Editor’s note: In this news brief, MSF Medical Advisor Ben Thrower, M.D., addresses the topic of flu shots and the flu, including H1N1, for people with MS.
It seems like everywhere you turn, there is news about the flu. What does
all this mean for a person with MS? We need to clarify that there are two
types of flu bugs being discussed. There is the common seasonal flu and
there is the H1N1 or swine flu strain. Vaccines for these two forms of the
flu come in both a nasal spray and injectable form. So, here are some
1) No person with MS should receive the nasal spray form of the
vaccination. This form is a live attenuated (weakened) virus and is not
recommended for people with MS.
2) People with MS who are on one of the beta interferons (Avonex, Betaseron,
Rebif or Extavia) or Copaxone are not considered to be immunocompromised.
The same is true for people with MS on no therapy. The risks and benefits
of getting vaccinated for seasonal flu or H1N1 has to be looked at
individually for these people. The risk of getting the flu is not higher in
this group, but if they do get the flu, there is a good chance that MS
symptoms will increase due to the infection.
3) Some people with MS may be considered to have lowered immune function.
This would include people on immunosuppressive drugs like Tysabri,
Novatrone, methotrexate, Cellcept, Imuran, Cytoxan and chronic steroids.
These people should strongly consider getting vaccinated as they may be at
higher risk for getting the flu.
4) The safety of the seasonal flu injectable vaccine has been established
by the CDC for people with MS. We expect the safety of the H1N1 vaccine to
be similar although in fairness the vaccine will not have been
specifically tested in people with MS.