Do Thyroid Patients Need a Flu Shot?

The Influenza Vaccine for Thyroid and Autoimmune Disease Patients

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

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 best time to get your influenza vaccine—also known as a "flu shot"—is between October and mid-November.

While you should always check with your doctor for guidelines and advice regarding your own situation, here are some considerations for thyroid patients.

Who Should Be Vaccinated?

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].
  • 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)

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.

In some years, the live attenuated influenza vaccine (LAIV), known by its trade name "FluMist," does contain live viruses, and is only approved to be given as a nasal spray 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.

There is no safety data on use of FluMist in people with autoimmune diseases, so before using this vaccine, discuss it with your doctor. The Centers for Disease Control do NOT recommend the LAIV nasal vaccine for the 2017-2018 flu season due to concerns about its effectiveness against the flu strains. 

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

Are There Side Effects from the Flu Vaccine?

A typical flu vaccine causes no side effects in most people. The most common side effect—an allergic reaction in those with severe allergy to eggs—is rare, 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 your arm. This occurs in "less than one-third of those who receive vaccine." Also, about 5 to 10 percent 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 you to "get the flu." 

The Controversy About Immunization for Autoimmune Patients

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 your 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 may caution you to avoid immunizations if you have an autoimmune disease—including autoimmune thyroid conditions like Hashimoto's disease and Graves' disease— because they believe that the safety of immunizations for you have 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. 

A Word from Verywell

When it comes to seasonal flu shots and other immunizations, if you have thyroid or autoimmune disease, you should talk to your physician about your own flu risk factors, as well as the benefits and potential risks of the vaccine for you.

Sources:

Centers for Disease Control. "CDC Guidelines for the 2017-2018 Flu Season." 

"Frequently Asked Flu Questions 2017-2018 Influenza Season." Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases (NCIRD), 

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

Interview with Dr. Kent Holtorf, October 2015

Interview with Dr. Richard Shames, October 2015.

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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