Should people with ME/CFS have a flu jab this year? | Dr Charles Shepherd weighs up the evidence | 6 October 2016

October 6, 2016

The ME Association has a leaflet that covers flu vaccination and ME/CFS in detail.

It can be obtained from the MEA website online shop:

We also have a leaflet covering the research that has examined the link between vaccines and ME/CFS


1 A dose of flu can easily cause a significant relapse of ME/CFS. If this has happened in the past then a flu vaccine is well worth considering – especially if you are in contact with people who may be infected.

2 People with ME/CFS who have other chronic illnesses affecting the heart, kidney, immune or respiratory function, where a dose of flu could cause serious complications, should also discuss having a flu vaccination with their doctor.

3 ME/CFS is classified as a neurological disease – so you should be able to have one on the NHS (in England) if you decide to do so

Confirmation from Dame Sally Davies, Chief Medical Officer for England:

“As you know, the risk of serious illness from flu and consequent hospitalisation and death is higher among those with underlying health conditions such as M.E.. We know that people with chronic neurological conditions are approximately 40 times more likely to die if they develop flu than individuals who have no other underlying health conditions.
“The best way for people at risk from flu to protect themselves and their families is to get the flu vaccine. People with clinical risk factors are eligible to receive the seasonal flu vaccine free each winter.”

4 On the other hand, people with ME/CFS do sometimes report having a relapse or significant exacerbation of symptoms following a vaccination – especially when they are experiencing flu-like symptoms. This may be related to the fact that some research evidence indicates that there is low level activation of the immune system in ME/CFS – rather than immune system deficiency. But if you do have evidence of lowered immunity due to another illness then this is another recognised indication for having a flu jab on the NHS.

5 The MEA website ran a poll in 2009 which asked for feedback from people with ME/CFS who have had a flu vaccine.

• How did your flu jab affect your ME/CFS symptoms?

◦ I felt the same (45%, 86 Votes)
◦ I felt much worse (27%, 52 Votes)
◦ I felt slightly worse (22%, 42 Votes)
◦ I felt slightly better (4%, 7 Votes)
◦ I felt much better (2%, 4 Votes)

6 Flu vaccine causing ME/CFS-like side effects:

7 Should influenza vaccination be mandatory for healthcare workers? We report two cases of Chronic Fatigue Syndrome (CFS) after Swine Flu vaccination.

8 Information from NHS Choices website:

Under the guidelines drawn up by the Department of Health people living with CFS are entitled to the seasonal flu vaccine as they are defined as living with a serious long-term condition.

Though there may be both pros and cons associated with vaccination. Catching the flu when you are already experiencing symptoms such as fatigue can be very debilitating so vaccination can protect against that.

On the other hand some people with CFS who received a vaccine reported that the vaccine appeared to make the symptoms of CFS more severe.

In a small survey carried out by the ME Association, just under half of people said vaccination made no difference to their symptoms, a fifth said it made it slightly worse and a quarter said it made it much worse. A small minority of those surveyed (6%) said vaccination appeared to make their symptoms better.

Dr Charles Shepherd
Hon Medical Adviser
The ME Association

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