What Kind of Flu Vaccine Is Right for You?

Aug 31, 2022

Know who should and should not get vaccinated

For some people, decisions around getting a flu vaccine may revolve around convenience—such as finding a place or a time in their schedules for a flu shot. Others may have age or health considerations that may cause them to wonder whether they should or can get vaccinated.

If you fall into the latter group—if you’re wondering, “Should I get a flu shot? Can I get a flu shot?”—you should talk to your doctor or another health care provider about your concerns. Regardless, it might help you to know that the Centers for Disease Control and Prevention (CDC) provides guidance as to who should and who should not receive an influenza vaccine.

As a general rule, the CDC recommends that everyone who is six months and older get a flu vaccine. There are a few exceptions, including anyone who has had a severe, life-threatening allergic response to any flu vaccine ingredient, not including egg proteins, as well as those who have had a severe allergic reaction to a flu vaccine.

Aside from this, there are recommendations for who should and should not get vaccinated according to the ways you can receive a flu vaccine—through a flu shot or a nasal spray vaccine.

Flu shot (injectable vaccines) recommendations

There are two different kinds of flu shots: Inactivated and recombinant vaccines, which are made using different vaccine technologies. Age can play a factor in whether you can have one or the other of these vaccines. For example, some standard-dose inactivated flu vaccines are approved for use in children who are six months old. Other vaccines are only available for use in adults. Make sure you get a flu vaccine that is appropriate for your age. According to the CDC, an adjuvanted flu shot or a higher dose flu shot is preferentially recommended over a standard-dose flu vaccine in adults 65 years and older.

Pregnant people, people with certain chronic conditions, and those who have egg allergies can get a flu shot. However, any known severe, life-threatening allergy to any flu vaccine ingredient (aside from egg proteins) means you should not get a vaccine with that ingredient. Also, if you’ve had a severe allergic reaction to a flu vaccine, you shouldn’t get that particular vaccine again—or, potentially, other flu vaccines. Make sure you consult a doctor or another health care provider for help in deciding which vaccine, if any, is appropriate for you.

You should also talk to your doctor before getting a flu shot if you have other medical considerations. These include an allergy to any flu shot ingredient or eggs; most people who have an egg allergy can get a flu shot, but they should still talk to a doctor before getting one. A history of Guillain-Barré Syndrome (a severe paralyzing condition), a past severe allergic reaction to a dose of any flu vaccine or even not feeling well in general—these are things that should prompt you to talk to your doctor before getting a flu shot, too.

Boy receives his flu shot from his doctor while mom looks on

Nasal spray flu vaccine recommendations

Nasal spray influenza vaccines are approved for use in those who are between two years and 49 years old. While many people—including those with egg allergies—can get this vaccine, some people need to avoid it.

According to the CDC, people who have had a severe or life-threatening allergic response to any ingredient (excluding egg proteins) in a nasal spray vaccine should not have this type of vaccine. This also applies to anyone who has had severe allergic reaction to any flu vaccine.

Based on CDC guidance, other people who should not receive a nasal spray vaccine include:

People who are pregnant
People between two and 17 years old who take medications made with aspirin or salicylate
People who are immunocompromised—a condition of having a weakened immune system—for any reason
Caregivers or others who are in close contact with severely immunocompromised people who must have a protected environment
One possible alternative would be avoiding contact with these immunocompromised people for seven days after getting the nasal spray vaccine
Children aged two to four years old who have asthma or a history of wheezing over the past 12 months
People who have leakage of cerebrospinal fluid (the fluid that surrounds the brain and spinal cord)
People with cochlear implants
People who have recently taken antiviral medications for influenza
The recommendation to not have a nasal spray flu vaccine may depend on the medication and when the last dose was taken

In addition, the CDC advises that certain people talk to a healthcare provider before getting a nasal spray flu vaccine, including:

Anyone with asthma aged 5 years and older
People who may be at higher risk of developing serious flu complications due to certain pre-existing medical conditions, such as chronic lung disease, heart disease (except for isolated high blood pressure), kidney disease, liver disorders, neurologic and neuromuscular disorders, blood disorders or metabolic disorders, such as diabetes
People who have moderate or severe acute illness, with or without a fever
People who have Guillain-Barré Syndrome after having had a flu vaccine

Many of the details discussed here relate to those who are at higher risk for serious flu complications. If you think you may be one of those people, you should take special care to protect yourself from the flu.

Read about risk factors for serious flu complications