1:09 p.m.
FLU Vaccination And ME/CFS
by Alison C. Bested MD FRCPC
October 2010 greetings! As we enter the flu season, I am writing to you about the flu
vaccine as my patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)
often ask me whether or not they should have it.
That depends on a number of factors:
. If you are allergic to eggs, you should not get a flu shot as the vaccine contains egg
protein.
. If you had the vaccine in the past and did not have any problems with it, then probably
you
would tolerate it this time.
. If you have never had it before, then the first question is whether you need it. If you
are totally
isolated in your own home and your caregivers and family are very aware that they should
not
come to visit you or care for you if they are ill, then your risk of exposure is
minimal.
. If you go outside the home, then you could take the following precautions. Take a
disposable
paper mask with you if you have to visit public places e.g. doctors' offices,
church, stores. If
anyone is coughing then put your mask on immediately so that you do not breathe in
viral
particles. Try to keep your hands off of your face, especially after coming into contact
with
another person (e.g. shaking hands) or an object just used by another person (e.g. a
pen) so
that you do not transfer viruses from your fingers to your eyes and nose. These are easy
entry
routes for viruses into your body.
If you decide you would like to be vaccinated, then I recommend starting with an injection
of one third the usual adult dose. If there are no side effects, then the same dose can be
repeated in a month's time, and the same again after one further month. The reason for
this is that Physicians specializing in ME/CFS, including myself, have reported cases of
flu symptoms in some patients with ME/CFS for 4 or more weeks after the full dose of flu
vaccine has been given. It is unknown whether patients with Fibromyalgia or Environmental
Sensitivities and/or Intolerances are more prone to such a response. However overlap of
these conditions with ME/CFS has been repeatedly reported in the medical literature, and
so caution is probably wise. Having symptoms for this length of time is not normal after a
flu shot. It is called an adverse vaccine event and needs to be reported to the Department
of Health. There is an Adverse Vaccine Event Form that must be filled out by the doctor.
Each region has its own Department of Public Health.
Last week I returned from a medical conference and one of the doctors reported that after
his patients' Vitamin D levels (Vitamin D 25 hydroxy) were monitored and brought up to
the mid-normal range that his patients had reduced outbreaks of flu last winter. Most of
his patients needed between 3,000 to 6,000 International Units of Vitamin D3 (its active
form) daily. I would suggest that patients and families have their Vitamin D25 hydroxy
levels checked and take Vitamin D3 to bring it into the mid-range and see if by having a
normal Vitamin D3 levels that it also helps them avoid the flu this winter. All of these
patients have a higher risk of developing osteoporosis due to decreased mobility from
their fatigue, so patients should have their Vitamin D levels checked for this reason
alone.
All the best to you and yours,
Alison C. Bested MD FRCPC
Haematological Pathologist
Staff Physician and Medical Specialist Liaison
Environmental Health Clinic
Women's College Hospital
Toronto, Ontario
Lydia E. Neilson, M.S.M. , Founder
Chief Executive Officer
NATIONAL ME/FM ACTION NETWORK
512 - 33 Banner Road
Nepean, ON K2H 8V7 Canada
Tel. 613.829.6667
Fax 613.829.8518
Email: mefmaction(a)ncf.ca
www.mefmaction.net