Hi all
Can anyone offer advice on whether it is worth having the flu jab (and/or the pneumonia jab) when you are suffering from PMR and taking steroids. As PMR affects part of the immune system logically this could effect your immunity to fight the flu from within. I have been offered both jabs by my G.P and having never had either of them before I thought it wise to ask first. Hope someone can assist. Dave
This question comes up every year at this time! It really is a good idea to have the jabs. I know there are some people who claim their PMR started because of the jab but that is onviously not the case is it! For the vast majority there are no problems, you may feel a bit of a reaction, there are always some who do. I wasn't considered at risk in the UK but I've had the jab the last 2 years here in Italy. My husband didn't get his done last year - he had bronchitis at the time - and forgot to go back. He got flu, was in bed for a week (so he must have been bad!) and then developed pneumonia. I didn't even get a sniffle despite being in close proximity!
The problem with your immune system isn't quite as simple as that - autoimmune illnesses are actually the immune system failing to recognise you as being you so certain cells attack bits of your body. It isn't always the same cells and bits but your immune system still works to produce immunity although in some people it may be a bit weaker. The point of the flu jab is that it prepares the body by getting it to have some immunity after being exposed to non-dangerous flu bugs (they are dead but the outside of the cells is what triggers the formation of antibodies). Even if it is partial immunity it means you will develop a milder infection. There is always the risk there will be a new unexpected bug appear - but the majority are covered.
Here the pneumonia jab is now a lifetime one - check which you are getting. The old one had to be renewed every few years. OH got his AFTER his attack of pneumonia!
Just been told by my Diabetic Nurse this morning, that as I am on a high dose (60mg) It's best to leave the Flu Jab for the time being & reconsider if they get the dose lowered but even 40mgs is still high :-/
I suspect your nurse may well be wrong. She is probably thinking of the fact that we are supposed to be immunocompromised when on steroids, particularly high doses. But she has it the wrong way round - you are MORE in need of the flu vaccine because you will have more difficulty in fighting the flu if you get it. It is a common mistake.
Being on pred does mean that you may not develop an immune response as efficiently - but since the flu vaccine is a dead vaccine there is no risk if you are given it of developing real flu. The vaccine trains your immune system to recognise the bugs in advance - so it knows what it is looking for in the real situation - like training teaches medics to recognise diseases.
A study was done in children with asthma on high dose pred and the conclusion was this:
"The authors conclude that high-dose prednisone therapy does not diminish the effectiveness of the influenza vaccine in children with asthma. Because the vaccine does not exacerbate asthma symptoms and, in fact, provides a protective immunologic response, physicians should administer the vaccine concurrently, when indicated, to children who are undergoing treatment of acute asthma."
As I explained to tavidu, the flu jab prepares you for a possible infection in a safe way. Being on pred does mean you may struggle a bit to develop your own immunity once you meet the flu for real - because it isn't a "dead" form. You MUST NOT HAVE THE LIVE FORM - this is now available as a nose-spray for children - but the jab is no problem.
The Joint Committee on Vaccination recommends vaccination for patients in various groups and we come under this one:
"Immunosuppression
Immunosupression due to disease or treatment.
- Patients undergoing chemotherapy leading to immunosuppression.
- Asplenia or splenic dysfunction.
- HIV infection.
- Individuals treated with, or likely to be treated with, systemic steroids for more than a month at a dose equivalent to prednisolone at 20 mg or more per day (any age) or, for children under 20 kg, a dose of 1 mg or more per kg per day.
Some immunocompromised patients may have a suboptimal immunological response to the vaccine."
I think you should speak to your doctor and possibly the nurse should be told not to give out incorrect information - it could be putting people at risk.
Hi,Having had flu once or twice every year for most of my life there's no way I would miss my flu jab having been free from this dreadful illness since reaching the age of 65 and having yearly flu jabs.I've already booked mine.
The pneumonia jab is only given once (Don't forget that getting pneumonia when you're elderly can kill you)
Many thanks to all that have offered advice, i will go ahead and book my jabs today.
My rheumy told me to have a flu shot. I think we are more at risk for flu as we are on Prednisone.
I had my flu shot 2 weeks ago. It was the one with 3 antibodies that they were offering at work (international organization, where many travel to far flung areas (not me, sigh!) to 1500 employees. Not experiencing any problems with it. Am on 9 mg of Prednisone.
The flu spray has live antibodies and not recommended for us on Prednisone.
Hi Dave,
I was surprised that my RA doctor asked me if I would want a flu shot, and I said NO! I don't think it is a good idea. Several years ago I have had flu shots in the past which made me sick soon after. Ever since my RA problem and now having PMR with higher prednisone dosage I would think that it would compromise my immune system.
Erika
Hi ericka
Many thanks for your imput. As with many of these discussions on the forum you get contradictory advice. I have been pre-warned by a friend that they did not think flu jabs were a good idea when on preds yet a majority on the forum recommend having them. Will have a good chat with my doctor before I decide what to do. Dave
Hi ericka
Many thanks for your imput. As with many of these discussions on the forum you get contradictory advice. I have been pre-warned by a friend that they did not think flu jabs were a good idea when on preds yet a majority on the forum recommend having them. Will have a good chat with my doctor before I decide what to do. Dave
Hi Dave,
I agree, I will do the same!
Erika
Hi Erika,
I think the decision whether or not to have a flu jab may depend on your previous experience, age etc.
As for me, at the age of 70 I can't allow myself, as I get older to be as ill as I was the last time I had flu.I've had a lifetime of chest infections so my decision is based on that.As for pneumonia,I've also had that and was left with a terrible chest infection for weeks after.I've also known people over the age of 70 who have died from pneumonia.
Some people have never had flu or had a very mild dose of it so their opinion may be different.
Speak to your doctor to address your concerns before making your OWN DECISION.
Honestly Erika, when people are ill soon after a flu shot it is usually because they were hatching something already - it is that time of year after all! Either that or you may be allergic to something in the shot.
But anyone who has had proper flu will tell you it is something you don't want when young and healthy - by real flu I mean the sort that you go from fine to unable to get from bed to toilet in the en-suite in half an hour! I have had that once - it was worse than PMR! I didn't get downstairs for a week and my husband was like that with his flu last year.
The flu shot won't compromise your immune system anything like as much as real flu - and in the case of flu, prevention is far better than cure. There was a lot of hysteria about the swine flu - but if people with weakened immune systems develop a viral infection it can be very serious as the options for treating it are very very limited. Having the flu shot not only protects you but also other people who may be even less able to fight off the flu.
Eileen, thank you for your opinion. I will discuss it with my GP who I trust and have known for almost 10 years.
Erika
Hi there. I have had PMR for three years now and taking 13 mg of pred a day. I am also diabetic. My diabetic nurse advised me to have the flu jab last year as well as the pneumonia jab, never had any side affects, all was good.
good luck
Sue
Many thanks Sue, as I am only on 22.5mg of pred (reduced today for the first time, down from 25mg) I think I will have both jabs and hope that I have no side effects as well. Good luck to you with your fight against PMR. Dave