Sep 11, 2009
Regular flu shot: As in previous years, the National MS Society recommends a regular flu shot as a safe and effective vaccination for people with MS. The flu shot—which is a de-activated or “killed” vaccine—can safely be taken by individuals who are on any of the disease-modifying medications (Avonex®, Betaseron®, Copaxone®, Rebif®, Novantrone®, or Tysabri®).
FluMist Intranasal®: In 2003, the FDA approved a flu vaccine nasal spray “for healthy children and adolescents, ages 5-17, and healthy adults, ages 18-49.” According to Dr. Aaron Miller, the Society’s Chief Medical Officer, FluMist—which is a live, weakened vaccine—is not recommended for use by people with MS, and should specifically be avoided by any person with MS who is on an immunosuppressive medication such as mitoxantrone (Novantrone®), cyclophosphamide (Cytoxan®), azathioprine (Imuran®), or methotrexate.
* Live-virus vaccines are more likely than de-activated-virus vaccines to cause an increase in disease activity in people with MS.
* A person taking an immunosuppressive medication is more susceptible to developing an infection with the vaccine strain of the virus—an infection that may be particularly severe because the person’s immune system is suppressed.
* The interactions between live vaccines and the disease-modifying medications are not known.
H1N1 (Swine Flu) vaccine: The H1N1 (Swine Flu) vaccine is still in production, so its safety and efficacy have not yet been established. It is anticipated that the vaccine will be available in the fall of 2009, probably in October. When it becomes available, the recommendations for its use in people with MS will likely be the same as the recommendations for the regular flu vaccine. If a live, attenuated version of the H1N1 vaccine is also produced, it should be avoided by individuals with MS.
The initial supply of H1N1 vaccine will not be adequate to vaccinate everyone. The CDC has indicated that five groups will initially be targeted for vaccination:
* Pregnant women
* Persons who live with or provide care for infants under 6 months of age
* Healthcare and emergency services personnel
* Children and young adults aged 6 months to 24 years of age
* Persons aged 25-64 who have medical conditions that put them at higher risk for influenza-related complications.
It is important to note that people with disabilities (including people with MS) are not necessarily considered part of this high-priority group. However:
* The flu virus (like any other virus) can precipitate MS exacerbations
* A person with advanced MS or someone with less severe disease (Kurtzke 6.0) who has reduced pulmonary function or has any difficulty with breathing is considered at risk for complications and a good candidate for the H1N1 vaccine.
We recommend that people talk with their MS doctor to determine if they are a good candidate for the H1N1 vaccine.
In summary:
* People with MS should consult with their physician about obtaining a regular flu shot as soon as the regular flu vaccine is available.
* They should also discuss with their neurologist whether they should get the H1N1 vaccination because (1) catching the flu would put them at greater risk of an exacerbation, or (2) their MS symptoms are severe enough to put them at risk for flu complications.
* The FluMist nasal spray vaccine and any live, attenuated version of the H1N1 (if one is produced) are not recommended for people with MS.
We will update this Web site when new information is forthcoming. You can read information from the Centers for Disease Control (CDC) about the regular flu vaccine at http://www.cdc.gov/flu/protect/keyfacts.htm and the H1N1 vaccine at http://www.cdc.gov/h1n1flu/vaccination/public/vaccination_qa_pub.htm. Comprehensive information is also available at www.flu.gov.
Sunday, September 20, 2009
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About Me
- Steve
- North Grafton, Massachusetts, United States
- Well-educated, disabled at this point with Multiple Sclerosis. I am very glad that I was able to do the things that I have been able to do over the years. had to change the picture, this one's more realistic.
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