To Flu or Not To Flu

If you're a brave little sjoggie, you MIGHT get a nifty sticker like this one found here. 

Dang. It's flu season again.

The Sjogren's Syndrome Foundation Facebook page posted a link recently which may answer your questions regarding the appropriate use of the seasonal flu vaccine for sjoggies.  This article  from last year's Moisture Seekers newsletter was written by Dr. Dan Small MD:

Q:  I understand there’s a new flu vaccine for the 2010-11 flu season. Do you recommend it for Sjögren's patients?

A. As a person with Sjögren's Syndrome you are wondering about whether or not you should have a flu shot this year.

First it’s good to have some information about the flu vaccine itself. The seasonal flu vaccine protects against three influenza viruses that research indicates will likely be most common during the upcoming flu season. The 2010-2011 flu vaccine will protect against 2009 H1N1, and two other influenza viruses (an H3N2 virus and an influenza B virus). Each influenza virus has a H and a N determinant which are variable. The viruses in the vaccine change each year based on international surveillance and infectious disease experts estimations about which types and strains of viruses will circulate in the next year. Due to the high mutation rate of the flu virus a particular vaccine formulation is effective for at most about a year. About two weeks after getting the flu vaccine, a person’s body will build up antibodies against the flu virus strains that are in the vaccine.

There are two main vaccines.

The "flu shot" — an inactivated vaccine (containing killed virus) that is given with a needle. The flu shot is approved for use in people older than 6 months, including healthy people and people with chronic medical conditions.

The nasal-spray flu vaccine —a vaccine made with live, weakened flu viruses that do not cause the flu (sometimes called LAIV for "live attenuated influenza vaccine" or FluMist®). LAIV (FluMist®) is approved for use in healthy people 2-49 years of age who are not pregnant. It is not recommended for people with compromised immune systems.

So what if you don’t get the flu shot? Worldwide, seasonal influenza kills an estimated 250,000 to 500,000 people each year. The majority of deaths in the United States occur in adults age of 65 and over, however, people with chronic disease can be at more risk of complications of the flu. Even if you are not at higher risk of complications, you may live with someone who is, and you could expose that person to the flu if you contract it.

What symptoms do you get with the flu? You may experience high fever, sore throat, generalized body aching, headache, and cough. I contracted the flu in 1975 when I was an Intern, and felt so bad that if I had died then I wouldn’t have minded it. I have gotten the flu shot every year since.

What complications could occur from the flu shot? Soreness at the site of injection is probably the most common adverse event. Occasionally, a systemic effect such as low grade fever, runny nose, or cough may occur. A very very rare neurological complication called Guillan-Barre syndrome has been linked to the flu shot. In this condition, the body’s immune system attacks the nerves. Fortunately most people recover, but it can be quite debilitating during the course of the illness.

Who shouldn’t get the flu vaccine? People who have had an allergic reaction to a flu shot in the past, people with an allergy to eggs, or a person who previously developed Guillain-Barre syndrome within 6 weeks of getting a flu shot.

I recommend that all my patients with Sjögren's get the flu shot each year. Save yourself the misery, the inconvenience, the risk of infecting a love one, and the chance of dying this coming flu season: get the flu shot.
~ Dan Small, M.D.