Saturday, December 16

Adverse Flu Shot Reactions: Immunocompromised Persons

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In United States, estimates show that almost 200,000 people become affected and hospitalized due to influenza whereas a staggering 41,000 of them will succumb to its complications. Worldwide, these numbers will rise to as much as 500,000 influenza related deaths and it has become the 7th leading cause of death in the American population.

Preventive strategy for influenza:

When looking at the enormous burden of morbidity, mortality as well as the 80 billion dolor hefty bill in managing these patients, US government through Center for Disease Control (CDC) issued recommendations to vaccinate all those who are more than 6 months of age with influenza vaccine. It is recommended to be given each year and will be available in two forms, the injectable form or the ‘flu shot’, and the ‘nasal spray vaccine’.

The ‘flu shot’:

The vaccine contains the killed viruses related to 3 strains of influenzas which are expected to cause trouble in the coming season. For 2010/2011, the strains contained in the vaccine include, A(H1N1), A(H3N2) and Influenza B strain. The likely site to receive the vaccine is the upper arm and a needle will be used in giving the vaccine as an intramuscular injection.

Mechanism of its action:

‘Flu shot’ will act by stimulating the body’s immune system and therefore the production of antibodies against the killed viruses. Thus, it emphasizes the need to sustain a healthy immune system in order to produce protective antibodies as expected from administering the flu shot. Being killed viruses, the vaccine itself would not have the ability to launch an influenza episode.

State of an immunocompromised:

In immunocompromised individuals, because of an underlying illness or else due to administering of immune suppressive drugs as in the case of organ transplant, the ability of the immune system to react towards invading organisms, substances…etc will be altered. Thus, as described earlier, such persons may not produce adequate levels of antibodies to protect themselves from an incoming influenza virus. But, given the fact that, immunocompromised individuals are highly susceptible to develop serious complications following influenza infection, receiving the vaccine would be far better than not receiving it at all.

Adverse flu shot reactions:

According to CDC, the adverse reactions related to the flu shot is rather minimal and in most instances, it is limited to mild local manifestations such as soreness, redness and swelling lasting for about 2 days following injection. Systemic manifestations such as fever, headache and muscle aches can also take place, although these would also be minimal and will disappear within 2 days of time. In immunocompromised patients, such reactions will take place in a similar manner and there had been no significant difference in such manifestations between healthy and immunocompromised individuals.

Some research have pointed towards a possible increase in replication of HIV-1 in plasma or peripheral blood mononuclear cells among HIV infected persons following administering of the ‘flu shot’. But, these were not substantiated to indicate it as a common occurrence or even a significant event.  

But, it should be noted that, an immunocompromised individual who receives flu shot should not lower his or her guard against infections as the effectiveness of the vaccine may not be potent. Thus, they should take precautions to minimize exposure to the virus, should practice hand washing often and needs to seek medical attention as soon as possible in case influenza related symptoms manifest.

References:

http://www.cdc.gov/flu/professionals/acip/adversetiv.htm

http://www.cdc.gov/flu/protect/keyfacts.htm

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