Friday, September 22, 2023

Flu Shot And Arthritis Flare

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What Should I Look Out For If I Have A Vaccination

Rheumatoid Arthritis Flares: What is a RA flare? | Johns Hopkins Medicine


The flu vaccine should provide enough protection, but if you do develop flu-like symptoms, especially if you had the vaccine while on rituximab, please speak to your doctor about antiviral treatment, which should be started within the first 48 hours of symptoms.


Pneumococcal vaccination will only provide protection against pneumococcal pneumonia. If you develop a high fever, breathlessness, and a cough with green spit, seek medical help immediately as its likely that youll need antibiotics to stop the infection developing.

Do Illnesses/infections Trigger Ra Flares

Our community had various things to say about this. While most of the community alluded to flu/other illnesses being a trigger which often resulted in a flare for them, a few expressed that flares resulted in them getting the flu or another illness, and others pointed to a vicious cycle of illness and RA flares. A subset of the community also brought up the importance of getting flu shots for people living with RA.

Know What Triggers Your Flares

Do a little detective work. If you can figure out what’s making your symptoms worse, you may be able to avoid problems down the road.

RA is unpredictable. It can be better or worse for reasons you can’t control. Infections can be a culprit. So can stress. Some people get flares if they overdo it. Others say certain foods trigger problems, though thereâs not a lot of research to back that up.

The important thing is to find out whatâs going on. The next time you have a flare, make notes about what’s been going on in your life. For instance:

  • What’s your overall health?
  • What kinds of things are you doing every day?
  • What foods have you been eating?

Once you learn your triggers, you can take steps to avoid them.

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How Long Will Protection Last After I Am Vaccinated

We do not yet know how long patients are protected from reinfection after having COVID-19. There have been a small number of cases reported where a patient clearly developed a second COVID-19 infection, after having an initial previously documented infection. We have even less information about how long protection will last following a vaccine against COVID-19. All people receiving vaccines against COVID-19, or recovering from COVID-19, should understand that prior infection or vaccination may not provide long lasting protection from future infections.

What Vaccines Do I Need

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Most people with lupus need the same vaccines as everyone else. Find out what vaccines are recommended for your age group. Then, ask your doctor which vaccines you need.

Protect yourself from flu and pneumonia

Its especially important for people with lupus to get the flu and pneumonia shots. Lupus makes it more likely that youll have serious health problems if you get the flu or pneumonia.

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Can The Flu Shot Increase My Risk Of Getting Sick

To my knowledge, there is no evidence suggesting getting a flu shot will make you more susceptible to COVID-19, says Owensby. Although they are both contagious respiratory illnesses, they are caused by different viruses. COVID-19 is caused by SARS-CoV-2 and flu is caused by different strains of influenza viruses.

Similarly, getting the flu shot will not give you the flu, says Dr. Curtis. In fact, those mild flu-like symptoms you may experience after the shot headache, achiness, malaise, low-grade fever are all signs of your immune system revving up to protect against the flu, he explains.

National Ms Society Recommendations On Ms And Vaccination

General recommendations

The Academy of Neurology, in collaboration with the Immunization Panel of the Multiple Sclerosis Council for Clinical Practice Guidelines, published a summary of evidence and recommendations regarding immunizations and MS. They concluded that:

  • The evidence supports strategies to minimize the risk of acquiring infectious diseases that may trigger MS relapses .
  • The influenza, hepatitis B, varicella and tetanus vaccines are safe for people with MS.

Special considerations

Specific recommendations for people with MS

1. Influenza vaccine2015-2016 Injectable Seasonal Flu Vaccine

The 2015-16 inactivated seasonal influenza immunization is manufactured by several different companies under different brand names. Each is a single injection that provides immunity to three or four different flu viruses. Trivalent vaccines protect against three types of flu: the A/California/7/2009 pdm09-like virus the A/Switzerland/971/2013 -like virus the B/Phuket/3073/2013-like virus . Quadrivalent vaccines protect against the same three viruses plus an additional B virus .

FluMist is a live-virus flu vaccine that is delivered via a nasal spray. This live-virus vaccine is not recommended for people with MS.

2. Hepatitis B vaccine

3. Human papillomavirus vaccine

4. Shingles vaccine

5. Smallpox vaccine

6. Varicella vaccine

Studies of Vaccine Safety and Effectiveness in People with MS

Some, but not all, immunizations have been evaluated for safety and efficacy in people with MS:

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Q: What Are The Recommendations For Vaccinations In Adults Now

A: Attached is the recommended Adult Immunization Schedule for the United States for 2016. There are no additional vaccination recommended for the MS population . Our recommendation is that MS patients receive the standard schedule of vaccinations for their age and other individual characteristics unless they are on specific medications with an impact on response to vaccination . MS patients should try to avoid live attenuated vaccines where possible .

What Causes A Flare

Rheumatoid Arthritis – Signs & Symptoms | Johns Hopkins Medicine

The most common causes of an OA flare-up are overdoing an activity and injuring a joint. Other things that can trigger flares are:

  • An infection, like a cold or the flu
  • Growths on the ends of your bones called bone spurs
  • Repetitive movements
  • Cold weather
  • Changes in barometric pressure

Over time, you can learn what causes your flare-ups and spot the signs that one is on the way. Early treatment helps you manage them. Before a flare, you might notice dull pain in your joints, or daytime sleepiness over several days.

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Q: Should Any Vaccines Be Used Before Starting Dmts And If So Under What Circumstances

A: Fingolimod , a sphingosine 1-phosphate receptor modulator approved for relapsing MS, may increase the risk of dissemination and potentially life threatening varicella zoster . At theMellen Center we check for VZV antibodies before initiating fingolimod therapy. If immunity is not demonstrated by elevated VZV titers, we initiate chicken pox vaccination prior to initiating fingolimod. Optimally checking for the development of VZV antibodies prior to beginning medication would be prudent. Having elevated VZV titers does not guarantee against developing zoster infections . At the Mellen Center we recommend waiting 1 month after last VZV immunization to initiate fingolimod.

Alemtuzumab is a humanized monoclonal antibody directed against CD52. CD52 is a cell surface antigen present on T and B cells. Alemtuzumab depletes circulating T and B cells for variable amounts of time over months T and B cell lines repopulate, with B cells usually repopulating over 6 months and T cells over 12 months. Because of this profound immunological effect, LIVE Attenuated Vaccines should not be used after initiation of alemtuzumab due to an increased risk of infection. Live attenuated vaccines include: Live Attenuated Flu Vaccine , MMR, chickenpox, and Zostavax . Vaccines which are not live include: tetanus toxoid boosters and injectable influenza vaccine.

One study showed retained immune competence related to prior vaccination after treatment with alemtuzumab .

What Type Of Flu Shot Is Best

Dr. Curtis says there are three considerations for people with inflammatory arthritis:

Is it a live vaccine?

A live vaccine, such as the nasal spray, can cause side effects in people with inflammatory arthritis who have weakened immune systems. Instead, opt for the flu shot, which is made from inactivated influenza virus, which cannot cause illness.

Is it quadrivalent?

According to the CDC, all flu vaccines for the 2021-2022 season will be quadrivalent. This means that its a four-component vaccine, which this year protect against the following four flu strains: A/Hawaii/70/2019 pdm09-like virus A/Hong Kong/45/2019 -like virus B/Washington/02/2019 -like virus , plus B/Phuket/3073/2013-like virus. The trivalent vaccine, which offers protection against three strains, does not include the fourth virus, B/Phuket/3073/2013-like virus.

Is it high-dose?

This is a more potent type of flu vaccine, and while its generally reserved for adults 65 and older, it is beneficial for people with inflammatory arthritis who may have a weaker response to the flu vaccine than people without these health conditions. In fact, research published in The Lancet Rheumatology reported that the high-dose flu shot substantially improved the immune response in seropositive RA patients compared to the standard-dose flu shot. However, many high-dose vaccines are trivalent, and dont protect against B/Phuket/3073/2013-like virus.

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What Does An Ra Flare Feel Like

Someone with RA may usually be able to do household chores, but a flare can interfere with their ability to perform these tasks. Even simple things like using the bathroom and combing one’s hair can become extremely difficult and tiring to complete. Some people have said that their joint stiffness was so severe that it felt like their limbs were stuck together with superglue.

Those experiencing a flare are likely feeling symptoms from head to toe. Fatigue can be debilitating, so much so that people experiencing an RA flare don’t feel refreshed even if they sleep for long periods of time. It may also keep someone in bed for hours or days.

The symptoms of an RA flare can be so bad that a person experiencing one feels like their thoughts are all scattered and will hide away from others. They can also result in significant distress, including tearfulness, irritability, and frustration, and lead to depression, which can lead to suicide ideation.

Work On How You Manage Stress

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When you’re stressed out, it’s not just in your head. Your body makes more stress hormones, which may trigger RA symptoms.

There’s no way to avoid stress completely, of course. But you can help prevent it if you take better care of yourself when you know that you have stressful events coming up, like work deadlines.

Look for new ways to ease your mind. For instance, exercise releases “feel-good” hormones called endorphins. Studies show that moving around improves your mood and helps you sleep better. Pick activities that don’t put pressure on your joints. For example, go for a walk instead of a jog.

Mind-body techniques also can lower stress. Examples are:

Check to see if your local community center offers free or low-cost classes.

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Talking To Your Doctor About Vaccines

Considering the average doctor visit lasts just 15 minutes and you have many RA concerns to address, vaccines can easily slip your mind. Write a note reminding yourself to bring them up. If your doctor doesnt initiate the discussion, you should.

Also make sure your electronic medical record is updated to help your doctors keep track of the vaccines youve had. Ask your rheumatologist or primary care doctor to send you a reminder when youre due for your shots so you dont neglect this.

Arthritis Patients: Get Your Flu Shots

As the COVID-19 pandemic continues, getting your flu and pneumonia vaccinations as well as your COVID-19 vaccination is vital to protecting your health.

Getting vaccinated against COVID-19 and its variants continues to be essential to protecting yourself and those around you. But just as important is getting vaccinated for influenza and making sure your pneumococcal vaccine is up to date especially for people with inflammatory forms of arthritis who take immune-suppressing medications.

According to the Centers for Disease Control and Prevention , the flu vaccines have been updated for 2021-2022 flu season to provide protection against four different flu viruses, also known as a quadrivalent influenza vaccine. Flu and COVID-19 vaccines can be received at the same time.

Autoimmune Risks

The flu is miserable and potentially dangerous for anyone, but its especially so for people with inflammatory arthritis. People with rheumatoid arthritis , lupus, psoriatic arthritis and other autoimmune diseases are at higher risk of flu, pneumonia and other infections. While the diseases themselves change how the immune system functions, many of the medications used to control the diseases suppress the immune system, making patients more vulnerable to infections.

Flu Vaccination

Early flu vaccination is also possible for women in the third trimester of pregnancy, because this can help protect their infants during the first months of life, when they are too young to be vaccinated.

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Rheumatoid Arthritis And Swine Influenza Vaccine: A Case Report

Gurjot Basra

1Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX 77555, USA

2Division of Rheumatology, University of Texas Medical Branch, Galveston, TX 77555, USA

Academic Editor:


Rheumatoid arthritis is the most common chronic inflammatory joint disease. Multiple scientific articles have documented that vaccinations for influenza, MMR, and HBV, to name a few, could be triggers of RA in genetically predisposed individuals. However, there is limited data regarding the association of swine flu vaccine and RA. We report the case of a Mexican American female who developed RA right after vaccination with H1N1 vaccine. Genetically, RA has consistently been associated with an epitope in the third hypervariable region of the HLA-DR chains, known as the shared epitope, which is found primarily in DR4 and DR1 regions. The presence of HLA-DRB1 alleles is associated with susceptibility to RA in Mexican Americans. Hence, certain individuals with the presence of the shared epitope may develop RA following specific vaccinations. To our knowledge, this is the first reported case of RA following vaccination with the swine flu vaccine.

1. Introduction

2. Case Report

3. Discussion

Conflict of Interests

How Do Vaccines Work

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Vaccines teach your body to recognize and fight off germs that cause serious diseases before they can make you sick.

Heres what happens when youre not vaccinated:

When theres a new germ in your body, your immune system learns to make antibodies to fight it off. But this takes time and in the meantime, you could get very sick.

And heres what happens when youre vaccinated:

Each vaccine gives your immune system a weak or dead version of a germ to practice on. The vaccine doesnt make you sick it just teaches your immune system to make the right kind of antibodies to fight off that germ. Then, if you ever catch the live version of that germ, your immune system is ready to fight it off.

COVID-19 vaccinations use a new method to help vaccinate people. It is called a messenger RNA or mRNA vaccine. The mRNA vaccines send a portion of a virus genetic code to allow the body to learn how to fight it. This will allow the body to create a defense system if it comes in contact with the virus that causes COVID-19.

The mRNA vaccines do not contain the COVID-19 virus and do not change a persons genes or DNA.

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Whats The Best Place To Get The Flu Vaccine

If you have a scheduled visit at your rheumatologist or primary care physician, you can always ask if they are offering the flu shot. Heading to your local pharmacy is also an option, but youll want to be sure to wear your mask and practice social distancing and proper hygiene. You can also call ahead to ask about how crowded the facility is and find out the times of day when its likely to be emptiest.

It doesnt matter where as long as you get one, says Dr. Owensby. He recommends using to find where flu vaccines are available near you. when going to get a flu vaccine, be sure to practice everyday preventive actions.

Causes Of Reactive Arthritis

Typically, reactive arthritis is caused by a sexually transmitted infection , such as chlamydia, or an infection of the bowel, such as food poisoning.

You may also develop reactive arthritis if you, or someone close to you, has recently had glandular fever or slapped cheek syndrome.

The body’s immune system seems to overreact to the infection and starts attacking healthy tissue, causing it to become inflamed. But the exact reason for this is unknown.

People who have a gene called HLA-B27 are much more likely to develop reactive arthritis than those who don’t, but it’s unclear why.

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Flu Shots And Flares:

  • Got my flu shot and no flu still have my RA symptoms.
  • The flu shot is a must, but remember often a new strain crops up after the vaccine has been produced for that season.
  • I get my flu shot every year as a birthday gift to myself. Havent been sick in years.
  • I got my flu shot this year- but I did get a sinus infection, took antibiotic and I got worse, then my RA flared up.
  • Flu shot is a must every year.
  • I get my flu jab every year and I really think if I didnt I would have been bad because everyone has a virus around me. I have to admit I dont get many flare ups now but when I do they are very painful.
  • Got the flu shot this year then got the flu.

What do you think about the flu/other illnesses and flares and which comes first for you? Join the conversation and comment below.

Protect Your Aching Joints

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These simple methods may work:

  • Use canes, special jar openers, and padded handles.
  • Make it easier to lift, carry, or bend. Use your bigger joints instead of your smaller ones. Use your whole arm to lift things, not just your hands and wrists.
  • Wear safety gear like knee and elbow pads, or wrist guards when you play sports or do outdoor activities.
  • Put your joints through their full range of motion. Use slow, gentle movements.
  • Strengthen the muscles and ligaments around your joints. If you don’t have a physical therapist, ask your doctor to help you find one.
  • Try to avoid extra weight, which puts pressure on your joints. Your doctor can tell you what your goal should be.

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