Doc: Vaccines may be safe with autoimmune disease

Keith Roach
To Your Health

Dear Dr. Roach: I am a 39-year-old male with systemic lupus. I read your article on artificial and natural immunity and how getting the flu shot helps “prime” the immune system. I have been told by some that priming the immune system with any vaccine is not a good idea in my case, since I could develop antibodies that attack my own body.

What I want to know: Is it a good idea to get the vaccine?

D.S.

Dear D.S.: I often see advertisements for products claiming to “boost” the immune system, but in someone with autoimmune disease, that could be a disaster, since increasing the immune and inflammatory systems overall could lead to worsening of the autoimmune disease. In systemic lupus, it could lead to a flare-up of the disease, in any of its many manifestations, such as arthritis, kidney disease or swelling of the brain.

Fortunately, none of the products touted to “boost” the immune system actually do so. Vaccines are very specific antigens (usually proteins purified from bacteria or viruses) presented to the body, which then prepares cells that can respond to invaders with these antigens. They should not increase autoimmune disease, and the majority of evidence suggests that vaccines are safe for most people with autoimmune disease and that, again, for most people, the proven benefits of vaccination outweigh the small and theoretical risk of worsening the autoimmune disease.

I say “most” because there are some exceptions in which the risk may be too high. Anyone with a history of Guillain-Barre syndrome within six weeks of previous influenza vaccination should not get the flu vaccine. People with autoimmune disease taking medication that compromises the immune system should not take live vaccines. Some physicians recommend against vaccinating patients with severe autoimmune disease, and my comments cannot be a replacement for the advice of a physician who knows you.

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