In October, according to the SZCZEGÓŁY recommendations published on June 4 by the Ministry of Health – «Prevention and control of influenza: recommendations for the 2020-2021 season» – the time in which it is recommended to get vaccinated against the flu begins.
And, these days, the AISM toll-free number 800.80.30.28 is receiving numerous questions from people with multiple sclerosis about the choices to make, about the opportunity to get vaccinated against the flu in this year marked by the pandemic caused by SARS-CoV- 2, on the safety and efficacy of this vaccine when you have multiple sclerosis.
Why is it recommended to get the flu vaccine and when?
To clarify and strengthen informed and aware choices on the part of everyone, we spoke about it with Professor Marco Salvetti (Sapienza University, Rome, head of Neurology, S. Andrea University Hospital, Rome), with Dr.
Lucia Moiola (Coordinator of the SM, San Raffaele Hospital in Milan), with Professor Agostino Riva (Specialist in Infectious Diseases III Division of Infectious Diseases Luigi Sacco Hospital, University of Milan) and with Dr. Grazia Rocca (neurologist of the AISM toll-free number, 800.80.30.28 )
Given the current epidemiological situation relating to the circulation of SARS-CoV-2 – we read in the ministerial recommendations – it is recommended to anticipate the conduct of flu vaccination campaigns starting from the beginning of October and offer vaccination to eligible subjects at any time of the flu season, even if they show up late for vaccination.
- Since a co-circulation of influenza viruses and SARS-CoV-2 is not excluded in the forthcoming influenza season 2020-2021, the importance of influenza vaccination is underlined, especially in high-risk people of all ages,
- for simplify the diagnosis and management of suspected cases, given the similar symptoms between COVID-19 and influenza. Furthermore, vaccinating against the flu reduces complications from flu in subjects at risk and accesses to the emergency room and hospital wards.
The vaccine is also recommended for people
«First of all – explains Prof. Marco Salvetti – in the months to come, it will be important both for the individual and for the health system as a whole to limit as much as possible the possible confusion between people who will have fever and other symptoms caused by the flu and those who will have the same symptoms caused by the Coronavirus.
With the flu vaccination, this risk of misdiagnosis is lower and therefore diversified intervention strategies can be implemented in order not to bring the national health system to collapse.- Furthermore, according to some theories, activating the immune system through any vaccination could also confer a certain degree of protection against infections (in this case that of SARS-CoV-2) not in relation to the microbe against which one was vaccinated.
Among the categories to which the flu vaccine is recommended, the Ministry’s circular explicitly mentions people with congenital or acquired diseases involving poor antibody production, drug-induced immunosuppression … and also people with chronic inflammatory diseases.
«Beyond what is indicated by the Ministry – says Dr. Moiola – the anti-flu vaccine is highly recommended by the world scientific community for all patients suffering from MS as evidenced by the lines of recommendation on both.
American vaccines
French (Lebrun et al, Multiple Sclerosis Journal and Related disorders 2019) and finally also from the Italian ones published in September 2020 in Multiple Sclerosis Journal».
Just recently, as mentioned by Moiola, the results of an initiative involving 27 neurologists and 27 infectious disease specialists from all over Italy have been published in the Multiple Sclerosis Journal, promoted and coordinated by prof.
Agostino Riva and by Lucia Moiola herself.
In this meeting, issues such as infections and vaccines in patients with multiple sclerosis were discussed on the basis of an extensive review carried out on the scientific reference literature and consensus statements were formulated, including the one concerning the flu vaccine, i.e.: «the administration of the seasonal flu vaccine should be done annually regardless of the treatment received”
World Health Organization
In general, Moiola and Riva explain, vaccination is one of the main interventions for the prevention of infectious diseases also for people with multiple sclerosis:
- «The course of multiple sclerosis can be complicated by infections which can lead to a potential increase in the risk of complications. Several factors contribute to this risk: in particular immunosuppressant drugs,
- highly effective drugs but with possible infectious risks, bladder dysfunction with greater risk of urinary tract infections and, moreover, in patients with greater disabilities, less chest expansion may predispose to respiratory tract infections; finally, during
MS exacerbations, steroid boluses are used which, in turn, can lead to an increase in infections. Therefore, prevention is a key tool to reduce the infectious risk and complications of infectious diseases as well as to avoid interruptions of MS therapy in the event of severe infections.
And the flu, let us not forget, is today a significant cause of disease complications and mortality worldwide; the estimates that there are 3-5 million severe cases of influenza each year, responsible for 250,000-500,000 deaths worldwide.