Flu shot

[Luciejc]

I was advised by my rheumatologist to get the regular dose not the senior dose even though I am 75 yrs old. Just thought I'd share this.

[DorsetLady PMRGCAuk volunteer]

Did he explain his reasoning?

[PMRpro Ambassador]

Did he say why?

[Luciejc in reply to PMRpro]

My GCA was triggered by a Shingles vaccination so I think my doctor rather have me not take the adjuvanted dose which is recommended for seniors.

[Smokygirl in reply to Luciejc]

So was mine!

[HeronNS]

Is the "senior's" dose adjuvanted?

[Luciejc in reply to HeronNS]

I think so. My GCA was triggered by a Shingles vaccination so I think my doctor rather have me not take the adjuvanted dose.

[HeronNS in reply to Luciejc]

Seems a wise decision.

[Hidden in reply to Luciejc]

How long after your jab did you get GCA Luciejc ?? I had that thought too after having mine. However, my PMR/GCA came on a year later....I guess the vaccine could have been circling in my body...who knows !! I think stress pay a very important part of getting any auto immune disease.

[Luciejc in reply to Hidden]

The night I took my second my shot, I felt body aches, had a fever and couldn't get out of bed the next morning....downhill until GCA symptoms progressed, biopsy confirmed. Vaccine July 1, 2019, diagnosis, Aug. 30th.

[Hidden in reply to Luciejc]

Wow, this is bad. We should all have been told of the risk

[PMRpro Ambassador in reply to Hidden]

There is no documented associated risk, i.e. that it is more than just coincidence - you have always to bear in mind that if the flu jab didn't do it, the flu or anything else might.

[Hidden in reply to PMRpro]

I suppose many would have to report this is happening after the injection, but many wouldn't associate it with the vaccine. Who knows what goes on with our bodies after having any vaccination. The next thing that will happen once the Covid19 vaccine has been produced, we will have to get it or maybe countries won't allow us in. So we may not have a choice.

[PMRpro Ambassador in reply to Hidden]

All cases would have to report after having the jab - countless millions have no problems at all. And vaccinations have saved many many times more lives than they have cost. Imagine the Covid effect for dozens of diseases - you wouldn't WANT to travel ...

[Jan_Noack in reply to HeronNS]

yes and best avoided. There used to be a choice of a double dose (high dose) or adjuvanted but at couple of years has only been adjuvanted (at least in Australia)..so we haven't had one. (especially this year when in Australia the isolation covid thing meant one couldn't also catch the flu.. watched the nos in qld (who run detailed stats every year) plummet to zero for months and gradually rise to maybe ten with the opening up.. not a great threat when isolating with COVID... but that meant no supermarkets or going out, sigh. Covid seems a bit easier t catch than influenza..and some people manage to get both at the same time...

[Mikb in reply to HeronNS]

I think in Canada there are high dose adjuvanted and not adjuvanted.

[HeronNS in reply to Mikb]

There are, although I believe no adjuvented ones are used in Nova Scotia. There is a high dose vaccine only used for people 65 and over who live in long term care facilities. This is info from last year, no description of this year's yet. if you want to avoid thimerosal you have to get your vaccine via a single dose vial.

[nickm001]

The reason that "seniors" kind of vaccine was created with adjuvants was because normal vaccine was not effective with seniors with weakened and non-responsive immune system reaction. Adjuvants enhance reaction perhaps 100x times, so there would be some antibodies generated. Since you are recommended "normal" flu vaccine I wonder if there would be any immune reaction at all? Will there be any benefit ? Just me thinking aloud.

[DorsetLady PMRGCAuk volunteer in reply to nickm001]

That’s why I asked about Rheumy’s thoughts.

[Hidden in reply to nickm001]

I've recently read that if our immune systems are compromised it's unlikely the flu jab will do any good...so we've filled ourselves with yet another vaccine that won't help us. Hopefully, not much flu about in the UK this Winter, as in Oz it was very mild I've been told.

[Smokygirl]

Hi! I had the under 65 flu vaccine last week as I did last year. I am 78.

My reasoning was that I didn’t want to trigger a flare.

I had absolutely no reaction to it at all, not even a pink dot, so I think that Nick may be correct! However my wild immune system attacked me a year ago and gave me PMR , so who knows? All being well, I’ll think about having the proper over 65 one with the adjuvant next year!

[Bcol]

Morning all, I had the normal over 65's jab last Saturday with no ill side effects at all.

[Sandradsn in reply to Bcol]

Me too

[borednow]

I've just had mine, about 20 minutes ago, and the nurse who took my temperature said I was normal. It's a long time since anybody said that about me ...............

[Hidden]

No idea there was a difference in the amount that's used. In UK we wouldn't be told, just given it.

[HeronNS in reply to Hidden]

We aren't told either. I look it up. I suspect this year's info isn't posted on-line yet because the vaccine isn't available. Vaccine will be available just after Thanksgiving (first weekend of October). I think the roll-out of the seasonal vaccine is based on when flu season actually starts in a particular jurisdiction, and as far as I know they expect us to be getting flu early in the new year, not before. And looking at that statement I wonder if that's because people travel and visit each other for Christmas? With covid case numbers continuing to soar in the rest of Canada I don't foresee too much travel this year so maybe the Atlantic Bubble, if still in place, will protect us from flu as well as covid.

[nuigini in reply to HeronNS]

Not sure if this link will work but it answers a few questions re Canada

open.alberta.ca/dataset/e3c...

[HeronNS in reply to nuigini]

It seems to imply that the cost is covered for nersing home residents, but if others want it (if they can even find a supply) they have to pay. And this is the result of cost/benefit analysis. Makes sense, actually. If you are vulnerable and aged enough to be in longterm care, plus in that facility the spread of any communicable disease is more likely, then that's who should get the vaccine if anyone does.

[benhemp]

Here in the U.S., there are two types of flu shots for seniors: one called Fluad in which the amount of adjuvant is greatly increased, and one called Fluzone High Dose Quadrivalent in which the amount of flu antigen is four times higher. I am planning to take the latter in October. I am more concerned about the amount of adjuvant being injected than I am about the amount of antigen.

[HeronNS in reply to benhemp]

It's Fluzone which the seniors in long term care facilities get in Nova Scotia. It's not offered to anyone else. And as of last year none of our flu vaccines were adjuvanted, although most contain preservative thimerosal.

[nuigini in reply to HeronNS]

Interesting Heron. I'll have to investigate the vaccine in Alberta when it becomes available.

I now recall there was a senior's vaccine last year which we didn't receive. We may have been told that it was only for seniors in care homes or senior residences and I simply forgot.

[HeronNS in reply to nuigini]

It would be interesting to know if our respective provinces made different choices!

[nickm001 in reply to HeronNS]

Single dose vaccine does not usually have thimerosal, only multi-dose. If I were to get one, I would ask for single dose ( I don't plan to get flu shot). To me with isolation and all measure to reduce spread of Covid19 should also protect us from flu.

[HeronNS in reply to nickm001]

Yes, the non-thimerosal single vial is available. I think this is what my doctor gave me a couple of years ago. Not sure what I got last year. I had no reaction, at least nothing memorable, either year. Before that I had only had a flu shot once, that was for h1n1. At that time it was a clinic at work and as the girl is telling me sometimes people feel a bit faint, I started to feel most peculiar. I developed the most impressive bruise at the site and had to sit quietly for about twenty minutes....

[HeronNS in reply to benhemp]

It depends which province you live in what you can get. As far as I can tell Fluad, both pediatric version and for seniors, is potentially available in Canada, but your own province may choose whether to provide it at no cost through medicare or not. I think nearly everyone would choose the publicly funded one if a doctor even bothered to offer a choice.

[arvine]

sorry, I am not familiar with the term "adjuvant" could you explain what that means to me please,

[PMRpro Ambassador in reply to arvine]

a substance which enhances the body's immune response to an antigen.

It is a an extra ingredient in the vaccine that encourages the immune system to react better to the actual vaccine.

[nuigini in reply to PMRpro]

This is all news to me. I'll have to do some investigating about the flu shots in Canada the next time I have the opportunity to have one. Do you have any recommendations on the best option for PMR folk?

[PMRpro Ambassador in reply to nuigini]

I don't get the choice - I get what I'm given! But the adjuvant one is for older, less efficient, immune systems - and so is the obvious choice for anyone on immunosuppressive medication.

[benhemp in reply to PMRpro]

The info I have here in the U.S. is that people over age 65 get either the Fluzone High-Dose vaccine or the Fluad vaccine:

- - - - - - - -

What type of vaccine is recommended for seniors?

For the 2020-2021 flu season, adults over age 65 should get either the Fluzone High-Dose vaccine or the flu vaccine with adjuvant (brand name FLUAD).

- - - - - - - -

I found the above at:

dailycaring.com/getting-a-f....

[PMRpro Ambassador in reply to nuigini]

cdc.gov/flu/prevent/qa_fluz...

has some details - but I have no idea how the differences apply in countries other than the US.

[arvine in reply to PMRpro]

thank you,

[Luciejc]

I am now on 6mg Methyprednisolone daily and a weekly injection of Actemra. I trust my doctor. She has excellent credentials, so I will follow her advice.

[kulina]

Thank you for sharing. That's very interesting. Does your rheumy think you got GCA from the Shingles vaccine? I believe your theory, I wonder if your doctor does too. I've never had the flu shot but I did give it a thought this year with Covid causing a pandemic. I've decided not to get one. Maybe it's a crazy decision but I've discussed it with my husband and we take every precaution there is to not catch Covid so that will help us with not catching the the flu too. We work at home, sell online, go to the supermarket as soon as it opens and wear 2 layers of masks. We figured we'll be ok. It's always a personal decision whether to take a medication or not.

[nickm001 in reply to kulina]

same here. We have similar lifestyle and in our assessment risk of getting flu is low.

[Luciejc in reply to kulina]

My doctor strongly recommends the flu shot, just not the over 65 one for me.

[Bcol]

Hi all, link to the explanation and different types of vaccine used in UK.

vk.ovg.ox.ac.uk/vk/inactiva...