“Season of mists and mellow flu-fulness ...”
It's that time of year again. The days are getting shorter, the air has a chill to it that holds the promise of frosty days and bitter nights to come and the trees are shedding their golden glory, forming satisfyingly crunchy carpets underfoot. Well, so much for the poetic beauty of autumn. But a more prosaic reminder that we have reached this point in the calendar is the abundance of public service posters and announcements encouraging everyone at particular risk of health complications to book their annual #flu-jab.
To jab or not to jab: that is the question
This poses, in fact, not just one, but two tricky questions for those of us who have #vitiligo (or any other autoimmune disease). 1) Does vitiligo count as one of those health conditions that carry a greater risk of flu-related complications? And 2) do any such risks outweigh those that might be associated with the flu vaccination itself? These are questions I ponder at this time every year because, even though my vitiligo is almost completely re-pigmented now (after spreading steadily for 5 decades) I know that I am still prone to certain de-pigmentation triggers and therefore cannot afford to be complacent.
So far, I have always chosen to run the risk of possibly catching flu over the potential risks of being vaccinated. I have never been quite sure whether this is the right decision – especially as I do usually go down with the flu once each winter. Nevertheless, I have continued to make that same choice, mainly because I have never noticed any adverse effect on my vitiligo as a result of getting the influenza virus, whereas most other #vaccinations and inoculations I have ever had in the past have left me feeling unwell. I am aware that this could be either coincidence or even imagination on my part and you could, quite reasonably, argue that catching the flu is likely to make me feel much more unwell. But my reluctance to have the jab is based on more than just a vague perception. I base it on a simple exercise of weighing up the potential pros and cons and realising that I am the only person who can make the decision because the doctors simply don't know whether it is wise for someone with vitiligo to have the flu jab or not.
Of course, the advice routinely handed out to anyone asking this sort of question is “ask your doctor”. But, since – in my experience - most doctors in general practice know less about vitiligo than the patients who have it, all you would get would be a well-intentioned opinion, based on limited knowledge. And, judging by everything I can find on the subject, asking a dermatologist would probably not be very much more helpful either. The fact is that the jury is still out on the subject of whether patients with autoimmune diseases should receive vaccinations and, to some extent, the jury is still out on the subject of whether vitiligo is a classic autoimmune disease in any case. So, where does that leave you and me? I think it leaves us to look at whatever evidence we can find and make up our own minds.
The battle ground
When it comes to vaccinations (not just the flu jab, but all vaccinations) feelings run high and opinions differ widely, both within the mainstream medical profession and the wider health system, as well as among the general public. No doubt some opinions are based on emotion and instinct, some on vested interests and some on a lack of accurate information. So this can make it difficult to get to the real facts – at least, the known facts, since the field of #immunology is still being explored and research still has a way to go before all of the questions we have about the immune system are answered.
Much of the controversy around the safety of vaccinations revolves around the question of infant inoculations. One camp says, quite rightly, that infant vaccination has saved millions of lives since it was introduced and has helped to eradicate a number of destructive and deadly diseases from the planet. When you look at the statistics, this is undeniable. Equally undeniable, though, is the fact that definite cause and effect has been established over the past few decades between significant numbers of individual cases of illness, and even fatalities, following vaccination. This is why the anti-vaccination camp argue that the body's own immune system should be left alone to do its job of protecting against infection and not be tampered with. From what I have read about infant vaccination, this view makes a lot of sense because to interfere with an infant's immune system while it is still in the process of developing does seem counter-intuitive and there appears to be quite a bit of credible scientific evidence to support this view. However, the question of infant vaccination is so complex and emotive that I want to confine this blog mainly to adult vaccination, since I am looking at this subject in the context of vitiligo, a condition that is usually not apparent until a person has past the infant stage. (But, I will refer briefly to the implications of infant vaccination later.)
10 known facts
I have read a lot about this subject while preparing this blog and realised what a minefield it is. So, rather than try to present all the research and the various conclusions and their implications in detail (which would require a skill set I don't have and would fill a very fat book into the bargain) I have decided to distill the known facts that I have been able to find into a very simple 10 point overview and draw some conclusions in relation to the question of vaccination for people with autoimmune disease in general and vitiligo in particular. I have then listed a number of references at the end to enable you to see how I came to my conclusions.
In coming to my own conclusions, I needed to filter out some of the misleading and biased information to be found on the topic of vaccinations online. I recognise that some doctors and researchers may be swayed by vested interests and personal reputation. And, as regards the views of non-scientists, there is a lot of well-intentioned but often ill-informed popularist hype on the subject.
It was hard for me not to get swept along by some of the views of the anti-vaccine lobby because I am a great believer in the power of nature to promote good health, so I instinctively feel that the immune system should be left to do its thing so that immunity to infection can be developed naturally over the course of a lifetime. My own, perhaps simplistic, view is that vaccinations would probably not be necessary if people all ate correctly from infancy to old age and lived in healthy environments, drank pure water and avoided environmental toxins. (But, of course, this is not the case.) And, for those of us who are prone to autoimmune disease, I believe that the answer should not be to boost or suppress the immune system artificially, but rather to balance it naturally.
However, putting my instincts on hold temporarily, I wanted to get to the bottom of the science behind the whole question and the best expert resource I found whilst I was reading up on this subject was Professor Yehuda Shoenfeld, founder and head of the Zabludowicz Center for Autoimmune Diseases attached to Tel-Aviv University, Israel. Based on his findings, as well as on everything else I have read so far, my own conclusion is that I shall be sticking to my policy of avoiding vaccinations wherever possible because the likelihood is that for someone with my genetic and medical history (a vitiligo sufferer who is also prone to allergies) vaccinations are likely to cause more problems than they cure.
Suggested reading & links
My name is Caroline.