About Lupus

Infections, Vaccines and Lupus

Preventive Care Strategies: Living with Lupus-Infections and Vaccines

Bella Fradlis, MD
Attending Physician, Division of Rheumatology
Assistant Professor of Medicine, AECOM
Montefiore Medical Center, Jacobi Medical Center

With lupus, you are always at increased risk for infections. Though overactive, your body’s immune system is not always able to fight off truly foreign invaders such as bacteria and viruses. The body is so busy fighting itself that it forgets to fight infections. Also, medications that suppress the overactive immune system lower the body’s ability to attack these invaders, increasing the risk for infections.

What infections are people with lupus at risk for?

Common infections among people with lupus include:

  • Pneumonia, colds, flu
  • Urinary tract infections
  • Skin infections
  • Shingles

What can you do to prevent infections?

  • Try to stay away from people who have a cold or other contagious condition.
  • Wash your hands often to cut down transmission of infectious germs.
  • Make sure members of your family are up-to-date on recommended vaccines to reduce their risk of passing along an infection to you.
  • Stay on top of your own recommended vaccines; when possible get vaccines BEFORE you start taking an immunosuppressive medication.

What vaccines are recommended for people with lupus?

  • Annual flu vaccine shot -- It cannot give you the flu. Symptoms like achiness or low grade fever are actually signs that your body is reacting to the vaccine as a foreign substance, not that you are infected with the flu virus. However, live flu vaccine is NOT recommended for people with lupus.
  • Pneumonia shot -- Prevents complications from infection from most strains of pneumonia bacteria.

Other vaccines to talk about with your physician

  • Because shingles can be dangerous and people with lupus are at higher risk for shingles, the shingles vaccine is recommended if you are 50+, your lupus is well-controlled and if you are on none or LOW doses of immunosuppressive medications.
  • HPV (human papilloma virus) vaccine is recommended for people with stable lupus. It helps protect against cervical cancer, which is a greater risk for people with lupus.
  • Hepatitis B vaccine is recommended with stable lupus.

What vaccines are NOT recommended for people with lupus?

Dr. Fradlis emphasized that live vaccines such as those for measles, mumps, rubella, varicella, yellow fever and smallpox, are NOT recommended for potentially immunosuppressed patients (including those treated with glucocorticoids alone at doses equivalent to ≥20 mg/day of prednisone for more than two weeks). Click Here watch a previous presentation Dr. Fradlis gave about how to prevent infections and other complications of lupus.

This column is not meant to substitute for medical advice from your own healthcare provider – please talk to your doctor about recommendations for preventing lupus complications Dr. Bella Fradlis is an attending rheumatologist who divides her time between Jacobi and Montefiore medical centers, treating a variety of systemic rheumatologic conditions. She received her medical training at Stony Brook University School of Medicine. She then completed an internship year at Long Island Jewish Hospital and internal medicine residency training at Columbia University Medical Center – New York Presbyterian Hospital. Dr. Fradlis completed a clinical rheumatology fellowship at Columbia University Medical Center.