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Should I Get a Flu Shot?

The flu shot is recommended for most people with cancer and cancer survivors. Their family members are encouraged to get flu shots, too.

The flu shot is a type of flu vaccine. 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. (The section called “What are the symptoms of flu?” covers this in more detail.)

In young, healthy adults, the flu is seldom life-threatening and often 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, preferably by October. 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?

Yes, people getting cancer treatment (for instance, radiation or chemotherapy) should get a flu shot. Treatment often causes them to have weak immune systems, which puts them at higher risk of serious and even life-threatening problems if they get the flu.

Many people with cancer worry that the flu shot will make them sick or react with other drugs 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 muscle aches, 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’re 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 a 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 whose immune system is weak 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. (These treatments greatly weaken the immune system.)

Can I get the intradermal flu shot?

Yes, this flu shot is an option for adults ages 18 to 64, including those with cancer. It was approved in 2011. A much shorter needle is used to inject the vaccine just under the skin instead of into 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?

Yes. Because the high-dose shot is an inactivated vaccine, it’s an option for most people with cancer who are 65 and older.

The Fluzone High-Dose® was created for older people because immune defenses tend to 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 high-dose shot is designed to boost immune response to better protect against flu.

If you are 65 or older, ask your doctor if the high-dose flu shot 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’ve 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 we do know that they’re at greater risk for having serious problems if they do get the flu.

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 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. The timing can vary, but in the US flu season is usually from October to May, peaking in January and February. Most doctors recommend that people get flu shots as soon as they’re available, preferably by October.

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 [TB], 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 so that you can stay home. 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 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’ve recently 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?

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

  • What symptoms should prompt a call to the doctor
  • Whether you should get an anti-viral drug if you get flu
  • How to get a prescription for an anti-viral drug 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
  • Extreme tiredness

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

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

Call your doctor right away. Your doctor may give you a prescription for anti-viral drugs to help keep you from getting the flu – especially if you have not gotten a flu shot – and it’s best if the drug is started within 48 hours of exposure.

Can I take an anti-viral drug if I already have flu symptoms?

Yes, prescription anti-viral drugs can be used to treat the flu. People with cancer and cancer survivors should call their doctor right away if they start to have flu symptoms (see “What are the symptoms of flu?”).

These drugs 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’s more information you might find helpful. You 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

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/

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

Website: www.cdc.gov/flu/index.htm

    Has up-to-date information on seasonal flu and flu vaccines.

*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/ on July 16, 2014.

Centers for Disease Control and Prevention (CDC). Flu Symptoms. Accessed at www.cdc.gov/cancer/flu/symptoms.htm on July 17, 2014.

Centers for Disease Control and Prevention (CDC). Fluzone High-Dose Seasonal Influenza Vaccine Questions & Answers. Accessed at www.cdc.gov/flu/protect/vaccine/qa_fluzone.htm on July 16, 2014.

Centers for Disease Control and Prevention (CDC). Influenza Antiviral Medications: Summary for Clinicians. Accessed at www.cdc.gov/flu/professionals/antivirals/summary-clinicians.htm#recommended on July 17, 2014.

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 16, 2014.

Centers for Disease Control and Prevention (CDC). Preventing the Flu: Good Health Habits Can Help Stop Germs. Accessed at www.cdc.gov/flu/protect/habits.htm on July 16, 2014.

Centers for Disease Control and Prevention (CDC). The Flu: What To Do If You Get Sick. Accessed at www.cdc.gov/flu/takingcare.htm on July 17, 2014.

Centers for Disease Control and Prevention (CDC). What You Should Know About Flu Antiviral Drugs. Accessed at www.cdc.gov/flu/antivirals/whatyoushould.htm on July 17, 2014.

Centers for Disease Control and Prevention (CDC). What You Should Know for the 2014-2015 Influenza Season. Accessed at www.cdc.gov/flu/about/season/flu-season-2014-2015.htm#recommendations on July 16, 2014.

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 on July 17, 2014.


Last Medical Review: 07/21/2014
Last Revised: 07/21/2014