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Julie  Stachowiak, Ph.D.

UPDATED: No FluMist for People with Multiple Sclerosis

By September 26, 2010

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UPDATE: There have been some changes in the recommendations for FluMist and people with multiple sclerosis (MS) in 2010. Looks like MS is no longer a contraindication for getting vaccinated with FluMist, although I have had a hard time finding specific current information about people on certain drugs, like Tysabri, Solu-Medrol and the chemo-based therapies. I write about my findings in my recent blog, FluMist and Multiple Sclerosis Update and True Confession.

I am leaving the original post from September 2009 intact below, but wanted to clarify one thing: despite my saying that there was a risk of developing "influenza from FluMist," this is inaccurate. The virus is weakened to the point of making this impossible, but people can develop symptoms that are flu-like (runny nose, headache, coughing), but not as severe as those caused by true influenza.

ORIGINAL POST: Most doctors and experts (and me, for whatever that's worth) recommend that anyone with multiple sclerosis (MS) gets a seasonal flu shot. Influenza (the "flu") is usually accompanied by high fevers and high fevers and infections can lead to relapses and/or increased symptoms and disability.

I'm sorry to say, however, that those of us with MS should NOT get their flu vaccine in the form of FluMist, the nasal flu vaccine spray. FluMist is a live-virus vaccine, which uses an attenuated form of the flu virus - in fact, the generic name of FluMist is LAIV (Live Attenuated Influenza Vaccine). People with MS that are on immunosuppressants, such as corticosteroids (Solu-Medrol) or Tysabri, or any of the immunoglobulin preparations (such as IVIG), are especially susceptible to developing influenza from FluMist. However, it is recommended that no one with MS (regardless of which medications they are on) gets FluMist, just to be sure. In fact, if you want to be extra cautious, it may be wise to ensure that the people in your family receive the shot, rather than FluMist, although some docs will say this is probably an unnecessary precaution.

For the sake of clarity, the "flu shot" is made of inactivated, or killed, virus, so poses no danger of infection (despite wild claims from many people that the shot "gave them the flu").

Oh, and for anyone interested (I was): No, the seasonal flu shot does NOT protect against HINI (otherwise known as Swine Flu) and neither does FluMist, for that matter. At this point, it looks like the HINI vaccines will all be inactivated virus vaccines, therefore safe for people with MS. Whether the HINI is specifically recommended for people with MS has not been specifically mentioned, as far as I know. I will keep you posted on this.

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September 1, 2009 at 11:48 pm
(1) isabella says:

Thanks again Julie for leaving us with such useful and practical advice. I had just been wondering recently if the swine flu vaccine would be safe for us to take and I appreciate you bringing it up and promising to keep us posted in the future. Keep up your great work!

September 2, 2009 at 12:59 am
(2) Trish says:

I no longer get flu shots or vaccines (mainly tetanus). They ALWAYS trigger my MS and it is not worth it to me.

September 2, 2009 at 8:50 am
(3) Lynne says:

I have always recieved the flu shot with no problems and want to take the shot for H1N1 when it become avalible for me if it is shown safe for people with MS. I work with children so I feel that it is important for me to get the shots.

September 2, 2009 at 11:13 am
(4) L says:

Hi Julie, I have to say I have had the flu shot 4 times and everytime I have had the shot that night I have had high temperatures, shivering and a feeling of general malaise. The next day it is gone without a trace, its like a mini flu. It is a real reaction I get to the flu shot. I have decided this year to give it a miss though as last time I got the shot I got the flu anyway!!

September 2, 2009 at 12:21 pm
(5) Meg says:

I get the flu shot along with my Husband who is a Type 1 Juvenile Diabetic every fall, especially the last 5, when it was finally “ok” to take with MS. A few years ago, when there was a shortage of shots, you wouldn’t believe the anger and nasty comments senior citizens were making to us, as we stood in line, because we are young. Both of us have been hospitalized in the past from catching the flu…in his case, he almost went into a coma, we learned our lesson. Luckily since we chose to not have kids, we don’t have to worry about our indoor cat family.

September 2, 2009 at 2:50 pm
(6) Huri (alias Puma) says:

Julie, thanks for the reminder, the warning about flu-mist and the information about the swine flu vaccination.

Sharing information: I have been vaccinated against the flu since +- 15 years and never had any side effects (never since had seasonal flu either). I followes the tip from my doctor who advised me to take a small dafalgan (paracetamol) or aspirin the first night. For those who have previously been vaccinated it seems especially inadvisable to skip the vaccination.

Best wishes

P.S. Sorry, for the name confusion but I do not remember if I use my name or my cat’s on this site

September 4, 2009 at 5:22 pm
(7) David says:

One thing I will say about the FluMist (I got it the past two years before I got diagnosed with MS) is that I got walking pneumonia the past two years I’ve taken the FluMist (and somehow managed to get mono too this past year).

I don’t know if that is just some bizarre reaction with my MS or what, but I would definitely advise against getting the FluMist for the reasons Julie listed and to avoid what I’ve gone through with it.

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