High-risk persons have been defined as: (1) persons age 65 years or over; (2) persons who reside in nursing homes or chronic care facilities; (3) adults and children with chronic medical disorders such as heart or lung disorders, including children with asthma; (4) adults and children who required medical follow-up or hospitalization during the previous year because of diabetes and other chronic metabolic diseases, kidney dysfunction, blood problems such as sickle cell anemia, or immunosuppression such as with chemotherapy for cancer or the presence of HIV; (5) children and adolescents who are receiving long term aspirin therapy and who therefore may be at risk for developing Reye's Syndrome after a chickenpox or respiratory infection; (6) women who will be in the last 6 months of their pregnancy during flu season; and (7) health care workers.

Vaccination is also recommended for persons who are in close contact with people in high-risk groups, including household members. Vaccination is recommended in anyone over the age of 50. Influenza vaccine can also be given to anyone who themselves want to reduce the likelihood of acquiring influenza, such as healthy working adults who cannot afford to be ill for a week at home.

For the first time, it is recommended that children from the ages of 6 months to 23 months receive the influenza vaccine beginning in November since this age-group is particularly susceptible to developing pneumonia following an influenza infection. If a child is receiving the vaccine for the first time, the first shot should be given in October since a booster dose is required one month later (preferably November). Once a child has received their first vaccination series, in subsequent years they would only require one vaccination per year.

Optimal time for vaccination is from September through October for high-risk individuals, and November for the rest. One can receive the vaccination even after influenza activity is occurring in the community, which peaks between late December and early March, since it takes only 2 weeks to develop immunity. In essence, it is never too late to receive the vaccine.  People allergic to eggs are no longer prevented from receiving the vaccine unless they had a severe reaction.  Adverse reactions to the injection are mild.  Soreness at the injection site for two days is most common, although fever, muscle aches, and general malaise for one or two days may occur. You do not get influenza from a vaccination since there is nothing “alive” in the vaccine.

For the first time, there is a nasally administered vaccine, with the advantage obviously of not requiring a shot. It is at least three times as expensive ($10 to $15 for the shot, and $50 for the nasal vaccine) and is not covered by insurance, whereas the shot is covered for most people. There are many people who cannot receive the nasal vaccine, so please check with your physician to see if you are a candidate.

Influenza is usually a mild to moderate self-limiting respiratory illness, but high-risk individuals can have serious complications, including death.  Therefore, strongly consider receiving the vaccine. If you still have questions, speak to your health care provider regarding whether or not the influenza vaccine is indicated for you.