Flu Shot Recommendations with Fibromyalgia

Content provided by the Faculty of the Harvard Medical School

Flu Shot Recommendations with Fibromyalgia

Question:

I have recently been diagnosed with fibromyalgia. Would it be OK if I got a flu shot?

Answer:

Because there is now abundant supply of flu vaccine in the United States, I encourage all adults to consider getting flu shots. There are only two conditions that would make me avoid giving a flu shot to someone who otherwise would benefit from it:

• An egg allergy. Since the flu vaccine is made in chicken eggs, we don't give flu shots to anyone who has had a severe allergic reaction (called anaphylaxis) after eating eggs.

• Previous Guillain-Barré syndrome after a flu shot. This neurological condition can develop following a flu shot. Fortunately, it is very rare. However, if a person has gotten the condition after a flu shot in the past, it is probably more likely to happen again after another flu shot. So I would be reluctant to give a flu shot to someone who has developed Guillain- Barré within 6 weeks of a flu shot in the past. Other doctors might disagree with me about this, particularly if the person is at greatly increased risk for complications from the flu—like someone who has serious heart or lung disease.

You say you have been diagnosed with fibromyalgia. In that condition, there is evidence that the immune system is in a state of chronic activation. The same is true for a similar illness called chronic fatigue syndrome. It is theoretically possible that any kind of immunization could push this hyper-stimulated state into overdrive, at least temporarily increasing the symptoms of these two conditions. However, there is little proof in the scientific literature that this happens, so I don't think having a diagnosis of fibromyalgia should cause you to avoid the flu shot—particularly if you are at increased risk of complications from getting the flu.

In general, any adult who desires vaccination can request a flu shot every year in the fall or winter. Healthy adults under age 50 may be able to receive a nose spray (FluMist) instead of a shot.

If any of the following apply to you, the CDC strongly recommends yearly influenza vaccination:

• You are age 50 or older

• You have a long-term (chronic) medical condition affecting the heart, lungs, brain, or immune system

• You have diabetes or major kidney or liver problems

• You are pregnant

• You live with or take care of anyone at high risk of flu complications, especially a child less than 6 months of age. (Children under 6 months old cannot get flu shots)

• You live in a nursing home or other long-term care facility

• You are a health-care worker

Last updated:	February 25, 2009