Flu Shots and Hospice Patients

Flu season begins in the fall and continues through spring, with most cases reported between December and February. The best way to prevent flu infection is to receive the flu shot, but many hospice and palliative care patients find themselves uncertain about getting one.

Many patients worry that the vaccine will actually give them the flu because of their already weakened immune systems, or they believe that they don't need one since they are already ill. The truth is, hospice and palliative care patients need flu shots perhaps more than any other group of people.

Flu Shot Recommendations

For the most part, the CDC recommends that everyone over the age of 6 months get a flu shot. People over the age of 65, or those with chronic diseases, or live in long-term care facilities or nursing homes are at an extra high risk for flu-related complications.

Hospice and palliative care patients are often over 50 years old, and have chronic medical conditions and weakened immune systems. Many are also living in some type of long-term care facility. This makes hospice and palliative care patients very high risk of contracting the flu virus.

The flu itself can range from mild to severe, and in some cases can lead to death. The risk of death from the flu is increased in people whose immune system cannot effectively combat the illness. For this reason, it's very important for hospice and palliative care patients, their caregivers, and their loved ones to get the seasonal flu shot.

Getting the Seasonal Flu Shot

Many hospice and palliative care patients can't physically make it to the flu clinic or their regular physician to get the flu shot. In these cases, it's best to talk with your hospice or palliative care nurse to make a plan for getting the vaccine. Many hospice agencies offer their patients the flu shot or will give one on request.

Hospitals and long-term care facilities almost always offer and encourage their patients to get the flu shot. If you are in the hospital and aren't offered a vaccine, it's perfectly appropriate to request one. The same goes for a long-term care facility. The more patients and staff that get vaccinated, the less likely it is a flu breakout will occur in those facilities.

Do I Have to Get the Vaccine?

You absolutely do not have to get the flu shot. It's always your decision whether or not to receive the flu shot. If you are still concerned about the flu vaccine negatively affecting your health, it is OK to decline it. However, it's still important for your caregivers, family and close friends to get the vaccine to prevent them from transmitting the flu virus to you.

Who Should Not Get the Vaccine?

There are some people who should not get the flu shot. These people include:

• Infants under 6 months of age
• Anyone with severe, life-threatening allergies to any ingredient in a flu vaccine (other than egg proteins)

Talk to your healthcare provider about getting the flu shot if you meet any of these criteria:

• Anyone who's had a previous severe allergic reaction to a flu vaccine
• Anyone with allergies to any ingredient in a flu vaccine (including egg proteins)
• Anyone with a current infection or fever
• Those with a history of Guillain-Barre Syndrome

Can I Get the Nasal FluMist Instead of the Shot?

FluMist is a live, weakened flu virus that is inhaled in the nose through a nasal spray. Because it contains a live flu virus, it is not recommended for anyone with a weakened immune system, or for anyone over 49 years old. For this reason, it's recommended that hospice and palliative care patients only receive the flu shot.

What's a Normal Reaction and What's Not?

Normal reactions to the flu shot include redness, tenderness, and swelling at the injection site. It is also normal to experience a low-grade fever (a temperature under 101 degrees), headache, muscle aches, and decreased energy.

Reactions that are not normal include:

• Difficulty breathing or wheezing
• Dizziness
• High fever
• Hives
• Swelling around the eyes or lips
• Rapid heartbeat
• Weakness

If you experience any abnormal reactions, contact your healthcare provider.