Another flu season is right around the corner. As a patient with Sjögren’s you are wondering about whether or not you should receive a flu vaccine this year. I do believe it is important to gain some knowledge about the flu.
The estimated mortality of flu death in the United States in the 2021-2022 season was estimated at 4,900. (In Canada, the number of estimated deaths is 3,500 with 12,200 hospitalizations).
People with flu can spread it to others up to about 6 feet away and should use use masks. The same precautions are needed for Covid-19 prevention. Most experts think that flu viruses spread mainly by droplets made when people with flu cough, sneeze or talk and less commonly from surfaces, which is similar to Covid-19. People with flu are most contagious in the first 3 to 4 days after the illness began. Most healthy adults may be able to infect others beginning one day before symptoms develop and up to 5 to 7 days after becoming sick. Children and some people with weakened immune system may pass the virus for longer than 7 days.
Antiviral drugs can lessen symptoms and shorten the time you are sick by 1 or 2 days. They also can prevent serious flu complications, like pneumonia. For people at high risk of serious flu complications, treatment with antiviral drugs can mean the difference between milder or more serious illness possibly resulting in a hospital stay. Prompt treatment for people who have influenza infection or suspected influenza infection and who are at high risk of serious flu complication is recommended.
An annual seasonal flu vaccine is the best way to help protect against flu. Vaccination has been shown to have many benefits including reducing the risk of flu illness, hospitalizations and even risk of flu related complications. Flu vaccine causes antibodies to develop in the body about two weeks after vaccination. These antibodies provide protection against infection with the viruses that are in the vaccine.
The seasonal flu vaccine protects against the influenza viruses that research indicates will be the most common during the upcoming season. Traditional flu vaccine (called “trivalent” vaccines) are married to protect against three flu viruses and influenza A (H1N1) virus, and influenza A (H3N2) virus, and an influenza B virus. There are also flu vaccines made to protect against four flu viruses (called “quadrivalent” vaccines). These vaccines protect against the same viruses as the trivalent vaccine and an additional B virus. Patients over age 65 need high-dose vaccine.
Annual vaccination against seasonal influenza is recommended for all persons aged ≥6 months. Effectiveness of seasonal influenza vaccine varies by season.
A paper by Wahren-Herlenius and colleagues, published in 2017 addressed the effect of H1N1 flu vaccine in patients with Sjögren’s. Untreated Sjögren’s patients had an exaggerated response with higher IgG levels to H1N1 flu vaccine, hydroxychloroquine treated patients did not show any exaggerated response.
To summarize, I strongly recommend inactivated injectable flu vaccines for Sjögren’s patients but caution is warranted when considering vaccination in non-treated Sjögren’s patients who have really active disease with multi-organ involvement. It is more important than ever to protect yourself and others from the flu, not only for you and your household, but for the entire community. The patients on immunosuppressive medications (like prednisone, methotrexate, azathioprine, mycophenolate mofetil, rituximab) should not receive live attenuated influenza vaccine (the nasal spray flu vaccine).
*article courtesy of www.sjogrens.org and Mehrnaz Maleki Fischbach, MD
