Getting a flu vaccination this winter Getting a flu vaccination this winter - prevention is better than cure. Getting flu is a thoroughly miserable experience. However, if you are steroid-dependent, the consequences can be very serious, with around a quarter of adrenal crises requiring hospital admission resulting from flu-like illnesses (ADSHG member survey 2013). Fortunately, flu can be prevented – and surely, prevention is better than cure? The NHS offers free of charge flu vaccinations to people with long-term health conditions which can be exacerbated by having the flu. As people with Addison’s disease are steroid- dependent and can become very unwell and even develop an adrenal crisis if they get the flu, they fall into this group and we would encourage people to take advantage of this over the coming months. In addition, an annual flu vaccination is important because, while replacement dose steroids do not suppress the immune response, it seems that primary adrenal insufficiency may be associated with impaired function of natural killer cells. These immune system cells are crucial in fighting viruses. This means that people with Addison’s disease may not be able to mount as robust a response to viral illness as people without Addison’s. I admit that having a flu jab will probably give you a sore arm – unless you are offered the nasal spray that is made available to paediatric patients. Occasionally, it can also make you feel a little under the weather for a couple of days afterwards. In addition, it is impossible to engineer a ‘flu vaccine that prevents all strains of ‘flu in all people, so having a flu vaccination does not guarantee 100% that you will not get ‘flu. However, the flu vaccine is safe and can prevent a very nasty illness. So, don’t delay - make your appointment soon! Dr Anna Mitchell, Clinical Academic Intermediate Fellow, Institute of Genetic Medicine, Newcastle University & Honorary Consultant in Endocrinology, Newcastle University. You can book an appointment to have your annual flu vaccination either at your GPs or at your local pharmacy. For more information, our ADSHG Clinical Advisory Panel have put together guidance about the flu vaccination in our 'Managing Your Addison's' leaflet which you can download for free here.