Why do I hear so much about flu shots?
Influenza is a common illness during the fall and winter months. Each year in North America, hundreds of thousands of people are hospitalized or die as a result of complications from the flu. If you or your child has a blood cancer, you may be at higher risk of contracting influenza, and at higher risk of developing serious complications as a result.
Many cases of influenza are preventable with annual vaccination. As a matter of fact, the Centers for Disease Control and Prevention (CDC) recommend flu shots for anybody in the high-risk population such as the elderly, healthcare workers, and individuals with suppressed immune systems, such as leukemia or lymphoma patients.
If I have a suppressed immune system because of my blood cancer, won’t I get the flu from the flu shot?
The most common form of the flu vaccine is the trivalent influenza vaccine (TIV) or the flu “shot” injection. This vaccine is an inactive form of the virus, so you will not actually “catch” the flu from TIV.
Another form of the flu vaccine is the live, intranasal influenza vaccine (LAIV). This comes in a nasal spray form, and contains the live flu virus. This is much less common than the injection, and should not be used if you have a suppressed immune system.
Will the flu shot interfere with my chemotherapy? When should I get the flu shot?
The chemotherapy that is used to treat your cancer may also weaken your immune system. As a result, your immune system may not be able to mount as much of a protective response to the vaccine as healthy individuals when you are undergoing treatment. Your cancer, since it affects your immune system as well, may also decrease your response. However, patients with blood cancers can still receive protective benefits from the flu shots.
In order to get the best response, you should try to get the flu shot either 2 weeks before chemotherapy, 4 weeks after chemotherapy is completed, or after your white blood cell count recovers to 1,000 cells/mm. If you are in the middle of a chemotherapy regime, you should get your flu shot at the furthest point away from a treatment time in your cycle.
What about drugs, such as Rituximab, that affect my immune system response? Will this make my flu shot less effective?
The answer to this question is still unclear. Researchers have noted that certain drugs, such as rituximab and alemtuzumab, seem to make the body’s response to vaccine less effective. Talk to your doctor about what's right for you.
What side effects may I experience from the flu shot?
Possible flu shot side effects include:
- Discomfort where the shot was given
- Low grade fever
- Body aches
These side effects usually only last a couple of days. In rare situations, patients have had an allergic reaction to the injection.
I have had a stem cell transplant for leukemia. Is it safe for me to get a flu vaccine?
While it is perfectly safe for you to get an inactivated form of the vaccine, research has shown that stem cell transplant recipients did not receive any benefit from the flu shot in the first 6 months following the transplant. So, even though vaccination is recommended in this group of patients, it is best to wait 3 to 4 months or more following your transplant before getting it.
What about my family and loved ones? Do they need to get the flu shot?
The CDC recommends that anyone caring for or living with a high-risk individual, such as someone with leukemia or lymphoma, should also get the flu shot. The idea is that the more of us who are immunized, the less of us are getting sick and spreading around the virus.
What else can I do to prevent the flu?
In addition to receiving the flu vaccine, you can help prevent influenza with these steps:
- Avoid people who are sick, and avoid others when you are sick.
- Use a tissue or your shirt sleeve to cover your mouth when you cough or sneeze.
- Use frequent, good handwashing.
- Avoid touching your eyes, nose, and mouth. If you have picked up germs or viruses on your hands, these are places where it can enter your body and make you sick.
- Stay healthy! Get lots of sleep, good food, and gentle exercise to keep your body in flu-fighting form.
Bottom line: Should I get the flu shot or not?
Despite that fact that patients with blood cancers such as leukemia and lymphoma may not get as strong of a response to the flu shot as healthy individuals, they still get a response. If you compare the risks to your health if you get the flu versus the unlikely adverse effects of the vaccine, the flu shot benefits will outweigh the negatives.
In short, the flu shot is safe, inexpensive, and may save your life. If you or your child has a suppressed immune system as a result of leukemia or lymphoma, or the treatment of a blood cancer, please speak to your hematologist or oncologist about your flu shot options.
Will you get a flu shot this year?. Why or why not?
Centers for Disease Control and Prevention. Key facts about seasonal flu vaccine. http://www.cdc.gov/flu/protect/keyfacts.htm. Accessed October 7, 2010.
Pollyea, D., Brown, J., and Horning S. Utility of Influenza Vaccination for Oncology Patients. The Journal of Clinical Oncology. May 10, 2010. 28: 2481- 2490.