As the crisp fall air brings forth cozy sweaters, seasonal décor and warm drinks, it is also a reminder to prepare for the looming respiratory illness season. Staying vaccinated is especially important if you live with rheumatoid arthritis.
COVID-19 has reshaped the vaccination landscape, adding another vaccine to consider. In an era of boosters, emerging variants and vaccine fatigue, you may have additional questions.
While influenza (the flu) and COVID-19 vaccines are generally highly recommended, it is important to speak with your healthcare provider. "Some people think that the ‘flu shot’ will give them the flu, this is not the case. Getting your yearly influenza and COVID-19 (booster) vaccines is especially important for people living with rheumatic diseases such as rheumatoid arthritis” says Dr. Ines Colmegna, Associate Professor of Medicine at McGill University.
Here’s what you need to know about seasonal vaccines to protect yourself this season:
1. Why get vaccinated?
- The flu and COVID-19 can lead to severe disease, complications, and even result in hospitalization or death. Vaccination is most the effective way to prevent these diseases and their related complications.
- Getting vaccinated helps reduce the spread of the flu and COVID-19, protecting both yourself and those around you.
- Annual vaccinations are necessary because the vaccine strains are updated regularly to better match the viruses expected to circulate each year. Additionally, the body's immune response to the flu and COVID-19 vaccines typically does not last beyond a year.
2. What are the risks for people living with rheumatoid arthritis?
Those with rheumatoid arthritis may have compromised immune systems, making them more susceptible to the flu, COVID-19 and related complications.
A study that looked at more than 46,000 patients with rheumatoid arthritis and a similar number of people without the diagnosis found that patients with rheumatoid arthritis were more at risk of having the flu and had a 2.75 times higher chance of complications like pneumonia and stroke.
Another study found that those patients with rheumatoid arthritis vaccinated for influenza had a lower risk of hospitalization due to complications from the flu and a lower risk of death.
Research in Canada suggests that COVID-19 vaccines are highly effective (92 to 97 per cent) in reducing severe COVID-19 outcomes (hospitalization or death) among people with immune-mediated inflammatory diseases (IMIDs).
For those looking to get both COVID-19 and flu vaccines in a single visit, the Ministry of Health has confirmed that “all seasonal influenza vaccines may be given at the same time as, or at any time before or after the administration of other vaccines including COVID-19 vaccines.”
3. What role do my medications play?
“Some immunosuppressive medications that are used in the treatment of rheumatic diseases can lower the body’s immune response to vaccines. Despite of this, it’s key to get vaccinated,” says Dr. Colmegna.
Your healthcare provider can guide you on how to adjust your medications when you receive the vaccines.
“Don’t stop your injections, infusions or medications. Consult with your physician about the best timing with respect to the COVID-19 vaccine. It might take a little adjustment in relation and your immunomodulating drug or other vaccines you are taking,” noted pharmacist Dr. Alan Low in an Arthritis Talks webinar.
4. What’s the optimal timing for the flu vaccine, and are there certain doses that should be avoided?
Flu season typically starts in December and peaks in February. Consider getting the shot in early November for optimal protection. Don’t worry if you miss this window—some protection is better than none.
Consider how you are feeling. If you are experiencing a flare-up or severe symptoms, perhaps postpone the shot until you feel better. Talk to your healthcare provider about the timing that’s right for you.
People with compromised immune systems should not get the nasal spray form of the vaccine. As this uses a live version of the virus, there is a theoretical risk of the live vaccine causing complications.
5. What about possible side effects and arthritis flares?
“The flu shot will not generally trigger a flare,” Dr. Colmegna noted.
Common side effects of the COVID-19 vaccine include fatigue, headaches, or pain and swelling in the injected arm.
In some rare cases, it is possible that the COVID-19 vaccine can trigger a flare-up of arthritis. According to data from a registry of over 5,000 patients from 30 countries, only 4 percent experienced a flare of their rheumatic disease, with most of the flares being mild or moderate. To alleviate the symptoms of the flare, only 1.5 percent required a new medicine or increased dose of their drug.
6. What are some other measures I can take to protect myself from the flu?
In addition to vaccines, you can help guard against the flu by:
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Frequently washing your hands
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Coughing and sneezing into your shoulder or crook of your arm rather than your hands
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Disinfecting commonly-touched items like phones, doorknobs and TV remotes
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Prioritizing sleep - sleep is important for keeping your immune system in tip-top shape, especially when you are immunocompromised
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Being as active as possible – whether it’s simple seated exercises or walking several days per week, having a regular movement routine can help strengthen your immune system
Additional COVID-19 recommendations from Health Canada include:
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Improving ventilation and filtration indoors (opening windows, changing filters in HVAC systems)
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Wearing a mask and putting distance between yourself and others. If you are planning to get together with family and friends, check in with them beforehand and if anyone is under the weather ask them to take a COVID-19 test before meeting.
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Testing yourself for COVID-19
If you live with rheumatoid arthritis, staying up to date with seasonal vaccinations, including flu and COVID-19 shots, is crucial. Though flares are rare, most experts agree the benefits of vaccination outweigh the risks. Use this as a starting point for conversations with your doctor.
This article should not be substituted for professional medical advice. Arthritis Society Canada strongly recommends connecting with your healthcare provider to discuss vaccinations.