Should People With Arthritis Get a Flu Shot?

People with arthritis or other rheumatic conditions are sometimes confused about whether they should get their annual flu vaccine. What guidelines should be followed regarding flu shots for that population of patients? Is there ever a contraindication for getting a flu shot?

What Is the Flu?

Flu, also referred to as influenza, is a viral illness that affects the respiratory tract. Symptoms include:

• fever (often high)
• headache
• fatigue
• dry cough
• sore throat
• runny nose (nasal discharge) or stuffy nose (nasal congestion)
• muscle aches and stomach symptoms (e.g., nausea and vomiting and/or diarrhea)

The number of flu cases varies widely from year to year, but it’s not unusual for more than 10% of the population to get ill with flu during a flu season. The number of hospitalizations may vary from under a quarter of a million in a season to well over half a million. Each year tens of thousands of Americans die of flu or flu-related complications, such as pneumonia.

Flu Vaccine: Two Types

The best way to prevent the flu is to get vaccinated each year. There are two types of flu vaccines:

• Flu shot: Contains a killed virus which means it can be given safely to people with chronic medical conditions such as lupus and rheumatoid arthritis.
• Nasal spray flu vaccine: Contains a live, attenuated (weakened) virus, which is contraindicated for people with weakened immune systems, which includes people with rheumatoid arthritis or lupus.

When Should You Get the Flu Shot?

October and November are the optimal time for vaccination but it still may be beneficial in later months. The CDC (Centers for Disease Control and Prevention) recommends patients at high risk for flu complications get the flu shot. Some of these groups include but are not limited to:

• People over 50
• Residents of nursing homes or long-term care facilities
• People with weakened immune systems—including patients taking medications that suppress the immune system.

Medications that may increase the risk of infection include:

• Corticosteroids (prednisone, methylprednisolone, hydrocortisone)
• Imuran (azathioprine)
• Trexall (methotrexate)
• Arava (leflunomide)
• Enbrel (etanercept)
  
• Humira (adalimumab)
• Remicade (infliximab)

What Else Can You Do to Prevent the Flu?

In addition to vaccination, other suggestions to help prevent infection from spreading include:

• stay home when sick
• cover your mouth and nose (ideally with a tissue) when coughing or sneezing
• wash hands
• avoid touching your eyes, nose or mouth

Finally, antiviral drugs such as Tamiflu (oseltamivir) may be used for preventing or lessening the effects of the flu. For more information visit the CDC website.