Should People with Autoimmune Diseases get the Flu Shot?
I get asked this question A LOT. But before I go on to tell you my thoughts about the flu shot, I want to be clear that I am NOT against vaccinations. I support vaccinations when they are necessary, especially when they provide herd immunity that can eradicate or greatly reduce the chances of people getting a deadly virus (such as polio, MMR, hepatitis…etc). But I also support people being educated around what they are putting in their body, and how that can affect them, as well as the community around them.
But before we get into it, let’s learn a little bit about the flu shot, or more specifically, why vaccines help prevent infection.
How Vaccines Work
Vaccines were designed to help our immune system be able to recognize bugs faster. When our bodies are exposed to foreign bugs, it is the responsibility of our immune system to 1) recognize that the bug is bad and needs to be dealt with and 2) deal with it. When the immune system initially recognizes something that is bad it’s slow to respond. But the more times that the immune system responds to a bug, the faster it gets because it remembers it. Vaccinations work by helping the immune system create memory to different bugs. It does this by showing the immune system pieces of the bug, so the immune system can remember it later. The next time the immune system comes into contact with that bug in the wild, it will respond in a rate fast enough to kill it before it causes problems in the body and spread.
Over time, if not exposed to the bug, our immune system may “forget” what it looks like and lose response time. This is why we sometimes need booster shots – to help boost our immune system’s response to the bug. If a bug can’t use a body to reproduce because the immune system has killed it first, then it greatly reduces the likelihood of that bug being able to survive.
How the Flu Virus Works
In order for vaccines to be effective, they need to be able to train the immune system to react to a SINGLE virus. But the flu virus is tricky. Every year, the type of flu virus that causes people to have the flu changes, so it isn’t the same every year. Every year, researchers have to study what type of virus was big last year, and try to make an educated guess on what virus might be more common THIS year. We don’t actually know how effective a flu vaccine is until AFTER the flu season is over and we can look back and see how many people were able to prevent the flu by getting the shot. And then the next year, we do it all over again. The flu vaccine does NOT provide herd immunity – meaning that it does not help to eradicate the virus completely.
How Effective is the Flu Shot?
Every year, the CDC puts out a statement of how effective the flu vaccine was for the previous year. While I hear a lot of people talk about the importance of the flu vaccine, I rarely ever hear people talking about how effective it is. For example, for last year’s 2018-2019 flu season, the overall efficacy for people of all ages was 29%, meaning that the flu shot only prevented the flu in 29% of those that got the flu shot (that’s less than 1/3). If you break it down by age, children ages 6mo to 8 years were the most benefited (49% effective), while young adults 9 – 17 were least benefited (6% effective). The flu vaccine was only effective in 12% of those older than 65.
Efficacy rates for other years are similar, but they can go up and down yearly. If you compare this to other vaccines, say the vaccine against measles (MMR), this vaccine is estimated to be 97% effective if both vaccines are administered. So you only need 2 vaccines in your LIFETIME to prevent measles 97% of the time. In comparison, you have to get the flu vaccine EVERY YEAR and there is still a 70% chance you will get sick with the flu.
So Should People With Autoimmune Diseases get the Flu Shot?
So back to the original question – should people with autoimmune diseases get the flu shot? Well the answer (that no one really wants to hear) is, it depends. Flu shots have been known to aggravate autoimmune diseases. I mean, you are in fact giving your immune system something to react to when you get a flu shot. But on the other hand, viruses can also cause autoimmune flares, so you want to prevent that also.
Essentially what I tell people is this: Getting the flu shot will only slightly reduce your risk of getting the flu. Small children, those who have weak immune systems, pregnant women and older populations are more likely to have complications from the flu. Even that small amount of prevention can mean a lot in trying to avoid flu related death. But for those that are relatively healthy and have autoimmune diseases, then you may want to think hard about whether the flu shot is right for you. I definitely do not recommend that those with autoimmune diseases in an active flare get a flu shot. But waiting until the flare is over may be a good option. Sometimes the best options is getting your body healthy enough to help fight the flu when it comes around.
It’s all about weighing out the risks vs benefits
And ideally, this is a conversation you should be having with your doctor who is familiar with your health and personal history. Naturopathic doctors are great advocates for patient choice when it comes to the flu vaccine. So if you are looking for a doctor that can help you look at all aspects of your health, they would be the best option. If you have specific questions about how this flu system would affect your autoimmune disease, you can call our office and schedule a free consult with one of our knowledgeable physicians.
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