Getting a Flu Shot? Skip the Advil, Tylenol, for Mild Discomfort

Oct. 15, 2015

Each year during flu season we check in with URMC scientist Rick Phipps to find out if his evidence-based advice holds true—and it still does: It’s best to avoid common pain relievers after a flu shot because they can dilute the power of the vaccine.

Ibuprofen, aspirin and Tylenol dampen the production of necessary antibodies that protect the body against illness, Phipps said.pills and syringe

Many over-the-counter pain and fever-reducers are classified as nonsteroidal anti-inflammatories (NSAIDs), which act in part by blocking the cyclooxygenase-2 (cox-2) enzyme. But blocking the cox-2 enzyme is not a good idea in the context of vaccination, because the cox-2 enzyme is necessary for high production of B-lymphocytes.  When people take medications like Advil for discomfort at the injection site, Phipps said, they’re also inadvertently reducing the ability of B cells to make the antibodies that protect against the flu.

“Unless your healthcare provider tells you otherwise, it’s best not to take pain relievers one or two days before the flu vaccine and for a week afterward,” said Phipps, who added that some local pediatricians also have begun dispensing this advice during flu season.

What about low-dose aspirin? Individuals who take aspirin for cardiovascular or vascular disease should talk to their doctors before stopping even low-dose aspirin. And people who take medications such as Aleve or Celebrex for arthritis or other chronic pain also should consult their physicians.

Phipps, Ph.D., is the Wright Family Research Professor of Environmental Medicine with appointments in six other URMC departments including Medicine, Pediatrics, and Microbiology and Immunology. After studying the body’s immune response for years, he gained national attention in 2009 when he presented the flu data at a scientific meeting, and then published two scientific articles in the journals Vaccine and Immunology. Around the same time, researchers in Europe published data in The Lancet confirming that children who took Tylenol when they got a flu shot made fewer antibodies against influenza.

Phipps’ latest studies have taken a new direction. Publications in 2012 and 2014 showed that lipids derived from omega-3 fatty acids can bolster protective antibodies. In a new article accepted this week by the European Journal of Immunology, his data shows that these same omega-3 fatty acids reduce harmful IgE antibodies linked to allergy and asthma.