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Flu Risks and Chronic Conditions

Last Updated February 2024 | This article was created by familydoctor.org editorial staff and reviewed by Deepak S. Patel, MD, FAAFP, FACSM

Chronic health conditions can increase your risk of being hospitalized with influenza (the flu). A study by the Centers of Disease Control and Prevention (CDC) reported that severe illness from the flu is more likely among adults who have specific chronic medical conditions compared with those who do not. This is because chronic conditions may leave your body too weak to fight the flu.

The higher your risk of flu complications, the more important it is that you get an annual flu vaccine. It’s the best way to protect yourself from the flu.

Even though COVID-19 has taken focus away from the flu, it is just as important as ever to protect yourself from the flu. Flu pandemics have come and gone for hundreds of years. Several strains of the flu virus circulate each year. A flu shot is your best defense.

People at high risk for flu complications include those with these chronic conditions, according to the CDC:

  • Asthma
  • Blood disorders (such as sickle cell disease)
  • Chronic lung disease (such as chronic obstructive pulmonary disease [COPD] and cystic fibrosis)
  • Diabetes
  • Endocrine disorders (such as diabetes)
  • Heart disease (such as congenital heart disease, congestive heart failure, and coronary artery disease)
  • Kidney diseases
  • Liver disorders
  • Obesity (with a body mass index (BMI) of 40% or higher)
  • History of stroke

Not only can having a chronic condition put you at high risk for serious flu complications, it also can make your chronic condition worse. This is true even if your condition is well-managed.

Path to improved health

You should get the flu vaccine as soon as it becomes available each fall. You also can get it any time throughout the flu season (usually until March). For some populations, it’s best to get it in the fall so that the vaccine can protect you throughout the flu season (about 6 months) but most adults under 65 with no chronic conditions can get it as early as July or August. In the United States, flu activity peaks between December and February. The vaccine is available by shot or by nasal spray (LAIV4). The CDC recommends that people who have chronic conditions or people over 50 years of age get the flu shot, not the nasal spray flu vaccine.

The vaccine can reduce the chance of hospitalization by 40% and the risk of admission to the intensive care unit (ICU) by 82% for people who have chronic conditions, according to the CDC.

Flu vaccines work by exposing your immune system to an inactive (killed) form of the flu virus. Your body will build up antibodies to the virus to protect you from getting the flu. The nasal spray vaccine contains active but weakened viruses. You cannot get the flu from the flu shot or the nasal spray vaccine.

If you are 65 years of age or older, the CDC recommends that you get either a high-dose flu shot, an adjuvanted flu, or a regular shot. The high-dose and adjuvanted shots are designed especially for this age group.

Vaccine safety

The flu vaccine is safe. There are very few side effects. After receiving the flu shot, your arm may be sore for a few days. You may have a low-grade fever, feel tired, or have sore muscles for a short time. If you received the nasal spray vaccine, you may have a runny nose, headache, cough, or sore throat. It is safe to get your flu shot at the same time as another vaccine on the same visit.

Where can I get a flu shot?

There are many places that offer flu shots. Where you decide to get a flu shot will likely depend on location and cost.

Flu shots are available from your family doctor, from national pharmacies (such as CVS and Walgreens), at clinics, community health centers, urgent care centers, public health departments, colleges (free for students), some employers, and more.

Cost for the flu shot ranges from free to around $50, depending on whether you have insurance (private insurance, Affordable Care Act, Medicare Part B). If you do have insurance, most of the places listed above will offer you a flu shot at no cost to you.

If you do not have insurance, look for places offering discounted flu shots. Many national pharmacies offer coupons or other discounts for flu shots. Prices vary widely, so shop around. It can mean paying $19 or more than twice that. Look for online coupons, as well, or look for cost comparisons on GoodRx. Also, be prepared to pay up front before receiving the flu vaccination.

If you want help sorting out where to find a flu vaccine near you, there are online tools that can help. Try looking on vaccines.gov. It uses zip codes to help you narrow the search.

Who should get the flu shot?

Who should get the flu shot?

Who should get the flu shot?

Things to consider

Complications from the flu can be lethal. If you have any of these emergency warning signs of flu sickness, you should seek medical care right away.

  • Difficulty breathing/shortness of breath
  • Chest pain/pressure that doesn’t go away
  • Dizziness or confusion
  • Seizures
  • Not urinating
  • Severe muscle pain
  • Severe weakness or feeling unsteady
  • Fever or cough that improve but then return or get worse
  • Worsening of your chronic health condition

There are some people who should ask their doctor before getting a flu shot:

  • People who have had a severe allergic reaction to a flu vaccine in the past
  • People who previously developed Guillain-Barré Syndrome (a reversible reaction that causes partial or complete loss of movement of muscles, weakness, or a tingling sensation in the body) within 6 weeks of getting a flu vaccine

Note: Children younger than 6 months of age should not get a flu shot.

Questions to ask your doctor

  • Can I get the flu vaccine?
  • How do I know if I have the flu?
  • Am I at higher risk for flu complications?
  • What else can I do to protect myself from the flu?
  • What should I do if I have the flu?
  • Is it too late for me to get the flu shot?
  • Can I get the flu shot if I’m not feeling well?
  • Are there any vitamins of herbal remedies for the flu?

Resources

Familydoctor.org Flu Vaccine Booklet

Centers of Disease Control and Prevention: People at High Risk for Flu Complications

Vaccinate Your Family

 

This content is supported by an unrestricted grant from AstraZeneca Pharmaceuticals LP.

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