Things to Know About Flu Shots if You Have MS

Ed Tobias avatar

by Ed Tobias |

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The start of flu season here in the United States is just a few weeks away. It’s time for my wife and me to get our flu shots, just as we have for as long as I can remember. My neurologist and our primary care physician both recommend the shot.

Many people, particularly those of us with MS, have questions or concerns about these shots. Each year I’ve found social media forums are filled with flu shot debates. Based on what I’ve seen, some of those debates are based on facts but others will be based on unsupported, or poorly supported, opinion. Let’s talk facts.

Types of flu shots

Three types of flu vaccines are available this flu season: inactivated influenza vaccine (IIV), recombinant influenza vaccine (RIV), and live attenuated influenza vaccine (LAIV), which is a nasal spray. But, according to the Centers for Disease Control and Prevention, only two, IIV and RIV, are safe for people with MS.

That’s because LAIV nasal spray is a “live” vaccine which, the CDC says, should not be used by people whose have a neurologic disease or whose immune system is compromised “due to any cause,” nor by their caregivers. So, people with MS and their caregivers need to stay away from it.

The remaining two vaccine types are each available in two forms: trivalent and quadrivalent. The trivalent form, which is the traditional shot given with a needle into your arm, is designed to protect against three different flu viruses: two influenza A viruses (H1N1 and H3N2) and one influenza B virus. The quadrivalent flu vaccine is designed to protect against those three viruses plus a second type B virus.

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Of those two injectable vaccines, the CDC isn’t recommending any specific type or form unless you’re very young or old or have certain allergies.

The National Multiple Sclerosis Society’s website recommends getting a flu shot but has a special note for people who are being treated with Lemtrada (alemtuzumab):

“The seasonal flu vaccine has been studied extensively in people with MS and is considered quite safe, regardless of the disease-modifying therapy they are taking. However, individuals being treated with Lemtrada® should be given the inactivated flu vaccine six weeks before receiving their Lemtrada infusion.”

There is a small group of people who shouldn’t get a flu shot at all, or who should speak with their doctor before getting one. People who’ve had Guillain-Barré syndrome are in that group. You can see the full list here.

When should you get a flu shot?

The flu can appear as early as October and can continue as late as May. It usually peaks between December and February.

According to the CDC website, “It takes about two weeks after vaccination for the body’s immune response to fully respond and for you to be protected, so make plans to get vaccinated. CDC recommends that people get a flu vaccine by the end of October. However, getting vaccinated later can still be beneficial. CDC recommends ongoing flu vaccination as long as influenza viruses are circulating, even into January or later.”

Had a shot and still had the flu?

I’ve read about that a lot, online, as a reason people give for not getting a flu shot. Some think the vaccine actually gave them the flu. The CDC says you won’t catch the flu from a shot, but you might catch the flu even if you’ve been vaccinated.

It’s possible you may have been hit with the flu bug during the two weeks that it takes the flu vaccine to become fully effective. There have also been some years where the vaccine hasn’t been a good match for the strain of flu that was prevalent in those years.

Find a place to get your shot

You can usually get a flu shot from your doctor or at most pharmacies. In most cases, it’s covered with no copay. If you’re in the U.S., you can enter your zip code below to find your nearest flu clinic.

My wife and I will be getting ours before the end of September.

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Note: Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Multiple Sclerosis News Today or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to multiple sclerosis.


Linda Sasser avatar

Linda Sasser

Three years ago, without telling/asking me, one morning, a pharmacist administered the high dose flu shot for seniors instead of the regular dose. I did not know I had been given the high dose until later in the day. I became so dizzy that I was afraid to move around my house. This feeling of dizziness/disorientation lasted for a day and a half before dissipating. I told my neurologist; we both attribute the episode to the senior formulation designed to kickstart an immune response. Since then I have returned to the regular flu dose with absolutely no reaction, nor have I had the flu, dangerous at any age, but especially so for mine(78) and MS.

Pat Jenkins avatar

Pat Jenkins

The same thing happened to me 2 years ago. I ended up with a severe episode of ritational vertigo sand nystagmus. With vomiting and diarrhea (from the nystagmus probably). I was dizzy off and on for over 6 months after that. My neurologist said it put my already overactive immune system in overdrive. She suggested I skip the flu shot for a year. Now I am afraid to get even the regular shot this year...??

Margaret Hanna avatar

Margaret Hanna

I experienced a relapse after receiving a DPT vaccine. I have declined to take any flu vaccines since then. How likely is it that I could experience a relapse if I took the high dose or regular dose flu vaccine?

Ed Tobias avatar

Ed Tobias

Hi Margaret,

The DPT vaccine, of course, is different from the flu vaccine. But the question you ask is really one which you should ask your neurologist. All that I can do is tell you my experience, which is that I've never had a problem taking either the regular or the senior dose of the flu vaccine.


optic neuritis avatar

optic neuritis

My first MS symptom (optic neuritis) occurred within a couple of days of getting the flu shot. That was 14 years ago. I have not gotten the flu shot since because I am afraid it will trigger a relapse. My body always reacts to vaccines- and I'm certain the optic neuritis was triggered by the flu shot, despite what neurologists claim.

Elizabeth Yadon avatar

Elizabeth Yadon

I also after receiving flu vaccine 10 yrs ago had optic neuritis and was shortly after diagnosed with RRMS.
I have had 2 flu shots since and had an MS episode of greatly increased leg fatigue. I am fearful of having the COVID vaccine because of this. I believe I have an allergy to something used in the vaccines.

Ed Tobias avatar

Ed Tobias

Hi Elizabeth,

I understand your concern. The COVID vaccine, of course, is an individual choice. In your case, you have to balance any possible side effects from the vaccine with the impact on you, and others in your life, should you become infected with the virus that causes COVID-19. It's certainly worth a discussion with a neurologist who knows how you reacted to the flu shots that you received.



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