Lupus and the Flu

Flu season is a given every year. The question is whether to get a vaccination. Lupus specialists we consult with say yes for people with lupus and other inflammatory illnesses or who take medicines that lower the ability of the immune system to fight off infection. As of 2014, there are two options that are not made with chicken eggs, a plus for anyone who may be allergic. Also, one of these vaccines does not contain latex, another potential allergen.

Ask Your Doctor About Getting the Seasonal Flu Vaccine!

The U.S. Centers for Disease Control and Prevention recommendations for preventing the flu include everyday actions like washing your hands frequently and avoiding contact with those who have been infected. But vaccination is advised when approved by your doctor as the best protection against getting the flu. To find out where the vaccine is offered in your area, visit nyc.gov for locations in New York or flu.gov for locations throughout the country.

Flu vaccines cause antibodies to develop in the body to protect against infection with the viruses that are in the vaccine. Antibodies develop in the body about two weeks after vaccination.

The seasonal flu vaccine protects against three influenza viruses expected to be most common during the upcoming season. Three kinds of influenza viruses commonly circulate among people today: influenza B viruses, influenza A (H1N1) viruses, and influenza A (H3N2) viruses. Each year, one flu virus of each kind is used to produce seasonal influenza vaccine.

The three types of flu vaccines are:

  • The traditional “flu shot” is a vaccine made with killed virus, called an inactivated vaccine given with a needle, usually in the arm.
  • The nasal-spray flu vaccine is made with live, weakened flu viruses given as a nasal spray. It is referred to as the Live Attenuated Influenza Vaccine. The viruses in the nasal spray vaccine do not cause the flu. This type of vaccine is NOT recommended for people with lupus.
  • A relatively new type of “flu shot” is a vaccine that does not contain any influenza virus.

Common Questions About the Flu

Q. I have lupus. Should I get the seasonal flu shot?

A. If you have lupus, ask your healthcare provider about getting the seasonal flu vaccination. The flu shot is administered by a relatively painless injection into the arm muscle. (Note that most flu vaccines are made in chicken eggs; it is very important to ask your physician about alternatives if you are allergic to eggs.) In rare cases, a person develops a localized injection site reaction (redness, pain, and/or swelling) as well as fever or muscle aches for a day or two. These types of reactions are not the result of contracting the flu; it is biologically impossible to develop the flu from the injected vaccine.

Q. What if I’m allergic to chickens or eggs?

Traditionally, the flu vaccine is produced using chicken eggs, presenting a potential concern for people allergic to eggs. If you are allergic to eggs ask your physician about two flu vaccines that do not use chicken eggs in production. 

Q. What are the two flu vaccines that do not use chicken eggs in production?

A. Two newer flu vaccines available since 2014, Flucelvax® and Flublok®, are produced differently than traditional flu vaccines. According to the U.S. Centers for Disease Control (CDC),  “Flucelvax is the first seasonal influenza vaccine licensed in the U.S. that is produced using cultured animal cells instead of fertilized chicken eggs, while Flublok is the first seasonal influenza vaccine made using recombinant techniques and does not use eggs at all in its production.”

The CDC also notes that Flublok does not use the influenza virus in its production. The stoppers used for the single dose vials are not made with natural rubber latex.

Similar to other flu vaccines, common reactions with Flucelvax and Flublok included pain and redness at the injection site, headache, fatigue, muscle aches and malaise.

Q. What if I am allergic to latex?

A. Most vaccines contain latex in the syringe cap or vial stopper. Flublok does not contain natural rubber latex.

Q. What else should I do if I have lupus to protect myself from getting the flu?

A. Most experts believe that flu viruses are spread primarily from person to person through coughing and sneezing. Sometimes a person can get infected by touching a surface or object that has the droplets of the virus on it, and then touching their nose or mouth. The CDC recommend following the basics of prevention—wash your hands thoroughly with soap and water (or an alcohol-based hand rub) before touching these areas of your body (or eating), and keep your distance from people who may be infected! In addition, linens, eating utensils, and dishes belonging to those who are sick should not be shared and should be washed thoroughly with soap and water.

Q. What should I do if I think I have the flu?

A. Since antiviral medicines should be taken within 48 hours in people who are at high risk for complications—which includes people with lupus, or who are taking medicines that suppress the immune system—call your doctor right away if you start to feel sick with some or all of the following flu symptoms: fever, cough, sore throat, runny or stuffy nose, body aches, headache, fatigue, chills, diarrhea and vomiting. Then wait for 24 hours to pass after your fever has stopped (on its own, without medicines) before going to work or school, or traveling.

Visit the CDC website for more information on preventing and managing the flu.