# CFS and the Flu Vaccine



## M&M (Jan 20, 2002)

Posted to the Co-Cure list:


> quote: Influenza Vaccination: Is it Appropriate in Chronic Fatigue Syndrome? Journal: Am J Respir Med. 2002; 1(1): 3-9. Authors: Sleigh KM, Marra FH, Stiver HG. Affiliation: Division of Infectious Diseases, Department of Medicine, Vancouver, British Columbia, Canada. NLM Citation: PMID: 14720070 Chronic fatigue syndrome (CFS) is a recognized clinical illness of unknown cause and pathophysiologic mechanisms. Immunizing patients against influenza would seem to be a prudent strategy since infection has been associated with symptom exacerbation. However, patients with CFS have demonstrated variable abnormalities in the immune system, the clinical significance of which is unclear. Anecdotal information has suggested that, due to the etiologic uncertainty surrounding CFS, many patients reject immunization, fearful of untoward effects. This article attempts to clarify the situation by reviewing immunologic findings in CFS and influenza vaccines in current use. Results from a recent survey of perceptions of patients with CFS regarding immunization revealed that 31% felt immunization was neither safe nor beneficial. This opinion was universal in those patients who had never received influenza vaccine. Among patients who had received vaccine and experienced an adverse effect, 26% felt the vaccine was safe and 28% felt it was beneficial. Among those who had received vaccine without an adverse effect, 45% believed the vaccine was safe, and 55% felt it was effective. CFS patients as a group expressed concern that influenza vaccine would alter an already dysfunctional immune system, or worsen CFS symptoms. Significantly more patients with CFS who had never received influenza vaccine voiced this opinion than did patients who had received immunization for influenza in the past. Contrary to the opinions expressed by the sample, clinical trials in CFS have yet to find that any type of immunization has produced a deleterious effect on symptoms or functioning. Moreover, patients with CFS in a randomized, placebo-controlled, double-blind trial of influenza immunization produced an antibody titer in the protective range to inactivated trivalent influenza vaccine, although the geometric mean titer was slightly blunted compared with healthy vaccinees. Although patients with CFS in placebo and active groups reported four times the number of post-injection adverse effects of healthy vaccinees, data re-analysis revealed that this finding was related to the overlap of common, post-influenza immunization symptoms and CFS constitutional symptoms. CFS is a poorly understood illness and some patients may believe in causal theories that lead to the rejection of disease prevention strategies such as immunization. However, influenza immunization appears to provide protective antibody levels without worsening CFS symptoms or causing excessive adverse effects. Efforts to motivate patients with CFS to obtain annual influenza immunization should take into account illness perceptions and concentrate on education based on placebo-controlled trials.


----------



## moldie (Sep 25, 1999)

Hi MrsM,I'm not sure exactly what this means:"Moreover, patients with CFS in a randomized, placebo-controlled, double-blind trial of influenza immunization produced an antibody titer in the protective range to inactivated trivalent influenza vaccine, although the geometric mean titer was slightly blunted compared with healthy vaccinees."My allergist gave me a subcutaneous version of the flu vaccine rather than the intramuscular version to see if I would get a reaction. I think that translated in me getting a milder dose of the vaccine, which he said should be good enough to protect me. I did not seem to react to it at all, nor get the flu that year compared to the time which I got the "aches and pains flu" five times within the year I had taken one of the (if not my first) flu vaccines. I had experienced fatigue years before getting this particular vaccine without a diagnosis, but this seemed to be the beginning year of my fibromyalgia muscular aching symptoms. That experience has caused me to avoid the flu vaccine ever since.If I could convince my local care-givers to give me the kind my allergist had given me, I certainly would get the flu vaccine. I may just have to talk more with my allergist and local doctors to find out if this would be possible. The studies seems inconclusive to me at this point.


----------



## M&M (Jan 20, 2002)

Well, lol I didn't understand the piece either. But, I thought I would share it, just in case someone could understand it better than I, and perhaps benefit from it. Oh well! LOL


----------



## Susan Purry (Nov 6, 2001)

> quote:I'm not sure exactly what this means:"Moreover, patients with CFS in a randomized, placebo-controlled, double-blind trial of influenza immunization produced an antibody titer in the protective range to inactivated trivalent influenza vaccine, although the geometric mean titer was slightly blunted compared with healthy vaccinees."


I think it means that the vaccine had the desired effect (produced some immunity to influenza), but not as much of an effect as in people without CFS or any other medical conditions. N.B that's my lay understanding; I have no medical training.


----------



## Clair (Sep 16, 2000)

Hmmm - this is an interesting article. I recently had this issue of whether to go for the flu vaccine as it was considered compulsory in my line of work (I work in a hospital and they dont like staff passing about bugs i guess







).I had read several articles about the vaccine and M.E. / CFS suggesting it was not wise to do so because it may trigger a worsening of your symptoms...but then having a bout of flu could do same thing - so I felt in a catch 22 situation.Rather confused I went and spoke to both my doctor and my specialist - and both said as soon as I mentioned the flu vaccine that it was a big risk to take - and considering my symptoms have been stable for a year a risk not worth taking for the sake of a small chance of getting a bout of the flu.So the problem is this - is it just anecdotal evidence from CFS/ME sufferers or are medical specialists advocating the flu vaccine as a risk - because in my case that is what happened. I guess the problem that comes is who do you believe? and how do you come to a decision about that risk?I think that if I had not made so much progress in the last year albeit very slow and alot of hard work then I probably wouldn't think twice about getting the flu shot...but I'm loathed to risk the small gains I have made for the sake of an injection. its a sad state of affairs for sure when something as seemingly innocent as protection against a common virus leaves you dithering and worrying endlessly about what decision to make


----------



## TaniaF (Jan 23, 2001)

Sorry, I'm quite late reading this. In my experience, I had not had the flu vaccine for many years until in 2001 I got a bout of walking pneumonia from a mild flu. So, I started taking the vaccine, but only HALF dose. Each year, I only take this small ammount and it has offered protection without side effects. Question: Do any of you have lowered IgG, IgM and IgA on immunity type testing? I also have chronic EBV and the doctors say there is no cure or meds for this?


----------

