Flu Vaccinations

[RichardE]

Hi folks,

We've seen a few posts recently about the annual flu jabs and given that some GPs seem to give out very limited information or confusing messages here is our take on the 2012-13 vaccination programme.

This year there are three vaccines that may be given to protect against flu.

Two are inactivated vaccines for injection and one is a nasal, live attenuated vaccine (sprayed into the nose).

The two inactivated vaccines that are injected are fine for immunocompromised patients such as us and indeed highly recommended. The mortality rates are higher for us than any other "at risk" group. Indeed if you also have diabetes, heart disease, kidney disease or lung problems then you are even more at risk.

The nasal (Fluenz) vaccine is being recommended for children from 2 to 17 years old. However it should not be given to immunocompromised children. Nor should it be given to children who are in contact with immunocompromised adults since as it's live it may be transferred. Children can be given an injection of the inactivated vaccine as an alternative but it is known to be less effective for young people.

Carers and others that live with immunocompromised patients are advised to be vaccinated too. However it appears to be up to the local GPs as to whether this will be a free vaccination or not.

Finally, if you are currently unwell or flaring then you should first check with your GP and/or consultant as to whether it is advisable to have the vaccine.

Regards,

Richard.

[RichardE Volunteer]

For those who want the detail, the following links have it in spades

patient.co.uk/doctor/influe...

This refers to the three types of flu vaccine :

•'Split virion, inactivated' or 'disrupted virus' vaccines - the whole virus is inactivated by exposing to organic solvents or detergents.

•'Surface antigen, inactivated' vaccines - these contain haemagglutinin and neuraminidase antigens prepared from disrupted viruses.

•A live, attenuated vaccine - Fluenz®.

The first two being OK the latter live one not.

The key point in the text is here :

"In addition, Fluenz® (live, attenuated vaccine) is contra-indicated for those who are clinically severely immunodeficient secondary to a condition or immunosuppressive therapy - eg, leukaemias, HIV (not on highly active antiretroviral therapy - HAART) and high-dose corticosteroids."

Here is the governments take on the flu vaccine

gov.uk/government/uploads/s...

Key point here is :

"The live attenuated influenza vaccine Fluenz® is the vaccine of choice for children in clinical risk groups aged 2-17 years as it has been shown to provide a higher level of protection for children than inactivated influenza vaccine. It is recommended that GP practices order this vaccine for children in clinical at-risk groups; however it is unsuitable for children under the age of 2 years and for those over the age of 2 years with contraindications such as severe immunodeficiency or egg allergy. GPs should ensure they have ordered sufficient supplies of suitable alternative vaccines for children who should not be given Fluenz®."

Further detailed information can be found in these two links :

gov.uk/government/uploads/s...

gov.uk/government/uploads/s...

[HiveMind]

Hi Richard,

With regard to your point about the Fluenz being live and we (Vasculitis patients) should not be in contact with children who have had it. I'm guessing we should avoid those children when they have immediately had the vaccine only? Or is the vaccine active for a longer period and therefore we're at risk for a longer period?

Would just like clarification please.

[RichardE Volunteer in reply to HiveMind]

A good question. I suspect there'll be period of at least a few days where they will be potentially infective but I don't know exactly how long for. I'll try to find out.

[vivdunstan Volunteer in reply to RichardE]

I posted links on the Vasculitis UK Facebook page to 2 websites giving guidance on exactly this. Patient UK say stay away for 14 days after the other person has had a nasal flu spray. The American CDC (center for disease control) say 7 days.

[HiveMind in reply to vivdunstan]

Thanks Viv.

[Hidden in reply to vivdunstan]

If I just have had my flu vaccine, does that leave me protected if I come into contact with a child who recently had the nasal flu vaccine?

[vivdunstan Volunteer in reply to Hidden]

No, you are still at risk of catching the flu. So you should still avoid anyone who's had the nasal spray for quite some time.

[Hidden in reply to vivdunstan]

Thanks, i didnt realise we should be careful about the live flu vaccine, my nephew will be getting the nasal spray and i assume many more children whom we will come into close contact with and not be aware of.

[vivdunstan Volunteer in reply to Hidden]

Yes I think the wider health implications of it haven't been thought through at all. I know for example that some children in the USA are getting flu nasal sprays in supermarkets, which then potentially puts anyone else immunosuppressed coming into the supermarket then at risk. Not great.

[vivdunstan Volunteer in reply to RichardE]

See patient.co.uk/doctor/influe... and cdc.gov/h1n1flu/vaccination...

[RichardE Volunteer in reply to vivdunstan]

Thanks Viv.

Just to add, we at VUK will try to get this sort of information out a bit earlier for next year's flu vaccinations to avoid any confusion.

[cazy-g]

Would like to thank you for this information . I don't post often but do keep myself informed by logging in and reading updates, it is all very informative and assists greatly with managing my W.G. Once again thanks to all for your efforts on researching relevant info .Kind regards

[RichardE Volunteer in reply to cazy-g]

You're very welcome. I like to think that sharing and contributing to this sort of information is what makes our HealthUnlocked and Facebook sites so useful.

[Skipper]

I understand some surgeries are offering a one off shingles injection with the flue jab. Should WG patients take up this offer? Any feedback would be appreciated. Thank you.

[vivdunstan Volunteer in reply to Skipper]

As far as I know no, because it is a live vaccine. So if you are immunosuppressed it is counter indicated because it could give you shingles. Though some recent research has shown it may be useful for people who are only very slightly immunosuppressed. I had chickenpox (first time) aged 24 and shingles aged 37. I would do anything sensible to avoid getting shingles again. It was horrible. But I don't think I can get this vaccine.

[Skipper]

Thanks Viv. Apparently you have to be over 70 to have the shingles injection but I shall be speaking to my Consultant in the next couple of weeks and will take on board her views. I had chickenpox when I was about 10 but have never had shingles, thank goodness! Think I will just have the flu jab for now. I am on 100mg azathioprine so am quite well immunosuppressed.

[RichardE Volunteer in reply to Skipper]

I agree with Viv's comments. Check with your consultant if you're seeing her shortly. We have a note on our website specifically about the shingles vaccine if you want more info :

vasculitis.org.uk/living-wi...

[Skipper]

Thanks Richard. Interesting reading - I will take a print out to my consultant, but at the moment feel I will not have it whatever she says!!!

[PaulBingham]

Moving from FLU vaccine to SHINGLES which is a vaccine that the NHS is about to launch for selected people over 70 years, has anyone had it yey or been refused it.

Getting Shingles when you are older can be pretty nasty and even fatal. However, it is potentially much worse for Vasculitis patients because their immune system is compromised which may prevent them from successfully fighting off the shingles .#

Any comments would be welcome as I have had two friends recently with Shingles.

[vivdunstan Volunteer in reply to PaulBingham]

I commented on the shingles vaccine in this thread 5 days ago. Look for my post earlier on this page, in response to skipper's question.

[vivdunstan Volunteer in reply to PaulBingham]

Also the shingles vaccine is only being offered to people in very specific age ranges, who are 70 or 79 at the right time. So, for example, my Dad who is just under 79 can't get it until next year. See nhs.uk/Conditions/vaccinati...

And it is noted as not suitable for people who are immunosuppressed. See nhs.uk/Conditions/vaccinati...

[AndrewT]

Dear all,

I know that the above can be a bit confusing to some, myself included!; basically the 'standard' flu jab is fine, so go and have one, if you haven't already done so.

I'm sure most GP's, who have any experience of immunosuppression- and even some who haven't-, will gladly advise anyone who is not sure. I have had the 'jab' for years and certainly never had any bad reactions- I haven't had the flu either, by the way! Incidentally if your GP says you are too old, or indeed, any other excuse- 'jump up and down' a lot and make a bl--dy nuisance of yourself and good luck!

AndrewT

[Myrear]

It states on the leaflet or handoutthstvit can cause vasculitis

[RichardE Volunteer in reply to Myrear]

Unfortunately a number of drugs can very rarely be a trigger for vasculitis. It can even be listed as a possible side effect for some quite common drugs such as ibruprofen. The thing to remember is that drug companies have to list *any* reported side effects on the leaflets even if they are very, very rare.

The general advice still stands that anyone who is immunosuppressed should consider having the flu vaccine to help protect themselves. But as always, if you're at all worried about it, do have a chat to your GP or vasculitis consultant.