Vaccines and LEMS

Many patients with an autoimmune disease such as Lambert-Eaton myasthenic syndrome (LEMS) may wonder whether it is safe for them to get vaccines.

What are vaccines?

Vaccines are treatments that stimulate your immune system to produce antibodies against disease. They usually contain either dead or weakened virus or bacteria, which cannot cause infection. Alternatively, they may contain only a small piece of a virus or bacterium rather than the whole germ. Your immune system will recognize this and generate antibodies against it.

The case of the flu vaccine

Some viruses, such as the flu virus, mutate very rapidly. As such, the strains a vaccine may protect against in one flu season may not be present in the next. At the end of the flu season, scientists try to predict which strains will be the most common in the next season and develop a new vaccine against these strains.

Are vaccines safe for LEMS patients?

Most vaccines are safe for people with LEMS, and doctors recommend the normal vaccination schedule for patients. However, if you are taking immunosuppressant medications, you should discuss with your doctor whether you need to change your vaccine schedule, as this type of medication may prevent you from developing a strong immune response following vaccinations.

Your doctor may recommend that you get the injected flu vaccine, instead of the inhaled version that contains a live but weakened virus. In people with a healthy immune system, this weakened virus cannot cause infection. However, it is a concern that people with compromised immune systems due to immunosuppressant medications, for example, may be able to get an infection from the weakened form of the vaccine. The injected flu vaccine contains a dead virus, which cannot cause infection.

A small study of myasthenia gravis and LEMS patients who received the tetanus vaccine indicated that the vaccine was safe and effective, and did not exacerbate symptoms in either patient group.

What about COVID-19 vaccines?

When a vaccine becomes available for COVID-19, the current recommendation is that LEMS patients should receive it. There is no data to date on COVID-19 cases among LEMS patients. However, it is a concern that weakness in the respiratory muscles may make LEMS patients more susceptible to dangerous breathing problems as a result of infection. As with other vaccines, LEMS patients should receive only those containing the dead (not weakened) virus when they become available to avoid the small risk of infection due to the vaccine.

Last updated: June 29, 2020

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