Hello friends I would like to share this information that I received in my Fall vitiligo newsletter through Vitiligo Support International.
Can a flu vaccination make vitiligo worse?
As we approach flu season, the federal government is working with pharmaceutical companies to manufacture a novel vaccine to combat the new flu variant, H1N1 or Swine Flu. Candidate vaccines are now being tested. Latest media reports say the new vaccine is anticipated to be made broadly available this fall.
Members have asked us if a flu vaccination could worsen their vitiligo. As vitiligo is a disease involving the immune system, could a flu vaccine which targets the immune system have an adverse impact on vitiligo?
What do we know thus far? According to the Centers for Disease Control (CDC), the federal agency overseeing the development and administration of vaccines, we know that flu vaccines carry risks for certain categories of people whose health and age make them vulnerable to potential side effects from these drugs. Also, flu vaccine used by people with chronic medical conditions or who are immune-suppressed may not be as effective in preventing an infection as when used in healthy young adults and children.
According to the CDC, during a typical influenza outbreak, vaccination is recommended for people who are at high risk for developing serious complications as a result of flu. These high-risk groups include all people aged 65 years or older and people of any age with chronic diseases of the heart, lung or kidneys, diabetes, immunosuppression, or severe forms of anemia. Specifically, the CDC recommends a flu vaccine for any person over the age of 6 months who - because of age or underlying medical condition - is at increased risk for complications of influenza.
Medications such as (to list a few) prednisone, methotrexate, and biologics such as Humira, Enbrel and Remicade, can weaken the immune system, making a patient more susceptible to the H1N1 virus (swine flu) and the regular seasonal influenza. If a patient on an immunosuppressive drug does contract such a viral illness, there is a higher risk of developing more severe-and thus more life-threatening-disease.
As to whether vaccines can trigger or worsen autoimmune disease, the CDC states in its most recent Guide On Vaccines and Vaccine Safety that any connection between autoimmune disease and vaccines remains unclear and that there is thus far "few data implicating vaccines in the induction of autoimmune disease".
As vitiligo is an autoimmune disease, what should a person with vitiligo do? We posed the following frequently asked questions to leading vitiligo experts.
Q1. I understand carbolic acid is being used as a preservative in the flu vaccine. Since this is a phenol, could this cause a problem for my vitiligo?
A1. Carbolic acid is indeed a phenol with the potential of triggering oxidative stress in the melanocyte. When topically applied in an individual genetically susceptible to developing vitiligo, it could trigger vitiligo. However, phenol is not likely to induce vitiligo when injected as a preservative in a flu vaccine. The carbolic acid will quickly be neutralized and will not reach the skin as a phenol. (Source: Ray Boissy, Ph.D., Professor of Dermatology & Cell Biology and Director of Basic Science Research at the University of Cincinnati College of Medicine (UCCOM)
Q2. Thimerosal, a mercury-based preservative, is often found in flu vaccines. Are there flu vaccines that are without thimerosal. I am concerned it will have an effect on my vitiligo.
" A2. Because of increased awareness of the theoretical potential of even low levels of mercury having harmful effects on humans, concerns about the use of thimerosal in vaccines and other products have been raised. As a result, the Food and Drug Administration (FDA) has been, and is, working with vaccine manufacturers to reduce or eliminate thimerosal from vaccines. The Centers for Disease Control and Prevention estimates that about 15 percent of the total H1N1 (swine flu) vaccine available will be mercury-free. (Source: CDC)
Q3. I have read that those who have a weakened immune system should not get the Zoster vaccine for shingles. If you have an autoimmune disease like vitiligo, does that mean you/we have a weakened immune system?
A3. No it does not mean you have a weakened immune system and I recommend the Zoster vaccine over the potential for shingles which could quite possibly cause vitiligo to spread. (Source: Nanette Silverberg, M.D., Attending physician, department of dermatology, St. Luke's-Roosevelt and Beth Israel, specializing in pediatric and adolescent dermatology, vitiligo)
Q4. I have read that vitiligo is one of the vaccine-related autoimmune disorders. Is this true?
A4: Vitiligo can be a side effect of vaccinations given to promote an anti-tumor response in melanoma patients, because pigment cells share many properties with their malignant variant, the melanoma cell. This type of vaccine is the only one with a known link to vitiligo.(Source: Caroline Le Poole Ph.D. Associate Professor of Pathology Loyola University Medical Center)
Q5. Can the flu vaccine make my vitiligo worse? Should I as a person with vitiligo take a vaccine?
A5. A skin prick per se can start a new lesion at the vaccination site in patients that have a tendency to respond to skin trauma (cut and burns etc) by depigmenting further. Apart from that, there is no evidence to link any other vaccine to vitiligo. The effect of the bulk of vaccinations on vitiligo development has not been tested. Unless there is a specific study to link vaccination with the development of vitiligo, such association has little chance of being found. (Source: Caroline Le Poole, Ph.D.)
There has, however, been a vitiligo response to a very specific vaccine in the Smyth line chickens (SL) which are an animal model that very closely mimic human autoimmune vitiligo. Dr. Gisela Erf reports that all USA poultry is required to be vaccinated for Marek's disease. If the Smyth line chickens are vaccinated with the Marek's live vaccine, the incidence of vitiligo is significantly higher than normal. However, when vaccinated for Marek's disease with an inactivated or "dead" vaccine, there was no abnormal reaction, nor have there been any such reactions to any other live vaccines. (Source: Gisela Erf Ph.D., immunology: Professor Department of Poultry Science Specializing in Avian immunology with emphasis on cell-mediated immunity, autoimmunity, tumor regression and immunology of the skin)
Talk with your medical care provider who can help you address any concerns and help you weigh the potential benefits and risks.
See the accompanying article prepared by the University of Missouri Arthritis Rehabilitation Research and Training Center. People with Autoimmune Diseases Should Consult a Doctor Before Flu Shot
To stay up to date on what is happening with the H1N1 vaccine, you may find these additional sources helpful
http://www.cdc.gov/FLU/protect/keyfacts.htmlhttp://www.nlm.nih.gov/medlineplus/print/h1n1fluswineflu.html
Nasal Mist (Live Vaccine) Facts H1N1 Vaccine Package Insert
http://marrtc.missouri.edu/media/stories/041020flushot.html
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Just FYI. Those of you who have been reading my discussion, my 8.5 year old daughter has the condition. Luckily, protopic has been a big help.
When our daughter was diagnosed with V almost 2 years ago, after extensive research and back tracking, the only root causes we concluded were: 1) Vaccination or 2) Sunbuns severe summer weather in India. My wife simply believes that vaccination triggered V. It appears that, there is a good amount of research on vaccination induced vitiligo.
Replies
When our daughter was diagnosed with V almost 2 years ago, after extensive research and back tracking, the only root causes we concluded were: 1) Vaccination or 2) Sunbuns severe summer weather in India. My wife simply believes that vaccination triggered V. It appears that, there is a good amount of research on vaccination induced vitiligo.