Should I get a flu vaccine?
Due to reports of severe relapses following immunization, flu vaccinations are generally NOT recommended to persons with CFS or FM unless (1) you have taken flu vaccinations in the past and tolerated them well or (2) you have a serious chronic illness (such as emphysema, diabetes, or heart disease) in addition to CFS/ME/ FM. Not only do some patients relapse after flu vaccination, but many do not sero-convert (develop antibodies) to the vaccination. Thus you may suffer the discomfort of a “shot” plus the misery of a relapse, and not even develop immunity. Recombinant influenza vaccine (FluBlok) does not contain inactivated virus and may be safer to take than other types.
These are the current recommendations from the Hunter-Hopkins Center: If you have tolerated it in the past, you may take a flu vaccination this year if you wish. Recognize, however, that you may not develop protective antibodies. If you are elderly, infirm, or have a serious chronic illness for which vaccination is recommended, weigh the risk of immunization against the risk of contracting the flu. If you don’t take the flu vaccination, “antivirals” are available to fight influenza. These should be started within 72 hours of onset in order to reduce the severity and the length of your illness.
These drugs include:
- Symmetrel (amantidine) 100mg twice daily for 5 days for influenza A
- Flumadene (ramantidine) 100mg twice daily for 5 days for influenza A
- Relenza (an inhaler) 2 puffs twice daily for 5 days for influenza A or B
- Tamiflu One tab twice daily for 5 days for influenza A or B
(Tamiflu and Relenza are currently preferred due to resistance that has developed to the other antiviral agents.)
There have been anecdotal reports of relapses being triggered by Hepatitis B and Rubella vaccines as well, but pneumococcal, H. influenza, tetanus, and the shingles vaccines seem to be tolerated satisfactorily.
Should I get a Covid vaccination?
Many PWCs (Persons with CFS or FM) have developed a flare or relapse after vaccination with live viruses, so we have always recommended avoiding immunization with influenza vaccine, the MMR, and Hepatitis B, if feasible. The question is: how safe are the COVID-19 vaccines?
The Pfizer and Moderna products are not made from live virus, so they are not likely to cause flares or relapses in our PWCs. They both require two doses 21 to 28 days apart. It takes about 2-3 weeks to develop a 50% level of immunity after the first dose, and that level persists for just a few weeks so the second immunization is necessary. The vaccines are about 90-95% effective, but there is no data yet on how long such immunity will last. Side effects of the vaccination include injection site soreness and fever in most cases, increased fatigue (up to 60%), headache (up to 50%), muscle aches (37%), and chills (32%), especially after the second jab. These symptoms usually resolve in 24 to 48 hours, and a minority of individuals have to take Tylenol or other remedies for them.
A third vaccine, Novovax, does not use the controversial mRNA vaccine technology. It uses a traditional virus-blocking technique that has been used against other diseases. Unlike previous vaccines, Novavax is updated to protect against newer currently circulating Omicron variants. We have not heard any adverse reports about Novavax.
Our concern is not the short term effects, but long term. The Pfizer and Moderna vaccines have been administered safely to millions of individuals with minimal adverse effects, but new issues are likely to arise over time.