Who Should Not Get a Flu Shot

The Centers for Disease Control and Prevention (CDC) recommends that pretty much everyone get a flu shot. However, there are certain groups of people for which this is not advised, or who at least need to discuss the pros and cons with their healthcare providers. For these people, the vaccine may pose significant risks and even be life-threatening.

Given the fact that the flu shot is the most effective method of preventing infection, it's important to know if you truly fall into a group for which the vaccination is not advised—and if you don't, to commit to getting your flu shot each year for your own protection and that of those around you.

Contraindications

The following individuals should not get a flu shot:

  • Infants younger than 6 months old: Babies do not yet have a fully functioning immune system that is able to produce the desired response from the vaccine.
  • Those who have had a previous life-threatening allergic reaction to the flu vaccine or its components (such as gelatin or antibiotics)
  • Anyone with a very high fever or who was recently admitted to the hospital at the time of vaccination (Later vaccination may be appropriate.)

Possible Contraindications

If you have any of the following conditions or circumstances, discuss the pros and cons of the flu vaccine with your healthcare provider before you get it:

Also be sure to tell your doctor if you are feeling ill at the time of your flu shot appointment and what symptoms you have. Postponing your vaccination may be advised.

The flu vaccine is considered safe for pretty much everyone else, but if you have concerns or questions, discuss them with your healthcare provider.

Other Health Concerns

If you are managing a chronic health condition or are otherwise concerned about your overall health, you may wonder if the flu vaccine is right for you.

Unless you fit into the above categories for which flu vaccination is/may be contraindicated, you might be one of the people who needs the flu shot the most.

If you are in a high-risk group, getting the seasonal flu vaccine is important as you may develop a severe complication from a bout of influenza.

High-risk conditions and groups include:

  • Older adults and elderly: As you age, your immune system weakens and is less able to mount a defense against the influenza virus, putting you at risk of severe complications. The majority of hospitalizations and deaths from the seasonal flu are those age 65 and over.
  • Children: Children younger than 5 years old, and especially those younger than 2 years old, are in the high-risk group for flu complications. These result in as many as 25,000 hospitalizations in a flu season for those under age 5, and over 150 deaths. Children with neurologic conditions are at even greater risk.
  • Asthma: Even if you have well-controlled asthma, you have sensitive airways and the influenza virus can provoke a severe asthma attack or pneumonia. It is the most common factor in children hospitalized for influenza, and a leading factor in adult hospitalizations for influenza.
  • Heart disease: Almost half of the adults hospitalized for influenza complications in the 2018 to 2019 flu season had heart disease. Having heart disease increases the risk of flu complications, and influenza raises the risk of having a heart attack or stroke.
  • Pregnancy: During pregnancy and immediately after giving birth, your immune system has been altered in ways that lead to an increased risk of flu complications. As well, if you get a high fever from the flu, it can harm the developing fetus.
  • Cancer: You are at higher risk for flu complications if you currently have cancer or were treated in the past for leukemia or lymphoma. You are more likely to have a weakened immune system due to cancer treatments or the effects of cancer itself.
  • People in long-term care facilities, nursing homes, and hospice: People in these facilities are at higher risk of flu complications, and influenza has been known to spread easily through these facilities.

Vaccinating for Others

While some people are medically advised not to get a flu shot, others choose not to get one for personal reasons such as a fear of needles or unfounded concerns over ingredients like thimerosal. Some opt not to get a flu vaccine simply because they believe "they never get sick" or that they are healthy enough to easily bounce back if they get they become infected.

It is true that flu vaccines do not provide 100% protection from the flu for everyone that gets one. Most years, the flu vaccine is 40% to 60% effective. Still, despite their relatively low prevention rate, they are still the best option to protect yourself from the flu.

Remember that getting the flu vaccine also helps protect those around you, which is especially important for individuals at high risk of complications and those for whom a flu shot is contraindicated.

Among those who are especially recommended to get a flu vaccine not just for their own benefit, but the protection it can provide those they interact with are caregivers of infants, adults over age 65, cancer patients, or anyone else in a high-risk group.

Those who work in big-group settings (schools, daycare centers, nursing homes, hospitals, etc.) should also be sure to get vaccinated.

Staying Healthy During Flu Season

If you are unable to get a flu shot (and even if you are), double-down on other prevention strategies that can go a long way in helping you stay well:

  • Wash your hands: Other than getting a flu vaccine, washing your hands frequently is the single most effective thing you can do to prevent the flu and stay healthy. Make sure you are doing it properly, so you get the full benefit and actually get the germs off your hands.
  • Avoid touching your face as much as possible: If you touch your face, eyes, nose, or mouth after you have touched anything that has germs on it (doorknob, computer keyboard, phone, another person, etc.), you are introducing those germs into your body.
  • Steer clear of sick people: As much is realistic, keep your distance if someone around you is exhibiting symptoms of a cold or the flu.

If you do notice symptoms that you think could be caused by influenza, talk to your doctor right away—especially if you are at high risk for complications from the flu or you live with someone who is. Antiviral medications can be prescribed to reduce the severity of your symptoms and the duration of your illness, as well as reduce the chance that you pass it to someone else.

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Article Sources
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  2. Centers for Disease Control and Prevention. People 65 years and older and influenza. Updated November 21, 2019.

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  6. Centers for Disease Control and Prevention. Pregnant women and influenza. Updated December 20, 2019.

  7. Centers for Disease Control and Prevention. Cancer and flu. Updated November 19, 2019.

  8. Doyle JD, Chung JR, Kim SS, et al. Interim Estimates of 2018-19 Seasonal Influenza Vaccine Effectiveness - United States, February 2019. MMWR Morb Mortal Wkly Rep. 2019;68(6):135-139. doi:10.15585/mmwr.mm6806a2

  9. Liu M, Ou J, Zhang L, et al. Protective Effect of Hand-Washing and Good Hygienic Habits Against Seasonal Influenza: A Case-Control Study. Medicine. 2016;95(11):e3046. doi:10.1097/MD.0000000000003046

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