Colds and flu

Updated 09 October 2017

Who should be vaccinated against flu?

There are certain groups of people to whom flu vaccination should be a priority.

Any person who wishes to reduce the likelihood of becoming ill with 'flu, should be vaccinated.

Specifically, the 'flu vaccine is strongly recommended for any person over the age of six months who is at increased risk to develop 'flu complications.

Adults in the high-risk group include:

  • All people aged 65 and older, especially those living in retirement homes;
  • Anyone with a heart problem, such as heart failure;
  • Anyone with a respiratory problem, such as asthma or emphysema;
  • Anyone with other chronic illnesses such as anaemia, diabetes or kidney failure;
  • The immune suppressed, including persons with HIV infection, or people receiving long-term corticosteroid treatment, or cancer patients receiving radiation or chemotherapy. In the case of HIV, people with a CD4 count of less than 200 per microlitre are unfortunately unlikely to respond to the vaccine;
  • People who have required regular visits to the doctor or have been hospitalised during the preceding year due to chronic illnesses;
  • Women in their 2nd and 3rd trimester of pregnancy (pregnancy can increase the risk for serious medical complications from influenza);
  • Pregnant women in their first trimester if they have a medical condition that increase their risk for complications;
  • Caregivers of the ill, staff at nursing homes and other facilities that provide care for chronically ill persons, health-care workers, and home-care providers – to protect themselves from infection and to reduce the risk of transmitting 'flu to their high-risk patients or clients;
  • Persons in close contact with any high-risk individual;
  • People planning to travel to the tropics at any time or to the northern hemisphere between October and February;
  • Police, ambulance personnel, fire fighters, and other community service providers.

The Centers for Disease Control and Prevention (CDC) in Atlanta, USA, recommends that people at risk of 'flu complications should be vaccinated against pneumococcal infection as well, as this complication can be fatal. This vaccination may be given at the same time as the 'flu vaccination.

Children and teens in the high-risk group include:

  • All children between the ages of 6 and 23 months, as their immunity levels against diseases are at its lowest and their exposure rate high if they attend a crèche;
  • All children who have chronic heart or lung disorders, including asthma;
  • All children who have chronic illnesses, as well as those who have required hospitalisation or regular visits to the doctor during the preceding year;
  • All children who live with someone in a high-risk group;
  • All children and teenagers (from six months to 18 years of age) on long-term aspirin therapy, because of the dangers of Reye's syndrome if they catch the 'flu and run a fever;
  • School-aged children are two to three times more likely than adults to get influenza, and to rapidly spread the virus to others. Studies have shown that families with school-aged children have more infections than other families.

Take note that Haemophilus influenza type b is not the cause of 'flu, but a bacterium that causes meningitis, ear infections, pneumonia and other infections. Talk to your doctor about this vaccination.

The 'flu vaccine is also recommended for persons between ages 50 to 65 because they are often in close contact with high-risk family members (see above), and because 50 is an age when other chronic illnesses may become more common.

Breastfeeding moms may also receive the 'flu vaccination without affecting the safety of the infant.

Reviewed (2006) by Dr Jane Yeats MBChB, BSc(Med)(Hons)Biochem, FCPathSA(Virology).

Read more:
Flu and pregnancy
How does the flu virus spread?
1918 - why the flu spread so rapidly


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Dr Heidi van Deventer completed her MBChB (Bachelor of Medicine and Bachelor of Surgery) degree in 2004 at the University of Stellenbosch.
She has additional training in ACLS (Advanced Cardiac Life Support) and PALS (Paediatric Advanced Life Support) as well as biostatistics and epidemiology.

Dr Van Deventer is currently working as a researcher at the Desmond Tutu Tuberculosis Centre at the University of Stellenbosch.

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