Shedding Light On The Flu Shot And Multiple Sclerosis

Shedding Light On The Flu Shot And Multiple Sclerosis

Every year as summer draws to a close our thoughts turn to the coming flu season, and whether we should get a flu shot.

There are some who question whether a flu shot can actually cause the flu.  Others wonder how bad the upcoming flu season will be, and if they don’t get a shot what their chances will be of catching the flu.

Let’s take a look at what the flu shot is and isn’t, and whether getting it is right for you.

What is the flu shot?

The flu shot is a single preparation that contains inactive vaccines, or dead viruses, protecting against three influenza viruses most common in the upcoming flu season. There is the H3N2 virus, an influenza B virus and H1N1 virus.  When you receive this year’s flu shot, you will be receiving one shot to fight against all three viruses.

Who can get a flu shot?

The flu vaccine is recommended for anyone over the age of six, and may be taken if you are currently on any of the FDA approved MS medications.  However, it is not yet known whether the vaccine is as effective if you are taking Natalizumab (Tysabri) or Fingolimod (Gilenya).

If you are experiencing an exacerbation and are unable to carry out “normal” daily tasks, it is recommended to hold off getting the flu shot until 4 – 6 weeks after the onset of the relapse.

What about the FluMist®? 

The FluMist® is a live-virus flu vaccine that, as its name indicates, is delivered as a nasal spray.  It is not recommended for people with MS.  The activity in this live virus has been reduced but not eliminated, so those with MS should avoid the FluMist®.

Are seniors able to receive a stronger dose of the flu vaccine? 

There is a higher-dose flu vaccine available for people over age 65, yet it has not been studied for that age group.  The CDC does not recommend getting the higher-dose vaccine instead of the seasonal flu shot.

Are there special considerations?

Yes.  The following information is provided by The National Multiple Sclerosis Society*:

  • People on therapies that suppress the immune system (immunosuppressants), such as mitoxantrone (Novantrone), azathioprine (Imuran), methotrexate (Trexall), cyclophosphamide (i.e. Cytoxan) and/or chronic corticosteroid therapy should consult their neurologist before taking any live-virus vaccine. A person with a suppressed immune system would be at greater risk for developing the disease.
  • Inactivated vaccines are generally considered safe for individuals who are taking an interferon medication, glatiramer acetate (Copaxone), mitoxantrone (Novantrone), natalizumab (Tysabri), or fingolimod (Gilenya).
  • People who have received immune globulin preparation in the past three months may not receive the full effect of a vaccine.  A recent study demonstrated that teriflunomide-treated patients (Aubagio) generally mounted effective immune responses to seasonal influenza vaccination1.

According to Dr. Aaron Miller, the National Multiple Sclerosis Society’s Chief Medical Officer, “The flu virus (like any other virus) can precipitate MS exacerbations, and people with limited mobility are more likely to develop complications of the flu, including pneumonia.”  He recommends getting the flu shot as a safe and effective vaccination for people with MS.

Speak with your doctor about getting a flu shot this year.  Discuss any concerns you have about getting one.  Doing your homework and speaking with your doctor is the best way to prepare yourself for the upcoming flu season.2-4

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.
View References
  1. Bar-Or, et al. Teriflunomide effect on immune response to influenza vaccine in patients with multiple sclerosis. Available at: Accessed September 2013.
  2. The National Multiple Sclerosis Society, Vaccinations. Available at: Accessed September 2013
  3. Centers for Disease Control & Prevention. Available at Accessed September 2013
  4. Centers for Disease Control & Prevention. Flu Season. Available at: Accessed September 2013


View Comments (15)
  • Susan
    6 years ago

    I could not remember the last time I had the flu so I had not been getting a flu shot. Then last year while I was on Tysabri I wound up in the hospital for 2 weeks with the flu and pneumonia. I probably should have stayed an extra week for rehab because when I got home I could barely move, but I’d already been in there over Christmas and wanted to get home New Year’s Eve. Even with solumedrol it still took several weeks for me to really feel anything close to semi-normal again.

    My initial thought was yes, I am going to get a flu shot and a pneumonia shot, but I am fixing to start Tecfidera and I’m not sure if it’s ok with those. I guess I need to call my neuro and check.

  • Cathy Chester moderator author
    5 years ago

    I am so sorry you endured such difficulties after getting the flu and pneumonia. I wish for you better and healthier times.

    Yes, you should definitely consult with your neuro, Susan. Together you can make the best decision for yourself.

    All best wishes~

  • Livingston
    5 years ago

    I wish you luck w/ the terrible Tecfidera. It certainly was awful for me – and continues to be altho I discontinued it 7 weeks ago. It’s damaged my liver. Am now officially on a well deserved break.
    You sound like you deserve a break too! Over $60,000 a year for Tecfidera! How much is necessary to keep the drug companies doing research and how much is GREED as the other companies have raised their drug therapies to be almost as expensive. Altho they certainly weren’t before…… Makes you wonder??? There should definitely be a law against THAT.
    Why aren’t there any generic MS drugs, BTW???? It’s time!!!!!

  • LeslieG
    6 years ago

    I do not get the flu shot. My neurologist is on board. I’d rather have the flu than take a chance of flaring up my immune system with the vaccine. My two children & spouse get the flu shot. I have not had the flu in as long as I can remember.

  • Cathy Chester moderator author
    5 years ago

    It’s such a personal decision, Leslie. We all have to do our research, speak with our doctors, and choose for ourselves.

    Have a healthy season, and the best of everything~

  • RichG
    6 years ago

    No mention at all on the effectiveness or the ingredients in the flu shot. For example, the flu shot is developed on a guesstimate on what type of flu will be prevalent for the upcoming season. Each and every vaccine carries an inherent risk of causing a reaction, injury, or death that can be greater for some individuals than others. The seasonal flu vaccine is no exception when it comes to serious health risks, both short and long term, for some people. Vaccines can also be immune suppressive—that is, they can suppress your immune system, which may not return to normal for weeks to months. Here are just some of the ways vaccines can impair and alter your immune response:

    Some components in vaccines are neurotoxic and may depress your immune response or cause brain and immune dysfunction, particularly heavy metals such as mercury preservatives and aluminum adjuvants
    The lab-altered vaccine viruses themselves may also affect your immune response in a negative way
    Vaccines may alter your t-cell function and lead you to become chronically ill
    Vaccines can trigger allergies or autoimmune disorders. Vaccines introduce large foreign protein molecules into your body. Your body can respond to these foreign particles in a way that causes an allergic reaction or triggers autoimmunity, especially in persons genetically or biologically vulnerable to allergy and autoimmunity
    The flu vaccine may also pose an immediate risk to your cardiovascular system due to the fact that they elicit an inflammatory response.

  • Cathy Chester moderator author
    6 years ago

    Here is some more information about the flu shot provided by The Centers for Disease Control. Reading it will answer some questions.

  • Janet
    6 years ago

    Thanks for this informative information on the flu shot. I have been getting a flu that every year since my diagnosis with no ill effects. I have questions about getting the shingles vaccine— my PCP and my neurologist will not give me a clear answer on this. Can anyone help?

  • Livingston
    5 years ago

    I have gone around and around about the shingles shot. I want to get one- having seen people, including my father, suffer for years with them.

    But my neuro said no – having recently been on Tysabri and Tecfidera. The shingles vaccine is a live vaccine. So we need to beware.

    I have been off everything for about 7 weeks – but my liver hasn’t recovered. So I’m still afraid to get the shingles shot.

  • Cathy Chester moderator author
    6 years ago

    And here is another article about the effectiveness of the flu vaccine:

    And information about the shingles vaccine:

  • Nani
    6 years ago

    I take Gilenya (a WONDER DRUG for me) and after starting the year in the hospital for 5 days with the flu, my neurologist and PCP agree (me too) absolutely Flu Shot this year.

  • Cathy Chester moderator author
    5 years ago

    Good, Nani. I believe in preventive medicine if possible.

    Take good care,

  • knit10purl5
    6 years ago

    Sue, I also take tecfidera and wondered the same thing. Have you had any
    Reactions to tecfidera? Do you think it is working

  • Sue
    6 years ago

    There’s no mention of the flu shot for someone on Tecfidera. Would that be okay? Is enough known about Tecfidera? I SHOULD have the flu shot b/c I’m also a Type 1 Diabetic, but I’m concerned about the Tecfidera, since Tysabri is mentioned above.

  • Cathy Chester moderator author
    6 years ago


    I am not a medical professional, and in my research I did not find material about having the flu vaccine while using Tecfidera. I would suggest you speak with your MS specialist about your question. Sorry I could not be of more help to you.

    Good luck and best to you,

  • Poll