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Influenza Immunisation
Immunisation against seasonal flu (the flu jab) is given every year to people at risk of developing serious
complications from seasonal influenza (flu). Those recommended to receive the flu jab are listed below. If
you have the flu jab you greatly reduce your chance of getting seasonal flu.
What is influenza?
Influenza (flu) is an illness caused by the flu virus. There are different strains of flu virus.
They are transmitted by coughing and sneezing.
Symptoms of flu include a high temperature (fever), muscle aches, cough, headache and
extreme tiredness. Flu usually lasts for between two and seven days and usually improves
spontaneously. Most people recover fully, but complications, such as a chest infection or
pneumonia, develop in some cases.
Complications are more common in young babies, older people, in those with an underlying
disease (especially heart or lung diseases), pregnant women and those whose immune
system is weaker than normal. Complications are sometimes serious and even fatal in some
cases. A number of people in the UK die each year (mostly elderly people) from the
complications of flu.
There are three types of flu virus - A, B and C. Strains of influenza A and B cause most of
the cases of flu. Each winter a different strain of the flu virus causes an outbreak of flu
which affects many people. This is called seasonal flu. During an outbreak of seasonal flu, if
you get a flu-like illness, it is more likely to be caused by the prevailing flu virus than by
another type of virus. Most cases of flu usually occur in a six- to eight-week period during
the winter.
Swine flu is caused by a particular strain of influenza A virus which is called influenza A
(H1N1v). It seems to affect children and young adults more commonly than those over the
age of 60 years. Most people with this type of influenza have a mild flu-like illness. You are
more likely to have sickness and/or diarrhoea with this type of flu.
The influenza A virus (H1N1v) caused the swine flu pandemic of 2009/10. It is highly likely
to be around this winter (2010/11) still.
Note: bird flu (avian influenza) is different and is more serious. See separate leaflet called
'Bird Flu (Avian Influenza)' for details.
Immunisation against seasonal flu
Flu immunisation (the flu jab) gives excellent protection against seasonal flu and lasts for
one year. The immunisation is normally ready and given in October and November each
year. It is made from the strain of flu virus that is expected in the coming winter. Each year
this is slightly different so a new immunisation needs to be made every year. You need a
yearly immunisation to keep protected.
Flu immunisation does not prevent other viral infections which can cause coughs, colds and
flu-like illnesses. It protects only against the flu virus that is expected in the coming
winter. The immunisation does not actually contain any living flu virus. This means that it
cannot cause flu or any other infections. It is a coincidence if you develop a cough or cold
shortly after having a flu immunisation.
Who should be immunised against the seasonal flu virus?
Seasonal flu is the strain of flu virus that arrives in the UK each autumn. The actual strain
varies from year to year and a new immunisation is developed each year to protect against
the prevailing strain. This year, 2010-2011, the flu immunisation will also provide
protection against the influenza A viral H1N1v strain (swine flu).
The flu immunisation will protect 7-8 out of 10 people against infection with flu. It takes up
to 14 days for full protection to be reached after having the immunisation. This protection
lasts for around one year. The flu immunisation has also been shown to reduce the risk of
developing complications from influenza, especially in the elderly.
The Department of Health (DH) issues advice as to whom should be immunised. This is
reviewed from time to time. The aim is to protect people who are more likely to develop
complications from flu.
Current advice is that you should be immunised against the seasonal flu virus each autumn
if you:
 Are aged 65 or over.
 Have any chronic (ongoing) lung diseases.
Examples include chronic bronchitis, emphysema, cystic fibrosis and severe asthma
(needing regular steroid inhalers or tablets). It is also recommended for any child
who has previously been admitted to hospital with a chest infection.
 Have a chronic heart disease.
Examples include angina, heart failure or if you have ever had a heart attack.
 Have a serious kidney disease.
Examples include nephrotic syndrome, kidney failure, a kidney transplant.
 Have a serious liver disease such as cirrhosis.
 Have diabetes.
 Have a poor immune system.
Examples include if you are receiving chemotherapy or steroid treatment (for more
than a month), if you have HIV/AIDS or if you have had your spleen removed.
 Have certain serious diseases of the nervous system such as multiple sclerosis or
have had a stroke in the past.
 Live in a nursing home or other long-stay residential care accommodation.
In addition to the main at-risk groups of people listed above:
 You should be immunised if you are the main carer for an elderly or disabled person
whose welfare may be at risk if you fall ill with flu.
 Staff involved in direct patient care may be offered a flu jab from their employer.
 Pregnant women. Even if you are otherwise healthy it is now recommended that all
pregnant women receive the flu immunisation.
 People who work in close contact with poultry.
If you are healthy and aged under 65 and you do not fall into any of the above categories,
then you do not need immunisation against seasonal flu. This is because you are unlikely to
develop complications from flu.
Why do pregnant women need to have the flu immunisation?
Pregnant women who develop influenza A virus H1N1v are at an increased risk of
developing a more severe illness and are also more likely than nonpregnant women to be
admitted to hospital. There are no known problems from giving the swine flu or seasonal flu
immunisation to women who are pregnant.
Are there any side-effects from seasonal flu immunisation?
Immunisation against the seasonal influenza virus usually causes no problems. You may
have a temporary mild soreness at the injection site. Sometimes, it can cause a mild fever
and slight muscle aches for a day or so. This soon settles and does not lead to flu or other
problems.
Serious reactions have been reported but are rare. For example, a severe allergic response,
inflammation of nerves and inflammation of the brain are very rare reactions.
Who should not have the seasonal flu immunisation?
The vast majority of people can receive the flu immunisation. However, the following
groups of people should also not be immunised:
 If you are have a severe allergy to eggs (however, you can still receive a different
immunisation that protects against the influenza A viral (H1N1v) strain).
 If you have had a previous allergic reaction to a flu virus immunisation in the past.
The flu immunisation can be given at the same time as other immunisation; it is often given
at the same time as the pneumonia immunisation. It is also safe to be given if you are
either pregnant or breast-feeding.
Further sources of information
Information on immunisation from the NHS
Web: www.nhs.uk/Planners/vaccinations/Pages/Adultshub.aspx
Department of Health
Their leaflet - Seasonal flu vaccination - who should have it and why
References
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The influenza immunisation programme 2010/11, Chief Medical Officer, Dept of
Health (June 2010)
Key vaccine information: Seasonal flu, Dept of Health (January 2011)
Immunisation against infectious disease - 'The Green Book', Dept of Health
(various dates)
Influenza, Clinical Knowledge Summaries (August 2009)
Immunizations - seasonal influenza, Clinical Knowledge Summaries (July 2009)
Tamma PD, Ault KA, del Rio C, et al; Safety of influenza vaccination during
pregnancy. Am J Obstet Gynecol. 2009 Dec;201(6):547-52. Epub 2009 Oct 21.
[abstract]
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Jamieson DJ, Honein MA, Rasmussen SA, et al; H1N1 2009 influenza virus
infection during pregnancy in the USA. Lancet. 2009 Aug 8;374(9688):451-8. Epub
2009 Jul 28. [abstract]
Derlet RW et al; Influenza, eMedicine, Jan 2011
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conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy.
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© EMIS 2011 Reviewed: 18 Jan 2011 DocID: 4281 Version: 43
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