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Take the Right Shots for Lupus! August 15, 2019 While August is when we savor the last weeks of summer, it is also the time to look ahead and prepare for fall. In recognition of National Immunization Month, our Chief Scientific Officer Dr. Teodora Staeva provides background on vaccines and relays government recommendations for which are safe for people with lupus. “Vaccines help to develop immunity, in other words protect against disease, by imitating an infection,” notes Dr. Staeva. “Most vaccines contain small amounts of the germs (or parts of them) that cause disease but are either killed or weakened. The vaccine prompts the immune system to produce T cells and antibodies against these germs, and thus allows the body to learn how to fight these microbes in the future. However, several rounds of vaccination are often required to achieve optimal protection.” Currently there are four main types of vaccines. Live-attenuated vaccines use the weakened (attenuated) form of the virus so that it does not cause serious illness in individuals with healthy immune systems. Vaccines with live viruses are generally NOT recommended for people with lupus. Inactivated vaccines are made by killing the germ while making the vaccine. These are considered safe and effective for people with lupus. Subunit or purified antigen vaccines use only specific pieces of the germ. Thus, they give a very robust immune response targeted to key portions of the microbe. Generally, these vaccines can be used widely, including on people with weakened immune systems. Toxoid vaccines use a toxin (harmful product) made by the germ that causes a disease. They create immunity to the parts of the germ that cause a disease instead of the germ itself. That means the immune response is targeted to the toxin instead of the whole germ. “People with lupus are at greater risk for infections due to immunosuppression, so vaccines are very important,” noted Dr. Staeva. “But speak to your doctor before getting any vaccine to determine which are right for you and when.” _________________________________________________________________________ Recommendations from the U.S. Department of Health & Human Services (HHS), Office of Women’s Health: People with lupus typically can get the following vaccines that do not contain live viruses: The flu shot (not nasal spray which contains a live form of the flu virus) Pneumonia vaccine Human papillomavirus (HPV) vaccine Tetanus, diphtheria, and acellular pertussis (Td/Tdap) vaccine Vaccines with live viruses that may not be safe for people with lupus, include: Nasal spray vaccine for the flu Varicella (chickenpox) vaccine Herpes Zoster (Shingles) vaccine Measles, Mumps, Rubella (MMR) vaccine Live typhoid vaccine (oral) Sources: U.S. Department of Health & Human Services, Office of Women’s Health https://www.lupusresearch.org/take-the-right-shots-for-lupus/

The Risk of Vaccinations and Other Ancient Myths Dr. Nahum Kovalski received his bachelor's of science in computer science and his medical degree in Canada. He came to Israel in 1991 and married his wife of 22 years in 1992. He has 3 amazing children and has lived in Jerusalem since making Aliyah. Dr. Kovalski was with TEREM Emergency Medical Services for 21 years until June of 2014, and is now a private consultant on medicine and technology. Editor: Have you had your flu vaccination and pneumovax? I am aware that some people, for good reason, have different opinions and this article in no way is meant as a criticism. Everyone has the right to decide what is best for their family. http://blogs.timesofisrael.com/the-risk-of-vaccinations-and-other-ancient-myths/ The following is a shorter blog post than usual (thank G-d). It is my answer to a friend of a friend who does not believe in vaccinations, based on an article from the Internet. I have marked out the harsh language I initially used in my response, but I do leave the placeholders, so that you appreciate the emotion that I and so many doctors have about this issue. “I am more than aware of the naysayers about vaccinations. I can clearly not convince these naysayers otherwise, just as I cannot convince most UFOlogists that we are not regularly being visited by Hugh Jackman-look-alike aliens. Nevertheless, this is how I see things. And let me already say that doctors make mistakes. Sometimes fundamentals in medicine change. The LIKELIHOOD of that, with regards to vaccines is near to 0 (and nothing is ZERO). Vaccines have saved millions of lives over the decades. There are few things in medicine that are better proven than the effect of vaccines. The risk of vaccines is a tiny fraction of the benefits. Very few doctors fail to vaccinate their own children. The ones who don’t, are ostracized. Those who claim that vaccination leads to autism, seem to ignore the risk of severe brain damage and death that comes from the lack of vaccination. Measles caused Helen Keller to go blind and deaf. Polio killed millions and put more millions in wheelchairs and iron lungs because they were unable to breathe on their own. I also have children and all three are special needs, who after years of work, were able to integrate into regular schools. And I would rather that all have autism, instead of severe brain damage and death. If a patient does not trust a doctor in regards to the medical literature about vaccines, why does a patient trust a doctor when that same doctor prescribes antibiotics for an ear infection or says that there is no evidence of a heart attack or claims that the x-ray is within normal limits. The risk of errors in just the three things I noted is much higher than the risk from vaccines. I appreciate that understanding this point requires some basic understanding of statistics. So I would say to such a person, either learn statistics and basic epidemiology or shut the **** up and listen to your doctor. Those are the only two responsible things to do. And if the naysayer claims that they have studied epidemiology and have come to the conclusion that vaccines are unnecessary, then they are brain dead and there is nothing I can do for them. If a person decides that there is no need to vaccinate as long as everybody else vaccinates, that is exactly what led to the outbreak of measles in Disneyland. In other words, if you are going to be a selfish p***k, you definitely deserve what you get.” I suspect that some people will be offended by what I wrote. If these people are not vaccinating their children, then let them be offended. Also, let them be denied access to schools, public pools, public parks, Disneyland, any place with pregnant women or people with cancer and other immune diseases, and public work places and any other place where they pose a danger to others. Some things are just clear. Do you buckle your child into their special car seat? Do you know that these car seats can occasionally be the cause of severe injuries? Older men who father children increase the child’s risk of autism. Should we deny men over 40 from having children? Should doctors tell older men that it is cruel and irresponsible to have children? What about women who suffer depression? A recent study in JAMA Pediatrics demonstrated that “SSRI Use During Pregnancy [was] Associated with Autism Risk in Children”. Should we deny mothers with depression and mood disorders their medication? Is it better if these mothers harm themselves or others? Should doctors tell these mothers that it is cruel and irresponsible to have children? In another study from JAMA, it was shown that “In this large, multiethnic clinical cohort of singleton children born at 28 to 44 weeks’ gestation, exposure to Maternal Diabetes diagnosed by 26 weeks’ gestation was associated with risk of Autism in offspring.”. Should we deny diabetic mothers the right to have children? Should doctors tell diabetic mothers that it is cruel and irresponsible to have children? I could go on but if you really have not gotten the point by now, then please, put your tinfoil hat back on and wait for Hugh Jackman to come visit you. To those who listened, Thanks for listening. And to those who did not, you are not worth my breath, except for the fact that you boldly endanger other innocent people