Who Should and Who Should not get a Flu Vaccine
Everyone 6 months and older is recommended for annual influenza vaccination, with rare exceptions. For the 2018-19 flu season, ACIP recommends annual influenza vaccination for everyone 6 months and older with any licensed, appropriate influenza vaccine (IIV, RIV4, or LAIV4) with no preference expressed for any one vaccine over another. Some vaccines are not recommended in some situations and health conditions, and some people should not receive influenza vaccines at all (though this is uncommon).
This page includes information on who should and shouldn’t get an influenza vaccine, and who should talk to their doctor or other health care professional before vaccination. Talk to your doctor or nurse if you have any questions regarding which influenza vaccines are best for you and your family.
All persons aged 6 months and older are recommended for annual vaccination, with rare exception.
Vaccination is particularly important for people who are at high risk for serious flu complications.
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 that are approved for people as young as 6 months of age.
- Some vaccines are only approved for adults. For example, the recombinant influenza vaccine is for people aged 18 years and older, and the adjuvanted and high-dose inactivated vaccines are for people aged 65 years and older.
- Flu shots are recommended for pregnant women and people with chronic health conditions.
People who SHOULD NOT get the flu shot:
- Children younger than 6 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 doctor before getting the flu shot:
If you have one of the following conditions, talk with your healthcare provider. He or she can help decide whether 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 Allergyfor more information about egg allergies and flu vaccine.
- 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.
People who can get the nasal spray flu vaccine:
- The nasal spray vaccine is approved for use in people 2 years through 49 years of age. It is an option for healthy, non-pregnant people in this age group.
People who SHOULD NOT get the nasal spray vaccine:
- Children younger than 2 years
- Adults 50 years and older
- Pregnant women
- People with a history of severe allergic reaction to any component of the vaccine or to a previous dose of any influenza vaccine
- Children 2 years through 17 years of age who are receiving aspirin- or salicylate-containing medications.
- People who are immunocompromised (those who have weakened immune systems)
- 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 protected environment (or otherwise avoid contact with those persons for 7 days after getting the nasal spray vaccine).
People who should talk to their healthcare provider before getting nasal spray vaccine:
If you have one of the following condition, talk with your healthcare 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 5 years and older.
- People with other underlying medical conditions that can put them at higher risk of serious flu complications. These include conditions such as chronic lung diseases, heart disease (except isolated hypertension), kidney disease, liver disorders, neurologic and neuromuscular disorders, blood disorders, or metabolic disorders (such as diabetes). See “People at High Risk of Developing Flu–Related Complications.”
- People with moderate or severe acute illness with or without fever.
- People with Guillain-Barré Syndrome within 6 weeks following a previous dose of influenza vaccine.
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 lung disease (including asthma), heart disease (except hypertension), and kidney, liver, neurologic, blood, or metabolic disorders (including diabetes mellitus);
- People who are immunosuppressed due to any cause (including immunosuppression caused by medications or by Human Immunodeficiency Virus infection);
- Women who are or will be pregnant during the influenza season and women up to two weeks after delivery;
- People who are aged 6 months through 18 years who are receiving aspirin or salicylate-containing medications 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 with extreme obesity (body-mass index [BMI] 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.
*Among adults, complications, hospitalizations, and deaths due to influenza are generally most common among those 65 years old and over. However, adults 50 years old and over are a priority group for vaccination because this group may be more likely to have chronic medical conditions that put them at higher risk of severe influenza illness.
People with egg allergies can receive 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 any symptom 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.