by Bruce H. Heckman, M.D., M.P.H.

Q. If someone is immune deficient and receiving IVIg every month, should they get the flu shot?

—Betty, Florida

A. Yes, with caveats.

When a healthy person gets sick, the body produces antibodies in the blood to help fight off the disease. The flu shot works because of this mechanism. It contains dead flu viruses that trigger the body to produce specific antibodies to combat the flu strain (or strains) going around that year. Because the shot only contains dead viruses, it doesn't actually give you the flu.

But for people with certain immune diseases, it's not that easy. Immune-compromised people don't produce enough antibodies to begin with. (That's why they may get injections of the antibody immunoglobulin, called IVIg therapy.) So the few studies that have been done on this subject show that they respond with a lower antibody level and to fewer flu strains.

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Since predicting which exact virus or viruses will cause the year's epidemic is an informed guesstimate, more cross-reactions offer more protection. So, getting the flu shot will give some level of protection, but less than usual.

Despite all that, we still recommend that immune-compromised people get vaccinated. As you might expect, if someone with a weakened immune system gets the flu, it's likely to be more severe, and the chance of developing pneumonia increases. So for most people, some protection is better than none.

Receiving the IVIg once a month does complicate the decision, though, since the general recommendation is to wait six weeks after receiving IVIg before getting a vaccination. You'd need to talk this over with your doctor.

BRUCE H. HECKMAN, M.D., M.P.H., is a board-certified internist at Phelps Memorial Hospital Center in Sleepy Hollow, N.Y. He's also in private practice in Buchanan and Ossining, N.Y.

Last updated and/or approved: December 2011. Original article appeared in November/December 2007 former print magazine. Bio current as of that issue. This general health-care information is not meant as individual advice. Please see our disclaimer.

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