Flu Shots

[Hopeful]

Hi,

The AA and MDS International Foundation is mixed on whether immune supressed people should get flu shots. I am pretty scared of the upcoming flu season because H1N1 is already pretty rampant in our area. What are your doctors recommending with regards to getting the flu shot and H1N1 (when it becomes available)? My hemotologist says to get it, but last year was the first time I didn't get a flu shot and also the first year that I didn't get the flu.

Thoughts?

[Neil Cuadra]

The flu shot vaccine is inactive (the virus is dead) so it can't cause the flu, but the nasal-spray flu vaccine contains an active virus so it shouldn't be given to anyone with a compromised immune system. The regular flu vaccine and the H1N1 (swine flu) vaccine will be available in the fall, so patients should consult their doctors about it now.

The Centers for Disease Control recommends that everyone, including the immunocompromised, get both vaccines in shot form. They don't recommend the nasal-spray version for anyone age 50 or older or anyone who is immunocompromised. See the CDC Seasonal Flu Shot and H1N1 question-and-answer pages.

The flu shots given to family members also protect the patient. My wife's doctor told me to make sure that I got the flu shot every year as soon as possible, and that our kids did too.

[Marlene]

This is such a personal decision and we've chosen not to get them. None of John's doc push the flu vaccines for him. Partly because of the nerve issues he has, another reason being that these still contain mercury and since SAA is an "autoimmune" disease, the vaccine can be a trigger for it. Hid doc at Hopkins feels his immune system can fight any cold or flu as well as someone who has not had SAA.

Our strategy over the past years involve lots of hand washing, getting rest, maintaining good eating habit (sugar is no friend to the immune system), lots of vitamin c and this year, we'll make sure that his vitamin D levels are at an optimal level. If we catch a virus, we add in elderberry syrup, which lessens the length and severity of viruses, extra vitamin C and some highly anti-viral essential oils.

John has had the flu twice in 7 years and has done very well in that it never settled in his chest. I think by upping his vitamin D, which we learned he was deficient in the past 7 years, will go a long way to protect him. The odd thing is that when his ANC was at its lowest, he never even caught a cold and he had a very low WBC for the first 3 years after treatment. Go figure.

I know many do well with the shots and get them every year. From everything you hear about the swine flu, it appears to be milder than the regular seasonal flu, especially for those of us over 50.

Marlene

[Neil Cuadra]

Information about the mercury (thimerosal preservative) question is available from the CDC here and from the FDA here.

Based on flu vaccine manufacturer's projections, more than 40% of this year's flu vaccines are expected to be preservative-free. The Fluzone flu vaccine is totally thimerosal-free while Fluvirin and Fluarix have only a trace thimerosal concentration (less than 0.000004). Almost all pediatric flu vaccines are thimerosal-free.

When patients discuss flu shots with their doctor, they can ask if thimerosal-free flu shots are available at their treatment center and whether the issue should be of concern to them.

[Hopeful]

I have a friend who is an ICU nurse, and she said that they have never seen so many people in there 20's, 30's, and 40's coming in so sick with the virus. Apparently their respiratory status deteriorates severely within 24 hours, and they are even having trouble ventilating them on the ventilators! It is being suspected that the virus is not effecting those born before 1957 because there was a flu pandemic then, and this virus may be related to that one.

I am especially nervous because I have a young daughter starting school (a.k.a the petri dish) next week!

I'm worried about getting the normal flu shot now because I suspect that it weakens my immune system and makes me more suspectible to other viruses. I usually get sick within 2 weeks of getting the flu shot. What to do... What to do...

Be careful out there!

[Neil Cuadra]

People sometimes get sick after a flu shot for any of these reasons:

• They may have already been incubating the flu before they got the shot.
• They may catch the flu before the shot takes effect, which takes 2 weeks.
• They may catch a different illness or even another type of flu.
• For people with a weakened immune system, the flu shot is sometimes not fully effective against its targeted strain of flu.

None of these is caused by the flu shot, but they show that a flu shot is not a 100% guarantee against getting sick.

The CDC gives these other tips for avoiding the flu and helping others avoid the flu (especially important for caregivers):

• Avoid close contact with people who are sick.
• If you are sick, stay home and keep your distance from others.
• Cover your mouth and nose with a tissue when you cough or sneeze.
• Wash your hands.
• Avoid touching your eyes, nose or mouth.
• Get plenty of sleep.
• Stay physically active.
• Manage your stress.
• Drink plenty of fluids and eat nutritious food.

Those are handy tips all year!

[Neil Cuadra]

The AA&MDSIF has issued an H1N1 (Swine) Flu Advisory for patients with bone marrow failure diseases. It includes advice about the regular seasonal flu shot as well.

[Jill2008]

My transplant doctor has recommended I receive the flu shot now and the H1N1 vaccine as soon as it becomes available. I haven't had a flu shot in many years and have done fine. The H1N1 virus has been affecting 20-50 year-olds in my hometown though. Also, I plan to travel to see my new granddaughter in November so I think it's best I follow my doctor's recommendations.

[launch]

My husband has MDS and is in Remission, with continued Vidaza treatments. He has already received the Flu shot at his doctors recommendation and will receive the H1N1 vaccine as soon as it becomes available - as recommended by his doctor as well.

[Jill2008]

Does anyone know if there is a themerisol-free version of the H1N1 vaccine? After talking to several nurses, I am not sure if I want to get it now. I'm flying to Colorado in a week to baby sit my 7-week-old granddaughter. Not sure what to do.
Jill

[Neil Cuadra]

I don't know what's available now, as opposed to soon, but there will be some H1N1 vaccines without thimerosal.

Thimerosal will be used in the vaccines that come in multi-dose vials, but some of the vaccine manufacturers are producing the vaccine in single-dose units with no thimerosal. The nasal mist (live vaccine) version will not contain thimerosal either.

[Birgitta-A]

Hi all,
Here is a report about how they protect cancer patients from the flu at Seattle Cancer Care Alliance - an outpatient clinic:
http://checkorphan.getreelhealth.com...h1n1-influenza
Kind regards
Birgitta-A