Researchers compared 54 patients with lupus and 54 without. They found that people with the condition had a diminished response to the vaccine because their immune systems are weaker.

But study author Albert Holvast, MD, a rheumatologist and clinical immunologist at the University Medical Center Groningen in The Netherlands, stresses that while they did find a decrease in immune 
response to vaccinations in lupus patients, it was a partial decrease and only observed in a minority of lupus patients.

“A large number of lupus patients displayed a response to vaccination that met criteria that correlate to clinical protection from flu,” Dr. Holvast explains. “Our advice is to still take the vaccine. It is of importance that a majority of patients do show a response to vaccination. It can be expected that a flu vaccination will decrease the number of flu infections, and that it will make infections which occur despite vaccination more mild.”

Dr. Janoff agrees. He says the bottom line is that you don’t need to be afraid just because you are taking immunosuppressants.

“There’s a risk to this virus just like there’s a risk to viruses every year,” Dr. Janoff says. “But people in this target group know how they respond to colds and flus in the past and they need to take care of themselves to prevent getting sick.”

“There are definitely things they can do to modify their risk of getting it,” he adds. “I think people have a lot of control – more than they think. They’re not just out there as susceptible victims.”

Does it matter if I get the vaccine in a shot or as a nasal spray?

Yes. The nasal spray (sold as FluMist) contains live, but weakened, flu viruses, and it is not recommended for people who take medications that suppress the immune system, pregnant women, anyone younger than age 2 or older than age 49.

Flu shots contain flu viruses that have been killed, so they are safer for people who have less immune function.

How many vaccines do I need this year?

The CDC has estimated that a vaccine for the H1N1 strain will be ready by mid-October. Currently, officials think most people may need two doses of the vaccine, given 3-4 weeks apart, to get adequate protection. But that position may soon change.

New studies released on Sept. 10, 2009, by The New England Journal of Medicine, indicate that just one dose of the vaccine provides adequate protection. That’s good news for the needle-phobic and anyone hoping to get in on the first doses, since there should be more vaccine to go around.

Currently, the CDC is recommending the H1N1 vaccine for pregnant women, health care workers and emergency responders, people caring for children under 6 months of age, children 6 to 24 years of age, and adults 25 to 65 with underlying medical conditions ­– such as rheumatoid arthritis and lupus, asthma and diabetes.

The vaccine for seasonal influenza is available now, and it is recommended for children ages 6 months to 19 years, pregnant women, adults over age 50, adults who have chronic medical conditions, seniors in nursing homes or long-term care facilities, health care workers, and people who take care of anyone who is at risk for complications of the flu.

As health officials suspected, however, the seasonal influenza vaccine doesn’t offer any protection against the H1N1 virus, so if you’re at risk for both of them, you’ll need both vaccines. Keep in mind that they take about three weeks to be fully effective, so be sure to take other precautions, like washing your hands frequently, in the meantime.

Can I get both vaccines at the same time?

The CDC says it is safe to get them both at the same time, but they should be given on different sides of the body (i.e. one in the right arm and one in the left).

Will the vaccine contain preservatives?

The CDC says that manufacturers will make flu vaccines with and without the preservative thimerosal, a mercury-containing compound that has been the source of controversy in recent years because of concerns that children exposed to too much mercury may develop neurological problems, including autism. 

The CDC stresses that there is no evidence that thimerosal can harm pregnant women or fetuses, but the agency says manufacturers will make preservative-free versions, packaged as single-dose syringes, for those who want them.