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Who Should and Who Should NOT get a Flu Vaccine

Who Should and Who Should NOT get a Flu VaccineThis page includes information on who should and who should not get an influenza vaccine, and who should talk to a health care professional before vaccination. Talk to your health care provider if you have any questions regarding which influenza vaccines are best for you and your family.

 

All persons six months of age and older are recommended for annual vaccination, with rare exception.

 

Vaccination is particularly important for people who are at high risk of developing serious flu complications.

 

 

Influenza (flu) shot

 

People who can get the flu shot:

  • Different flu shots are approved for people of different ages. Everyone should get a vaccine that is appropriate for their age.
  • There are inactivated influenza vaccines (IIV) that are approved for people as young as six months of age.
  • Some vaccines are only approved for adults. For example, the recombinant influenza vaccine (RIV) is approved for people aged 18 years and older, and the adjuvanted and high-dose inactivated vaccines are approved for people aged 65 years and older.
  • Pregnant women and people with certain chronic health conditions can get a flu shot.
  • Most people with egg allergy can get a flu shot.

 

People who SHOULD NOT get the flu shot:

  • Children younger than six months of age are too young to get a flu shot.
  • People with severe, life-threatening allergies to flu vaccine or any ingredient in the vaccine. This might include gelatin, antibiotics, or other ingredients. See Special Considerations Regarding Egg Allergy for more information about egg allergies and flu vaccine.

 

People who should talk to their health care provider before getting a flu shot:

If you have one of the following conditions, talk with your health care provider. He or she can help decide whether the vaccination is right for you, and select the best vaccine for your situation:

  • If you have an allergy to eggs or any of the ingredients in the vaccine. Talk to your doctor about your allergy. See Special Considerations Regarding Egg Allergy for more information about egg allergies and flu vaccine.
  • If you ever had Guillain-BarrĂ© Syndrome (a severe paralyzing illness, also called GBS). Some people with a history of GBS should not get a flu vaccine. Talk to your doctor about your GBS history.
  • If you are not feeling well, talk to your doctor about your symptoms.

 

 

Nasal spray flu vaccine

 

People who can get a nasal spray flu vaccine:

  • The nasal spray vaccine is approved for use in healthy non-pregnant individuals, two years through 49 years of age.

 

People who SHOULD NOT get a nasal spray vaccine:

  • Children younger than two years
  • Adults 50 years and older
  • Pregnant women
  • People with severe, life-threatening allergies to flu vaccine or any ingredients in the vaccine
  • Children two years through 17 years of age who are receiving aspirin- or salicylate-containing medications
  • People with weakened immune systems (immunosuppression)
  • People who care for or are close contacts of severely immunocompromised persons who require a protected environment (or otherwise avoid contact with those persons for seven days after getting the nasal spray vaccine)
  • Children two years through four years who have asthma or who have had a history of wheezing in the past 12 months
  • People who have taken influenza antiviral drugs within the previous 48 hours

 

People who should talk to their health care provider before getting a nasal spray vaccine:

If you have one of the following conditions, talk with your health care provider. He or she can help decide whether vaccination is right for you, and select the best vaccine for your situation:

  • People with asthma aged five years and older
  • People with other underlying medical conditions that can put them at high risk of developing serious flu complications. These include conditions such as chronic lung disease, heart disease (except isolated hypertension), kidney disease, liver disorders, neurologic and neuromuscular disorders, blood disorders, or metabolic disorders (such as diabetes).
  • People with moderate or severe acute illness with or without fever
  • People with Guillian-BarrĂ© Syndrome after a previous dose of influenza vaccine

 

 

Who should be prioritized for flu vaccination during a vaccine shortage

 

When vaccine supply is limited, vaccination efforts should focus on delivering vaccination to the following people (no hierarchy is implied by order of listing):

  • Children aged six months through four years (59 months)
  • People aged 50 years and older*
  • People with chronic pulmonary (including asthma) or cardiovascular (except isolated hypertension), renal, hepatic, neurologic, hematologic, or metabolic disorders (including diabetes mellitus)
  • People who are immunosuppressed due to any cause, including immunosuppression caused by medications or by human immunodeficiency virus (HIV) infection
  • Women who are or will be pregnant during the influenza season and women up to two weeks after delivery
  • People who are aged six months through 18 years who are receiving aspirin or salicylate-containing medications and who might be at risk for experiencing Reye syndrome after influenza virus infection
  • People who are residents of nursing homes and other long-term care facilities
  • American Indians/Alaska Natives
  • People with extreme obesity (body-mass index [BMI] is 40 or greater)
  • Health care personnel
  • Household contacts and caregivers of children under five years and adults aged 50 years and older
  • Household contacts and caregivers of people with medical conditions that put them at increased risk for severe illness and complications from influenza

 

*Among adults, complications, hospitalizations, and deaths due to influenza are generally most common among those 65 years old and over. However, adults 50 years and over are a priority group for vaccination because this group may be more likely to have chronic medical conditions that put them at high risk of severe influenza illness.

 

 

 

People with egg allergies can received any licensed, recommended age-appropriate influenza vaccine (IIV, RIV4, or LAIV4) that is otherwise appropriate. People who have a history of severe egg allergy (those who have had symptoms other than hives after exposure to egg) should be vaccinated in a medical setting, supervised by a health care provider who is able to recognize and manage severe allergic reactions. Two completely egg-free (ovalbumin-free) flu vaccine options are available: quadrivalent recombinant vaccine and quadrivalent cell-based vaccine.

 

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