With the recent campaign to encourage vaccination against hepatitis B for people at risk of acquiring this disease, I have received a number of enquiries regarding the benefits and dangers of patients with CFS receiving the hepatitis B and other immunisations.

There can be no doubt that the hepatitis B and other vaccines (e.g. influenza, tetanus, typhoid, cholera) are an effective and important means of gaining protection against the specific diseases. However, we have observed in our experience in looking after patients with CFS, that a numbers of patients appear to have developed CFS immediately following an immunisation, and that some patients with CFS have developed a worsening of their symptoms after immunisation.

Consequently, when considering the potential benefits and risks of a particular immunisation, patients with CFS have this extra consideration of possible harm. There can be no simple guideline to the use of immunisation in patients with CFS. My approach is to weigh up the risks and benefits.

For example, I have been asked by a nursing sister who works in the operating theatre and who has CFS, whether she should be immunised against hepatitis B. The answer is yes she should, because the risk of acquiring hepatitis B from an accidental needlestick injury in the operating theatre is significant, hepatitis B is a serious disease and the vaccine is effective; all factors which outweigh the risk of worsening the CFS symptoms.

Similarly, with regard to immunisation against influenza, the vaccine is recommended for patients with serious, chronic lung, heart or liver disease, and in patients with CFS who also have one of these added conditions. I believe the influenza vaccine is appropriate.

The best approach may be to discuss the risks and benefits with your own doctor, perhaps informing him/her of the added issues for patients with CFS.

Reprinted from M.E. and You, Newsletter of the M.E./C.F.S. Soc. of N.S.W. Inc. Written by Dr. Andrew Lloyd.

Reprinted from Emerge, June 1990.