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Do Thyroid Patients Need a Flu Shot?

The Influenza Vaccine for Thyroid and Autoimmune Disease Patients

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Updated January 11, 2013

Do Thyroid Patients Need a Flu Shot?

Should thyroid patients get flu shots? The question is controversial.

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Influenza, known as the "flu," is a viral infection of the respiratory system that can be severe, or even life-threatening, for some people. Flu season typically runs from fall through spring in North America, and usually, the optimum time for getting the influenza vaccine -- also known as a "flu shot" -- is between October and mid-November.

Each year, however, many thyroid and autoimmune disease patients have questions regarding whether or not they should get a flu shot.

Remember to always check with your doctor for guidelines and advice regarding your own situation. But in general, here are some considerations.

Generally, according to the CDC, during a typical influenza outbreak, vaccination is recommended for people who are at high risk for developing serious complications as a result of flu. These high-risk groups include all people aged 65 years or older, children under 5 and especially those under 2, pregnant women, and American Indians and Alaskan Natives. The CDC also recommends the flu vaccine for people who have medical conditions including:

  • Asthma
  • Neurological and neurodevelopmental conditions [including disorders of the brain, spinal cord, peripheral nerve, and muscle such as cerebral palsy, epilepsy (seizure disorders), stroke, intellectual disability (mental retardation), moderate to severe developmental delay, muscular dystrophy, or spinal cord injury].
  • Chronic lung disease (such as chronic obstructive pulmonary disease [COPD] and cystic fibrosis) Heart disease (such as congenital heart disease, congestive heart failure and coronary artery disease)
  • Blood disorders (such as sickle cell disease)
  • Endocrine disorders (such as diabetes mellitus)
  • Kidney disorders
  • Liver disorders
  • Metabolic disorders (such as inherited metabolic disorders and mitochondrial disorders)
  • Weakened immune system due to disease or medication (such as people with HIV or AIDS, or cancer, or those on chronic steroids)
  • People younger than 19 years of age who are receiving long-term aspirin therapy
  • People who are morbidly obese (Body Mass Index, or BMI, of 40 or greater)

Can a Flu Vaccine Help?

The flu vaccine can greatly reduce your chance of getting the flu, the seriousness of flu if it is contracted, and the chance of complications or death due to influenza.

What is the Flu Vaccine?

The injectible flu shot is made up of inactive flu virus, which stimulates an immune reaction to the current strains of flu. This vaccine is made from dead influenza viruses -- NOT LIVE viruses, as some erroneously report -- which cannot cause flu infection. It's generally given in the upper arm, and is not painful.

The Live Attenuated Influenza Vaccine (LAIV) vaccine, known by its trade name "FluMist," does contain live viruses, and is only approved to be given to healthy people 2-49 years of age who are not pregnant, and who do not have a chronic disease. FluMist contains live, weakened virus, and there is no safety data on use of FluMist in people with autoimmune diseases, so before using this vaccine, discuss it with your doctor.

For more information about the flu vaccine, see the Key Facts About the Flu Vaccine from the Centers for Disease Control.

Are There Side Effects?

A typical flu vaccine causes no side effects in most people. The most common side effect is still rare--and that's an allergic reaction in those with severe allergy to eggs, since the viruses used in the vaccine are grown in hens' eggs. For this reason, people who have an allergy to eggs should not receive influenza vaccine.

The main side effect, according to the CDC, is a bit of soreness in the arm in "less than one-third of those who receive vaccine." Also, about 5% to 10% of people experience mild side effects, such as headache or low-grade fever for about a day after vaccination. Today's vaccines, unlike the less refined vaccines from the 1940s to the 1960s, do not cause more serious side effects or cause someone to "get the flu."

The Autoimmune-Immunization Issue

Rarely, some people develop an autoimmune disease known as Guillain-Barre Syndrome after immunizations, including the influenza vaccine. Guillain-Barre (pronounced ghee-yan bar-ray) is an autoimmune condition that affects the nervous system, causing symptoms that range from weakness and tingling in the extremities, to a period of paralysis that can last weeks or months, and require the patient to be on a respirator to breathe. There are also controversial studies showing potential connections between immunizations and onset or worsening of other autoimmune diseases, including multiple sclerosis.

The issue of this connection between vaccination and other autoimmune illnesses is a controversial one, however. Some practitioners caution their autoimmune disease patients to avoid immunizations whenever possible, because they believe that the safety of immunizations for people with autoimmune diseases -- including autoimmune thyroid conditions like Hashimoto's disease and Graves' disease -- has not been sufficiently examined.

Richard Shames, MD, author of Thyroid Mind Power, Thyroid Power and a number of other popular books about thyroid and autoimmune disease, has said that he is careful about recommending the flu vaccine to his patients with autoimmune thyroid disease:

Generally, the people at higher risk should be concerned about getting the flu shot. But if you have Hashimoto's disease, having a flu shot is an immunological event. The determination needs to be made more carefully, then, because there is the potential for the flu shot to trigger the Hashimoto's into flareup or exacerbation.
Kent Holtorf, MD, founder of the Holtorf Medical Center network of health and hormone clinics, generally does not recommend the flu shot:
While the overwhelming majority of people are fine with the shot, I have seen it -- and hear about hundreds more a year -- precipitate chronic fatigue syndrome (CFS) in asymptomatic people, or severely exacerbate symptoms. The body has two sides to the immune system -- TH1 (cellular) and TH2 (antibody). Normally they are balanced, but many conditions are associated with low TH1 and increased TH2, contributing to symptoms such as fatigue, CFS, fibromyalgia, asthma, allergies, ADD, and autoimmune disease such as Hashimoto’s, etc. The flu vaccine intensely stimulates the TH2, and can worsen symptoms -- subtly or dramatically -- or precipitate these conditions. For those who do get the vaccine, we recommend the Flumist nasal spray, which stimulates TH1 in the nose, so is much safer and as effective, especially for those who have any of the above conditions.
Ultimately, when it comes to seasonal flu shots and other immunizations, thyroid and autoimmune disease patients should talk to their physicians about their own flu risk factors, as well as the benefits and potential risks of the vaccine.

More Information

More information for thyroid patients is available at Information for Thyroid Patients About Flu / Influenza. For in-depth coverage of colds an flu, visit About.com's Cold and Flu site.

What You Should Know for the 2012-2013 Flu season (CDC)

Sources:

Centers for Disease Control Influenza Site, http://www.cdc.gov/flu

Halsey, Neal and Dr. Noel Rose, Director, Autoimmune Disease Research Center, Johns Hopkins University, Bloomberg School of Public Health, "Autoimmunity And Smallpox Vaccine - A Risk?" InFocus,Vol. 11, No. 1, March 2003

Shoenfeld Y, Aron-Maor A. "Vaccination and autoimmunity-'vaccinosis': a dangerous liaison?" Journal of Autoimmunity 2000 Feb;14(1):1-10. Email interviews with Richard Shames, MD and Kent Holtorf, MD, October 21, 2011

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