End Fatigue

Should People with CFS/FMS Take the Flu Shot?

If you are not one of the ~10% whose symptoms flare with vaccines, I recommend you do. In my experience, getting the flu vaccine has rarely posed a problem for those with CFS, but getting the flu has (though some CFS patients actually feel better when they have the flu!). From a theoretical point of view, the nasal flu vaccine (FluMist) stimulates the immune system differently than the injections (in a way that helps CFS), so some experts recommend it be given this way, and this is a reasonable option as well.

Interestingly, a study out of Scandinavia has shown that using a special vaccine given frequently can markedly decrease Fibromyalgia symptoms. The study below also suggests that the flu vaccine in safe and usually well tolerated in CFS.

Double-Blind, Randomized Study of the Effects of Influenza Vaccination on the Specific Antibody Response and Clinical Course of Patients with Chronic Fatigue Syndrome

KM Sleigh, DG Danforth, RT Hall, JA Fleming, and HG Stiver Can J Infect Dis, September 1, 2000; 11(5): 267-73.

Division of Infectious Disease, Department of Medicine;

OBJECTIVE: To determine whether influenza immunization is associated with early side effects, a deleterious impact on the illness course and depressed antibody response in patients with chronic fatigue syndrome (CFS).

DESIGN: Prospective, randomized, double-blind, placebo controlled trial. CFS patients and healthy volunteers filled out a questionnaire on immunization side effects and had hemagglutination-inhibiting (HI) antibody titres measured pre- and three weeks after immunization. CFS patients completed symptom and function questionnaires before and during the six-week, postimmunization period.

SETTING: Ambulatory care.

POPULATION STUDIED: Convenience sample of 40 CFS patients fulfilling the Centers for Disease Control and Prevention criteria and 21 demographically matched healthy volunteers.

INTERVENTIONS: CFS patients were randomly selected to receive commercially available whole virus influenza vaccine (n=19) or an injection of saline placebo (n=21). Healthy volunteers received vaccine only.

MAIN RESULTS: As a group, immunized CFS patients had lower geometric mean HI antibody rises than healthy volunteers (P<0.001). However, there was no difference in the rates of fourfold titre rises, and immunization did achieve a probably protective titre (1:32 or greater) in most CFS patients. No difference could be detected between immunized and placebo CFS patients in immunization side effects, although CFS patients as a group reported four times as many side effects as healthy volunteers. Further, in the six weeks following immunization, placebo and immunized CFS patients did not demonstrate any differences in terms of functioning, symptom severity and sleep disturbance.

CONCLUSIONS: In patients with CFS, influenza immunization is safe, not associated with any excess early reactions, and stimulates an immunizing response comparable with that of healthy volunteers.