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Vaccination: Who Should Do It, Who Should Not and Who Should Take Precautions

Everyone 6 months and older is recommended for annual flu vaccination with rare exception. This page lists all people recommended to get the flu vaccine, who can and can’t get the flu shot or the nasal spray vaccine and who should take precautions or talk to their doctor or other health care professional before vaccination. Talk to your doctor or nurse if you have any questions regarding which flu vaccine options are best for you and your family.

All persons aged 6 months and older are recommended for annual vaccination, with rare exception.

Vaccination to prevent influenza is particularly important for people who are at high risk for serious complications from influenza. See People at High Risk of Developing Flu–Related Complications for a full list of age and health factors that confer increased risk.

The Flu Shot

People who can get the flu shot:

  • Different flu shots are approved for people of different ages, (see Note), but there are flu shots that are approved for use in people as young as 6 months of age and up. Flu shots are approved for use in pregnant women and people with chronic health conditions.

 

People who can't get the flu shot:

  • Children younger than 6 months 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.

Note: There are certain flu shots that have different age indications. For example people younger than 65 years of age should not get the high-dose flu shot and people who are younger than 18 years old or older than 64 years old should not get the intradermal flu shot.

 

People who should talk to their doctor before getting the flu shot:

  • If you have an allergy to eggs or any of the ingredients in the vaccine. Talk to your doctor about your allergy.
  • If you ever had Guillain-Barré Syndrome (a severe paralyzing illness, also called GBS). Some people with a history of GBS should not get this vaccine. Talk to your doctor about your GBS history.
  • If you are not feeling well. Talk to your doctor about your symptoms.

The Nasal Spray Vaccine

People who can get the nasal spray vaccine:

  • The nasal spray vaccine is approved for use in people 2 years through 49 years of age.

 

People who cannot get the nasal spray vaccine:

  • Children younger than 2 years
  • Adults 50 years and older
  • People with a history of severe allergic reaction to any component of the vaccine or to a previous dose of any influenza vaccine
  • People who are allergic to eggs
  • Children or adolescents (2 years through 17 years of age) on long-term aspirin treatment.
  • Pregnant women
  • People with weakened immune systems (immunosuppression)
  • Children 2 years through 4 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 care for severely immunocompromised persons who require a protective environment (or otherwise avoid contact with those persons for 7 days after getting the nasal spray vaccine).

 

People who should talk to their doctor before getting nasal spray vaccine:

There are also other “warnings and precautions” for the nasal spray flu vaccine. You should talk to your doctor if you have any of these:

  • Asthma: People of any age with asthma might be at increased risk for wheezing after getting the nasal spray vaccine.
  • A chronic condition like lung disease, heart disease, kidney or liver disorders, neurologic/neuromuscular, or metabolic disorders. The safety of the nasal spray vaccine has not been established in people with underlying medical conditions that place them at high risk of serious flu complications. See People at High Risk of Developing Flu–Related Complications.
  • If you ever had Guillain-Barré Syndrome (a severe paralyzing illness, also called GBS). Some people with a history of GBS should not get this vaccine. Talk to your doctor about your GBS history.
  • If you have gotten any other vaccines in the past 4 weeks, or if you are not feeling well.

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 6 months through 4 years (59 months);
  • People aged 50 years and older;
  • People with chronic pulmonary (including asthma), cardiovascular (except hypertension), renal, hepatic, neurologic, hematologic, or metabolic disorders (including diabetes mellitus);
  • People who are immunosuppressed (including immunosuppression caused by medications or by human immunodeficiency virus);
  • Women who are or will be pregnant during the influenza season;
  • People who are aged 6 months through 18 years and receiving long-term aspirin therapy and who therefore might be at risk for experiencing Reye syndrome after influenza virus infection;
  • People who are residents of nursing homes and other chronic-care facilities;
  • American Indians/Alaska Natives;
  • People who are morbidly obese (body-mass index is 40 or greater);
  • Health-care personnel;
  • Household contacts and caregivers of children younger than 5 years and adults aged 50 years and older, with particular emphasis on vaccinating contacts of children aged younger than 6 months; and
  • Household contacts and caregivers of people with medical conditions that put them at higher risk for severe complications from influenza.

Special Consideration Regarding Egg Allergy

People who have ever had a severe allergic reaction to eggs can get recombinant flu vaccine if they are 18 years through 49 years of age or they should get the regular flu shot (IIV) given by a medical doctor with experience in management of severe allergic conditions. People who have had a mild reaction to egg—that is, one which only involved hives—may get a flu shot with additional safety measures. Recombinant flu vaccines also are an option for people if they are 18 years through 49 years of age and they do not have any contraindications to that vaccine. Make sure your doctor or health care professional knows about any allergic reactions. Most, but not all, types of flu vaccine contain a small amount of egg. 

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