactive system. Has anyone else ever had a doctor tell them this?
  • capt.melanie   Jan 14, 2014 10:48 PM
    I've been trying to decide what to do???? Take it or not? My doctor said no because people with MS already have an over active immune system and the vaccine would cause it to get even more active!!!! Then my Dr.tried to figure out why or what was bad in it , for people with MS. My Dr. Believes it is the mercury!!!!! I've been calling around this week trying to find someplace that has a vaccine with out the mercury but haven't found one. Does anyone know any place? Or is it safe?I was told the last couple of years it was OK to take it and now they think its not?? I'm confused and worried about getting the flu!
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    new2me  Jan 21, 2014 10:29 AM
    Wow, all the different opinions and options. I'm not sure what to do. I did take the shot last year. Just haven't gotten around to it this year. With the news saying it's worst this year I'm just not sure which way to turn. My Dr. says I can take it, I'll make a decision soon. I did get sick last year with a cold after the shot but other than cold symptoms nothing else happened. And last year I didn't know about my having MS, found that out between Thanksgiving and Christmas 2013. Thanks for all the great advise.
  • karen hutchinson   Nov 3, 2015 2:26 PM
    before i was diagnosed with ms, each year i would get the flu shot and with in a few days have the flu, so i stopped doing that, not more then a year being diagnosed with me me doctor talked me into to it again, i have been down with the flu now for 4 days, my ms is are a bit stronger, how can this be a good thing for me? im new at this any feedback is welcome. thank karen
  • karen hutchinson   Nov 3, 2015 2:31 PM
    hope you all were able to make heads or tails out of my last question, im having some ms symptoms, thank you for your understanding. karen
  • Charles Kazer   Jun 28, 2017 10:52 PM
    19 years ago Got Flu Shot Developed MS Within Months!!! any Connection? I Think So ! Peace&Love Skip
  • Gordon   Aug 28, 2017 7:47 AM
    Thank you for the information. What about the child of someone who has MS receiving the live flue virus vaccine ? is this a possible immune response trigger ? are there any studies or statistics ? I guess the vaccine programme is too new to have that sort of data. My feeling is to not give it.
  • Ken Kole   Feb 11, 2018 4:41 PM
    I have had RRMS for twenty years always did get the flu shot never got the flu. I still get nervous going out in public so I limit myself to doing just things I need to do until the worst is over and hope for the best. Good luck to us all.