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Should I Get a Flu Shot?

The flu shot is recommended for most people with cancer and cancer survivors.

The flu shot is a type of flu vaccine (vak-seen). Flu vaccines cause the body to make antibodies that protect it against flu (influenza) virus infection.

In most people, the flu causes body aches, fever, tiredness, and cough. In young, healthy adults, it’s usually not life-threatening and is gone within 2 weeks. But cancer patients and survivors are more likely to have serious problems if they get the flu, as are people over 65 and those with lung disease, heart disease, and other medical problems. They are more likely to end up in the hospital or might even die from flu-related problems.

It’s best to get the flu shot as soon as it’s available, or before December. But first talk with your cancer doctor (oncologist) about if and when you should get a flu shot. Flu vaccines cause the body to make antibodies that protect it against influenza virus infection. It takes up to 2 weeks after the shot for the body to do this. This is why you should get the flu shot as soon as you can – so your body has time to form the protection you need.

Can I get a flu shot during cancer treatment?

People getting cancer treatment (radiation or chemotherapy) often have weak immune systems. For them, the flu can lead to serious, even life-threatening problems.

Many people with cancer worry that the flu shot will make them sick or react with other medicines they are taking. Talk to your cancer doctor about this – he or she knows your situation best.

Some people do get mild symptoms, such as a low-grade fever or achy muscles, after a flu shot. These symptoms are caused by the immune system’s response to the flu shot and should go away in a day or so. The flu shot cannot cause the flu.

The Center for Disease Control and Prevention (CDC) recommends that people who live with or care for a person at high risk for flu-related problems get the flu shot, too. This means that if you are being treated for cancer, your family members, caregivers, and children at home should get the flu shot.

Remember that a few people who are allergic to chicken eggs might have an allergic reaction to flu shots. Talk with your doctor about your reactions to eggs and any other allergies you have before you get the flu shot.

What types of flu vaccines are recommended for people with cancer?

People with cancer have to be careful about the type of flu vaccine they get. There are 2 main forms of flu vaccines:

  • Live vaccines are made of weakened live virus and given as a nasal spray – people with cancer should NOT get this.
  • Inactivated vaccines are made of dead virus. They are given as shots or injections. This includes the intradermal flu vaccine (see below).

People with cancer should get the inactivated flu shots, NOT the nasal spray. Even a very weak live virus might cause illness in a person with immune system damage from cancer treatment. Family members of a person with cancer can safely get the nasal spray unless the patient needs extra protection from germs. For example, household members should not get the nasal spray if a family member recently got a stem cell or bone marrow transplant or is getting high-dose chemotherapy.

Can I get the intradermal flu shot?

This flu shot is an option for adults with cancer who are 64 and younger. It was approved in 2011. A much smaller needle is used to inject the vaccine into the skin instead of the muscle. Like the other flu shots, this one is made from inactivated (dead) virus.

Should I get the high-dose flu shot for older people?

Approved in late 2009, Fluzone High-Dose® is a flu shot made for people who are 65 or older. Because the high-dose shot is an inactivated vaccine, most people with cancer can get it.

Immune defenses become weaker with age, which can lessen the body’s immune response to a flu shot. This means the standard flu shot may not work as well in older people.

The higher-dose shot is designed to boost immune response to better protect against flu. Even though the immune response looks better on lab tests, it’s not yet certain that this vaccine will prevent more influenza. Studies are still being done.

If you are 65 or older, ask your doctor if this is something you should try.

I had cancer, but I have no signs of cancer now. Is it still dangerous for me to get the flu?

Yes. If you have had cancer, you might have a higher risk of serious problems if you get the flu, even if you are cancer-free now. Talk to your doctor about getting a flu shot.

Are cancer patients and survivors more likely to get the flu than other people?

No one knows for sure if cancer patients and survivors are more likely than others to get the flu. But they are at greater risk for having serious problems from the flu. Even if cancer patients have the same risk of getting the flu, once they get any type of flu they are at higher risk of complications.

Why do I need a flu shot every year?

The flu shot is a seasonal vaccine. This means it’s changed as needed to protect against the flu viruses that look like they will cause the most illness that year.

You cannot count on any former flu vaccines, including last year’s flu vaccine or the 2009 H1N1 flu vaccine to protect you against this year’s flu.

People are more likely to be exposed to influenza and get the flu during the flu season. In the US this is usually from October to May, peaking in January and February, but it can start earlier. Most doctors recommend that people get the flu shot as soon as it’s available, or before December.

What can I do to protect myself from the flu?

The best way to keep from getting the flu is to get a flu shot. For extra protection, encourage everyone in your household older than 6 months to get a flu vaccine, too. This lessens their chance of illness, and lowers the risk they will bring the flu home to you.

All types of flu are spread the same way. Even if you haven’t yet had the flu shot, there are things you and others can do to help prevent spreading flu viruses and many other germs.

  • Wash your hands often. Use soap and warm water or alcohol-based cleaners or wipes.
  • Do not touch your eyes or nose. Keep your fingers away from your mouth.
  • Cover your mouth and nose with a tissue when you cough or sneeze. Then throw the tissue in the trash and wash your hands.
  • Try to stay away from sick people. At least 6 feet is thought to be a safe distance (except for chickenpox and tuberculosis, which can travel on air currents).
  • Try to stay away from small children who spend their days in group settings like day care or school – germs spread easily in these places.
  • Be ready just in case you do get sick. Have the things you might need at home (food, tissues, hand cleaners, medicines for cough and fever, and so on) so that you won’t have to go out to get them.
  • Take care of yourself. Follow public health advice about outbreaks, like school closings and avoiding crowds.
  • Certain strains of flu affect mainly pigs, but can be passed from pigs to humans. Avoid close contact with pigs, and stay away from swine barns if you go to a fair.

In some cases, prescription flu medicines and anti-viral drugs can be used to try to prevent the flu in someone who has just been near someone with it. They can also be used to treat people who recently have been infected. (See the sections called “Can the flu be treated if I already have symptoms?” and “When should cancer patients and survivors get anti-viral drugs to prevent the flu?” for more on this.)

What else can I do to be prepared for the flu?

Plan with your doctor ahead of time what to do if you get sick. Talk with your doctor about:

  • What symptoms should prompt a call to the doctor
  • Whether you should get anti-viral medicine if you get flu
  • How to get a prescription for anti-viral medicine quickly if you need it
  • Making sure your vaccines are up to date

Keep a written record of these important facts in a place you can find them quickly:

  • The type of cancer you have or have had
  • Cancer treatments you’ve had and when you had them
  • The name and contact information for all your doctors
  • A complete list of medicines you are taking

What are the symptoms of flu?

The flu is not just a very bad cold. Common flu symptoms include:

  • Fever
  • Cough
  • Sore throat
  • Runny or stuffy nose
  • Body aches
  • Headache
  • Chills
  • Fatigue (tiredness)

You can have some or all of these symptoms. A few people may have vomiting and diarrhea as well.

Many doctors offer quick tests that use a sample from your nose or throat to find out if you have the flu. The tests work best if they are done within a day or 2 of the start of symptoms. So if you think you have the flu, call your doctor right away.

When should cancer patients and survivors get anti-viral drugs to prevent the flu?

If you have been within 6 feet of someone known or suspected to have the flu, and you:

  • Have had cancer treatment like chemo or radiation within the last month

OR

  • Have a blood or lymph cancer (such as leukemia, lymphoma, or myeloma)

Call your doctor right away. Your doctor may give you anti-viral drugs to help keep you from getting the flu.

Can I take anti-virals if I already have flu symptoms?

Prescription flu medicines like Tamiflu® and Relenza® can be used to treat and prevent the flu.

Other prescription anti-viral drugs can also be used. They work by keeping the virus from reproducing in your body. They can make the flu symptoms milder and can help you feel better faster. They can also help keep the infection from causing severe problems.

Anti-viral drugs work best if they are started within 2 days after getting sick, so don’t wait.

If you are a cancer patient or survivor, and you think you have the flu, follow these steps:

  • Contact your health care provider and follow his or her instructions.
  • Stay home and away from others as much as possible to keep from making them sick. Avoid public activities like work, school, travel, shopping, social events, and public gatherings. Stay home for at least 24 hours after your fever is gone (without the use of fever-reducing drugs). Only go out to get medical care or other things you must have.
  • If you need to go to the doctor, emergency room, or any other health care facility, let the staff know right away that you’re there because you think you may have the flu. They may have you cover your mouth and nose with a face mask. If not, cover your mouth and nose with a tissue when you cough or sneeze.

To learn more

More information from your American Cancer Society

Here is more information you might find helpful. You also can order free copies of our documents from our toll-free number, 1-800-227-2345, or read them on our website, www.cancer.org.

Infections in People With Cancer

After Diagnosis: A Guide for Patients and Families (also in Spanish)

Coping With Cancer in Everyday Life (also in Spanish)

National organizations and websites*

Centers for Disease Control and Prevention (CDC)
Toll-free number: 1-800-232-4636 (1-800-CDC-INFO)
Website: www.cdc.gov/cancer/flu/#1

    Has information on flu and flu vaccines for people with cancer.

Website: www.cdc.gov

    Has up-to-date information on influenza and flu vaccines, including side effects and which types can be used for people with serious illness.

*Inclusion on this list does not imply endorsement by the American Cancer Society.

No matter who you are, we can help. Contact us anytime, day or night, for information and support. Call us at 1-800-227-2345 or visit www.cancer.org.

References

Centers for Disease Control and Prevention (CDC). Cancer, the Flu, and You: What Cancer Patients, Survivors, and Caregivers Should Know About the Flu. Accessed at www.cdc.gov/cancer/flu/#1 on July 26, 2013.

Centers for Disease Control and Prevention (CDC). Estimating Seasonal Influenza-Associated Deaths in the United States: CDC Study Confirms Variability of Flu. Accessed at www.cdc.gov/flu/about/disease/us_flu-related_deaths.htm on July 26, 2013.

Centers for Disease Control and Prevention (CDC). Intradermal Influenza (Flu) Vaccination. Accessed at www.cdc.gov/flu/protect/vaccine/qa_intradermal-vaccine.htm on July 26, 2013.

Centers for Disease Control and Prevention (CDC). Key Facts about Influenza (Flu) & Flu Vaccine. Accessed at www.cdc.gov/flu/keyfacts.htm on July 26, 2013.

Centers for Disease Control and Prevention (CDC). Key Facts About Seasonal Flu Vaccine. Accessed at www.cdc.gov/flu/protect/keyfacts.htm on July 26, 2013.

Fiore AE, Fry A, Shay D, et al; Centers for Disease Control and Prevention (CDC). Antiviral Agents for the Treatment and Chemoprophylaxis of Influenza: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2011;60(1):1-24. Accessed at www.cdc.gov/mmwr/preview/mmwrhtml/rr6001a1.htm?s_cid=rr6001a1_w on July 26, 2013.

Fiore AE, Uyeki TM, Broder K, Finelli L, et al; Centers for Disease Control and Prevention (CDC). Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2010. MMWR Recomm Rep. 2010;59(RR-8):1-62. Accessed at www.cdc.gov/mmwr/preview/mmwrhtml/rr5908a1.htm?s_cid=rr5908a1_w on July 26, 2013.


Last Medical Review: 08/12/2013
Last Revised: 08/12/2013