One Patient's Positive Perspectives

H1N1 Flu virus – a thousandth the size of bacteria

While at the doctor’s office with my injured husband, we both got our annual flu shots.  He has asthma and I have lupus, and our doctors heartily recommend we both get a flu shot every fall.  Most rheumatologists and other medical authorities on Lupus recommend getting flu shots every year.  However, for patients with lupus, other chronic illnesses or otherwise problem immune systems, there is one caveat and caution.

For more information, you can read about how a flu virus works at

Inactivated flu virus safer for lupus

One Caveat – Get Only the Dead Flu Virus Shot

Urban legend and unsubstantiated hype re-emerge every fall based on the faulty premise that a flu shot can cause the flu.  Unfortunately, because of this widely spread myth, many Lupus patients who need to protect themselves against the season’s worst flu viruses, instead question the safety of getting their flu shot.

To reproduce and cause the flu, live viruses must attach to the cells lining the respiratory or intestinal tract. After attaching to the cells, they insert genetic information into the hostage healthy cell nucleus to convert it to a virus factory.  A flu virus carries only half the genetic material of a normal cell, and can only reproduce by hijacking another cell to reproduce.  Then, the invaded cell pumps out countless copies of the virus that infected it and the infected cell is completely destroyed in the process.

Dead fragments of dismantled viruses cannot carry out this manufacturing wonder. The most common form of flu shot contains the bits and pieces of dead viruses, and once injected into the body, the patient’s immune system recognizes them as part of a virus and creates antibodies against them. If the patient later is exposed to a live virus containing the components of the dead virus in the flu shot, their immune system is ready for the new invaders.

When the system is later bombarded with the flu virus by contact with sick people or the things they have touched, it is as if the immune system says, “I have seen these, I have met this virus before,” and starts pumping out antibodies the flu shot taught it to make.  The body’s reaction to the earlier encounter with the bits and pieces of dead virus parts later prevents the patient from catching that version of flu.

Who needs a flu vaccine? You!

A Thought to Contemplate – Dead Flu Viruses Don’t Reproduce

Knowing all this about the flu makes it is easier to understand that catching the flu from a normal dead virus flu shot is a medical and biological impossibility.  All flu vaccinations use either live or dead (inactivated) forms of flu virus.

Since the normal flu shot has only the disassembled parts of dead flu viruses, rather than whole live viruses, it is even safe for people with compromised immune systems.  Once dead, all previously living things, including the dead parts of broken up viruses, cannot be reassembled and brought back to life.  (The only accounts of resurrection I know of were a small number of historical folks who came back to life through miracles described in the Bible.)  Once dead, a virus broken up into pieces cannot make you sick with the flu, but it can keep you from getting sick with the flu.

It is possible to feel the effects of your body responding as it develops immunity to the flu virus, during the couple of weeks it takes to take full effect.  Your immune system responds a little like you are sick, even though there is no real infection, as it produces immunity to the versions in the shot.  Here are a few good quotes on the subject:

Flu virus penetrating healthy cell wall

“Flu is often more severe and deadly for lupus patients than for people without the autoimmune disease. Fortunately, flu vaccine is safe for people with lupus, known medically as systemic lupus erythematosus or SLE.”  — Daniel J. DeNoon at

“Overall, the influenza vaccine is considered to be safe and effective for people with lupus, and it is recommended that lupus patients receive the flu vaccine every year”  — The Lupus Foundation of America at

“Typically, the most you’ll get is a little soreness at the site of the shot. Low fever, mild rash, or a little “yucky” feeling for a day or so may happen, but flu shots can NOT give you the flu. Period. It’s a dead vaccine and can’t cause the flu.”  — Dr. Gregg Alexander at

“Patients with the autoimmune disease systemic lupus erythematosus (SLE) have an increased risk of infection, due to both disturbances in their immune responses and treatment with immunosuppressive drugs. Because morbidity and mortality related to influenza are increased in immunocompromised patients, it is recommended that patients with SLE get annual flu shots, which are safe and do not increase disease activity.” — The Lupus Research Institute, New York

“If you have lupus, you should strongly consider getting the seasonal flu vaccination—as long as it is not in the form of a “live attenuated nasal vaccine.” — Richard Furie, MD of New York at

Avoid flu nasal mist or live flu shot

One Caution – Stay Away from Live Virus Flu Shots/Nasal Flu Mist

In contrast, a live weakened flu virus vaccine can prevent the flu by teaching the body to make the right antibodies, but it can also cause a mild case of the flu. For this reason people with lupus, autoimmune diseases, other chronic illnesses, or compromised immune systems are cautioned to get the dead virus form of the flu shot. Both dead virus and live virus flu shots are effective, but the dead version is safe for lupus patients and other immune challenged people.  Risk for secondary infections are greater with the flu or following it, so the disease can be dangerous for people with a chronic condition such as lupus, asthma or heart disease, or for the elderly, very young and others with a weaker immune system.  Flu can also lead to bacterial infection, such as bronchitis or life-threatening pneumonia.

Some flu shots (or nasal mist) use a controlled live dose of the flu virus. Live but weakened flu virus can be administered through a nasal mist format. This vaccine does not cause flu in healthy people.  This vaccine is also known as LAIV, for “live attenuated influenza vaccine.” The live virus triggers the body to react by developing antibodies to the virus, and preventing a future attack by protecting the body when it encounters virulent strains later on.  Since the immune system thinks they already had the disease, it responds the second and later times by quickly pumping out anti-bodies it learned to produce after the first exposure by vaccination.

Protect yourself from the Flu

Protect Yourself from the Flu

If you are not sure about getting a flu shot this year, perhaps contact your rheumatologist or family practice doctor and get their recommendation that fits your personal health situation.

It might also be a good time to consider getting a pneumonia shot if your physician recommends it.

My personal advice to you is to be proactive and protect yourself from the flu.

Comments on: "Lupus and an Annual Flu Shot" (1)

  1. Funny to read this now as I just got a mini-lecture from my Rheumy’s nurse about getting the flu shot … no ifs ands or buts, so to speak. BUT, I’m only a week out from my 1st Benlysta treatment and was told to wait two week to get the flu shot. Okay … only that means my 2nd infusion then two weeks later my third. Will plan my shot two weeks after my third infusion. Hope that math agrees with the docs. GREAT blog reminder to all!!! Thank you.

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