Wednesday, 24 January 2018

Tragic news: have you had your flu jab?

I have just heard the tragic news that one of my patients, who was admitted to intensive care over the weekend with pneumonia as a complication of influenza,  sadly passed away last night. I called the patient's partner to express my sympathy and was surprised to hear that she had not had this season's flu jab. This is a problem. 


We are in the throes of a major, and more virulent, flu epidemic than usual. People with MS are at high risk and are therefore eligible for the dwindling stocks of this season's flu vaccine. There has been a national appeal for all high-risk patients to get vaccinated. 

If you live in the UK and have not yet had the vaccination please contact your GP for an appointment to have the vaccine. In some parts of the country, you can get vaccinated by your pharmacist. For more information please read the NHS webpage on the vaccine. 

ProfG    

25 comments:

  1. It is very kind and thoughtful of you to follow-up with the patient's loved ones.
    I am curious to know if MS patients should take tamiflu in case they get struck by the flu in spite of getting the vaccine.

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    1. Tamiflu has been in the news in the US recently, neuropsychiatric issues of children taking the drug and having visual and auditory hallucinations.

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  2. I received the second round of Alemtuzumab in November, and was advised I shouldn't have the flu vaccine.

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    1. I'm on tysabri and have always been advised not to have it.

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  3. Would it be possible to say whether she was young and if she received treatment which made her (severely) immunosuppressed?

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  4. Thanks for the post ProfG. So sorry to hear about your patient. What about people post alemtuzumab. Given they have a weekend immune. Should they also have the flue jab?

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  5. I am very sad and sorry to read this and am thinking of your patient’s partner and all their loved ones and friends. How awful.

    Would having the flu jab really have prevented this tragedy?? I always feel so sceptical, but do it every year.

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  6. Here in Brazil unfortunately we are having an relapse of Yellow Fever, almost two years after the environmental disaster caused by the rupture of one of the barracks of the mining company Samarco.

    And the consensus is that anyone with MS would not be eligible for the Yellow Fever vaccine.

    Before MS I have been vaccinated 03 times against Yellow Fever.

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    1. Australia had a bad flu season this fast summer and that more often than not predicts the severity in the Northern hemisphere in the winter. Was the recent flu season particularly severe in Brazil this season?

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    2. "Was the recent flu season particularly severe in Brazil this season? "

      Very severe in u.s. even people in their 20's who work as physical trainers are dying. Vaccine said to be only 30% effective because of a virus mutation.

      https://qz.com/1143420/the-2017-2018-flu-vaccine-is-less-effective-than-usual/

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    3. Steve S so far here in Brazil the biggest problems of late 2017 to early 2018 were viral and parasitic infections transmitted by mosquitoes (mainly by mosquitoes Aedes aegypti, Haemagogus, Sabethes) such as Zika, Dengue, Chicungunya , Malaria and now the return of Yellow Fever, so far without flu outbreaks across the country.

      There were also some cases of Chagas' Disease in the country. Much of this problem results from environmental imbalance, deforestation, disorderly occupation of the environment, and environmental disasters caused by human action.

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  7. Did she have lymphopenia?

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  8. I am from Germany and my insurance only pay a flu jab without B - Yamagata. So it‘s not working.

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  9. I'm so sorry to hear about your patient.

    This may not have been the circumstances for your patient but
    there is still a misunderstanding about the flu vaccination.
    Some people believe incorrectly that it can give you flu. Or may not understand what flu can do to a person with MS, weakened immune system or not.

    I had 2nd course of Alemtuzumab in November and made sure I had vaccination beforehand, as soon as it was available. I knew that my body may not be able to fight flu afterwards.

    Some people are told in the case of Alemtuzumab that they can't have it but are not told why so think it must be because it's unsafe.

    My understanding is that the main issue is timing. Alemtuzumab affects the immune system so the timing of vaccination means it may not have the desired immune response so may not be effective.

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    1. Re: "My understanding is that the main issue is timing. Alemtuzumab affects the immune system so the timing of vaccination means it may not have the desired immune response so may not be effective."

      Yes, that is correct. But instead of second guessing whether or not your immune system can respond to the vaccine you should have it.

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    2. Definitely. This is why I don't understand why people are advised not to have it. I can understand people being told 'try to have it xyz weeks before if you can', so It makes me wonder if it's being misinterpreted.

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    3. Exactly and as another positive benefit, it might divert all those rebounding B cells from making autoantibodies ;-)

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    4. MD2, I don't intend to be rude at all, but this sounds very speculative to me.

      I don't wish to discuss MS on a public forum, but I will say that I am diagnosed PPMS and I am terrified of both flu _and_ the jab. The flu jabs I had had some very undesireable effects on me. I fully appreciate that, looked at on a national scale, the jab saves lives. But each person is unique.

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    5. Thanks for the additional clarification.
      I personally think the guidance on ways and means do be self protective/caring when immunosuppressive is poor.
      I will now have the flu vaccine.
      The death of anyone from MS, or anything that impacts on a PwMS because of this awful disease, is terribly sad and I'd like to echo my appreciation of your contacting the relatives ProfG

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    6. "Exactly and as another positive benefit, it might divert all those rebounding B cells from making autoantibodies ;-)"

      Is that for real??

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    7. Nah, pure speculation on my part. Still, you never know.

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  10. Would heard immunity help pwMS and the flu?
    I've read that ....depending on the illness in question, research has shown that it takes 80 percent to 95 percent vaccination coverage in a community to reach herd immunity.

    'Just 44% of people aged under 65 with an underlying medical condition, and only 43% of pregnant women, have had the jab.
    In addition, only 46% of NHS staff had the jab by the end of October, the period covered by the data, with some GPs among those who had not yet been vaccinated. '(14/12/17 The Guardian).

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    1. Re: "Would herd immunity help pwMS and the flu?"

      Definitely, herd immunity stops the spread of virus!

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  11. Is it safe to have the flu jab if you are on a DMT? Credible sources seem to have different opinions on this?!

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    1. Yes, the inactivated or component flu jabs are safe.

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