Whether or not ME/CFS patients should have vaccinations has been a hot topic for many years. The question is reasonable, however, since if the illness involves immune dysfunction – as we all suspect – then patients’ responses to vaccination might be very different from those of healthy people.
Researchers from Radboud University Nijmegen have published results in BMC Immonology of an investigation into immune responses to vaccination, using the seasonal influenza vaccination as a “model”. In essence, they wanted to test whether the flu jab induced abnormal immune responses in ME/CFS patients, which would suggest a disorder of immunity compared with the healthy population. In fact, influenza vaccination fulfilled its function – and the patients were able to mount a protective antibody response and a cellular immune response 7 days after a single shot of influenza vaccine. Overall, the degree of protection against flu was similar in patients and healthy controls, both before and after vaccination, leading the authors to conclude that “Standard seasonal influenza vaccination is thus justified and, when indicated, should be recommended…”.
So, it that the end of the story? The authors have certainly shown that the standard 2010/11 seasonal flu vaccine was “immunologically” effective in Dutch Fukuda-defined CFS patients after 7 days. Unfortunately, they report no follow-up assessments of “clinical” outcomes, such as adverse effects on symptoms or even relapses, in the days and weeks after the flu jab. This is important because some patients say that vaccinations, including for flu, significantly worsen their condition – and the numbers affected might be higher than we think. For instance, in Action for ME’s very interesting article in 2006, “To Jab or not to Jab” – which drew together patients’ experiences of vaccinations and the views of some clinicians and charities including ME Research UK – 4/20 (20%) patients said that the flu jab provoked a marked flare-up in their symptoms while other respondents reported a variety of reactions to other vaccines, though most respondents reported little or no adverse effects. Ideally, for a more complete picture, research studies on vaccination and ME/CFS should include both immunological outcomes AND clinical outcomes over time.