Populations that should receive annual influenza vaccinations

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The PCV13 vaccine-or the pneumococcal conjugate vaccine-is the main vaccine used. This is the primary vaccine referenced throughout this page.

All persons aged 6 months or older recommended for annual vaccination, with rare exception

Note: There is no recommendation for pregnant women or people with pre-existing medical conditions to seek special permission or secure written consent from their doctor for influenza vaccination if they get vaccinated at a worksite clinic, pharmacy or other location outside of their physician’s office.

People who can’t get the flu shot:

  • Children less than 6 months old
  • People with severe, life-threatening allergies to the vaccine or any ingredient in the vaccine

Note: There are certain flu shots that have different age indications. For example people younger than 65 years of age should not get the high-dose flu shot and people who are younger than 18 years old or older than 64 years old should not get the intradermal flu shot.

Persons at increased risk for complications

  • Persons age younger than 5 years old, especially younger than 2 years old
  • Persons age 65 years of age or older
  • Adults and children with chronic pulmonary or cardiovascular disorders including asthma, COPD, CHF, CAD
  • Adults and children who required regular medical care or hospitalization in the past year because of chronic metabolic disease, including diabetes mellitus, renal dysfunction, hemoglobinopathies, or immunosuppression.
  • Children and adolescents age 6 months to 18 years who are on long-term aspirin therapy (they may be at risk for Reye’s syndrome after influenza infection).
  • Pregnant women (and women up to two weeks post partum).
  • Residents of nursing homes or other chronic care facilities that house persons of any age with chronic medical conditions.
  • People with a variety of medical conditions, including blood, endocrine, liver, metabolic, and kidney disorders See complete list
  • People who are morbidly obese (BMI of 40 or greater)
  • American Indians and Alaskan Natives also seem to be at higher risk

Persons who can transmit influenza to those at high risk All persons aged 6 months or older recommended for annual vaccination, with rare exception

  • Physicians, nurses, emergency response workers, and other personnel in hospital and outpatient settings.
  • Employees of nursing homes and chronic care facilities who have contact with patients or residents.
  • Employees of assisted living and residences for patients in high risk groups.
  • Household members (including children) of patients in high-risk groups.
  • Home care providers for patients in high-risk groups


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Pneumococcal Polysaccharide Vaccine

For people 2 years of age-64 years of age who are at high risk of pneumococcal disease should also get the Pneumococcal polysaccharide vaccine or PPSV23. People in this category include: those with chronic heart disease, adults with asthma or who smoke, and those who are immunocompromised.

For a complete list of high risk factors indicating that someone should receive the PPSV23 shot see here.

The alternative to the shot is a nasal spray vaccine:

  • The nasal spray vaccine is approved for use in people 2 years through 49 years of age.

People who cannot get the nasal spray vaccine include:

  • Children younger than 2 years, or 2-4 years old who have asthma or a history of wheezing in the past 12 months
  • Adults 50 years and older
  • Pregnant women
  • People with a history of severe allergic reaction to any component of the vaccine, a previous dose of any influenza vaccine, or eggs
  • Children or adolescents (2 years through 17 years of age) on long-term aspirin treatment.
  • Individuals with immunosuppression or those who care for them (or avoid contact with immunosuppressed individuals for 7 days post vaccine)
  • People who have taken influenza antiviral drugs within the previous 48 hours.


1. Vaccination: Who Should Do It, Who Should Not and Who Should Take Precautions (Centers for Disease Control and Prevention) Updated November 2014

2. Pneumococcal Vaccination: Who Needs It? (Centers for Disease Control and Prevention) Updated June 2015