# More info: Flu Shot Pros and Cons



## M&M (Jan 20, 2002)

This was posted to the Co-Cure mailing list today:


> quote:A 5 yr old article, but full of practical advise and still relevant. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~Flu Shot Pros & ConsDateline: It's that time of year again. As the leaves begin to change colorand temperatures start to dip, there is another aspect of the autumn seasonthat is on many people's minds-the flu. For those of us with Chronic FatigueSyndrome, flu symptoms may be all too familiar and are often a part of oureveryday lives. But an acute bout of Influenza can easily leave a CFSsufferer totally debilitated for weeks or months. So what can we do? Is aflu vaccination a good idea, or does it put CFS patients even more at riskfor a relapse? Opinions vary widely among both doctors and patients; inorder to make the best decision for yourself, it's important to evaluate theavailable information and discuss it with your own treatment provider.Following are some things for you to consider.What is Influenza?Influenza, commonly known as "the flu," is a virus that is highlycontagious. The onset of symptoms is usually sudden and can include a feverof 100-104 degrees Fahrenheit, muscle aches, sore throat, a dry cough,headache, and extreme fatigue. Healthy people tend to recover within about3-7 days, but for those with compromised health the effects can last muchlonger. The flu is the 5th leading cause of death among the elderly in theU.S., taking as many as 70,000 lives each year.What is the Flu Vaccine?Each year's flu vaccine contains three strains selected by the U.S. PublicHealth Service which are believed to be most likely to spread in theupcoming flu season. The vaccine is made up of purified viruses grown in eggcultures which have been made inactive and noninfectious. Injection of thevaccine, usually in the upper-arm, stimulates an immune reaction.Although flu season typically runs from November through April, flu shotsare ideally given between late September and mid-November. It takes abouttwo weeks after receiving the shot for the vaccine to become effective. Tobe protected, you must be immunized every year.According to the CDC, there are very few side effects of vaccination. Mostcommon is soreness in the arm around the injection site; a few people reportother mild side effects, such as low-grade fever or body aches, for a day ortwo following vaccination.It is estimated that flu shots are about 70% effective in preventing theflu. Even for those who are vaccinated and do get the flu, the vaccine issaid to reduce the severity of the infection.Who Needs a Flu Shot?Each year the U.S. Centers for Disease Control and Prevention (CDC)recommends the influenza vaccine for people who are at high risk ofdeveloping serious complications as a result of an influenza infection.These high-risk groups includeeople aged 65 years and older People with diabetes People with otherunderlying chronic conditions (i.e., renal dysfunction, pulmonary, orcardiovascular disorders) Women who will be in the second or third trimesterof pregnancy during the flu season Residents of nursing homes and otherchronic-care facilities. Flu shots are also recommended for students livingin dorms or other close quarters, international travelers visiting thetropics, those in daily contact with children such as teachers and day-careproviders, and those with suppressed immune systems. Since eggs are used inthe production of the vaccine, the flu shot should not be taken by anyonewith severe egg allergies.Should People with CFS Get Flu Shots?There is no conclusive evidence about the effect of the flu vaccine onpeople with CFS (PWCs). Many CFIDS specialists remain unsure about how toadvise their patients. There are a number of issues involved which arelikely to vary greatly among individuals. While the flu can be particularlydebilitating for someone who is already severely depleted by chronicillness, many PWCs maintain that they have experienced relapses and symptomflares following a flu shot. As a result, many doctors are wary aboutrecommending flu shots to certain patients, if the risks seem to outweighthe benefits.Dr. Charles Lapp, a well-known CFIDS clinician and researcher, says that inmost patients with CFS, "their immune systems are so up-regulated, they areso turned on, that any virus that gets in the system usually gets gobbled upanyway." In addition, Dr. Lapp cited studies done at Duke University inwhich CFS patients didn't "convert" the vaccine; in other words, the immunesystem didn't respond to the shot and, therefore, the shot has no benefit.Dr. Paul Cheney, another CFIDS specialist in North Carolina, agrees that forPWCs with up-regulated immune systems, the immunization may not benecessary. More importantly, he expresses concern about the effect ofinjecting an antigen into a "fired-up" immune system. Both Lapp and Cheneycite patients who seem to have relapsed as a result of a flu shot.But Dr. Stanley Schwartz, an infectious disease specialist in Tulsa, pointsout that while there is a great deal of accumulated scientific medicalknowledge about the potential complications of influenza, there has been noscientific study of the effects of influenza vaccine in patients with CFS.He has rarely seen post-vaccination flare-ups with CFS patients in hispractice. He states, "In medicine, it's always better to base decisions onwhat is known rather than what is not known." His rule of thumb is torecommend that people with CFS get vaccinated if they fall into any of thegroups at increased risk for complications of influenza, as specified by theCDC. For example, CFS patients who are over age 65 or who have diabetesshould receive the vaccine.Dr. Cheney also emphasizes the importance of weighing the risks and benefitsof a flu shot on a case-by-case basis. He says, "There is no way togeneralize across the entire range. If these patients are working ormarginally sick, exposed to the general population, I tend to immunize...Ifthey are extremely sick, [with] very active immune systems [and] are notgoing into the public arena much, I think I tend to not immunize because ofthe fear I'm just going to make them worse."In deciding whether or not to get a flu shot this year, be sure to discussthis with your doctor. By considering your health history along with yourown personal profile of risks and benefits, you are more likely to make thedecision that's right for you.Lisa LordenImmuneSupport.com10-13-1999


----------

