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Can Childhood Cancer Patients Get the Flu Vaccine?

Flu shot is really important during pandemic

Most childhood cancer patients are encouraged to get a flu shot each year.

An annual flu shot is recommended for all children older than 6 months including those receiving treatment for cancer. Organizations who advise this include the Centers for Disease Control and Prevention, the American Academy of Pediatrics, and the Infectious Diseases Society of America.

Exceptions would be patients who are not likely to respond to the flu vaccine although they are unlikely to be harmed by it. Patients not likely to respond include those who have received strong chemotherapy or those who have received anti B-cell antibodies within 6 months.

If patients are undergoing certain treatments, doctors may recommend waiting to get the vaccine. Transplant, cellular (CAR T-cell) therapy, and gene therapy patients may get a flu shot 6 months after their infusion. If there is a flu outbreak in the community, they may receive a flu shot 4 months after transplant.

Why is the Flu Vaccine Important?

The flu vaccine protects people from developing the flu. It causes a person to develop antibodies that recognize and fight flu viruses. A vaccine strengthens the immune system to protect the body from illness. It builds up the body’s natural defenses (immunity) against infection.

People need a flu vaccine once a year because the makeup of the vaccine is different each year. Influenza viruses are constantly changing. The body’s immune response decreases over time.

Getting a flu vaccine is even more important during the 2020-2021 flu season because of the COVID-19 pandemic. Flu and COVID-19 will be spreading at the same time. Both are respiratory illnesses. 

There is not yet a vaccine for COVID-19.

Most people who get flu recover in a few days to less than 2 weeks. But some people develop more serious symptoms or complications. Some complications can be life-threatening.

Sinus and ear infections are examples of moderate complications from flu. Pneumonia is an example of a serious flu complication.

Flu vaccination is especially important for people with certain medical conditions such as asthma, heart disease, and diabetes. Flu also can make these chronic medical problems worse. For example, people with asthma may experience asthma attacks while they have flu. People with heart disease may become worse because of the flu.

These same chronic conditions increase the risk of serious complications of COVID-19.

To protect pediatric cancer patients, it is important that all family members and health care providers get the flu vaccine. Young children and patients with weak immune systems are at higher risk for life-threatening complications from the flu. Having all family members and caregivers vaccinated helps create an extra layer of protection around the patient.

Some people may still get the flu after being vaccinated. Even if you do get the flu, you may not get as sick because your body is better able to defend itself.

What is the Flu?

Flu is short for influenza. It is a respiratory illness caused by a flu virus. Flu symptoms include fever, chills, cough, sore throat, runny nose, body aches, headaches, and fatigue. In severe cases, flu can cause breathing problems, pneumonia, or other life-threatening complications.

Which Flu Vaccine Should My Child Get?

There are 2 main ways the flu vaccine is given:

  • Flu shot (needle injection)
  • Nasal spray (Flumist®)

Your doctor will recommend the best flu vaccine for your child. Children with weakened immune systems should not get the nasal spray because it contains a weakened live form of the flu virus. People who live in the same household as your child should not receive the nasal spray either.

The flu shot is made with dead (inactivated) flu viruses. It is safe for people with cancer. It may be given at least 2 weeks before chemotherapy or between chemotherapy cycles.

There are several different types of flu shots. Most are given in the muscle of the upper arm. Infants and very young children may get the flu shot in the upper thigh.

When is the Best Time to Get the Flu Vaccine?

If possible, get the flu shot in September or October. But getting one any time during the flu season can help protect you. In general, flu cases usually start to rise in October, peak in December through February, and can last until May.

It takes about 2 weeks to develop an immune response after the flu vaccine.

In certain cases, children may need 2 doses of the flu vaccine. Your doctor will tell you if this necessary.

Can You Get the Flu and COVID-19 at the Same Time?

Based on what we currently know, it is possible that you could be infected with both viruses at the same time. However, it is hard to predict how often this might happen. Both COVID-19 and flu are respiratory infections. The symptoms of COVID-19 and flu can be very similar. If you have symptoms, it is likely that your doctor will do both a COVID-19 test and a flu test. The test results can help your doctor decide the best treatment. For example, antiviral flu medicines are available if you test positive for the flu.

What Are Antiviral Medicines?

If the flu test is positive, a doctor may prescribe flu antiviral drugs. They help to keep the flu virus from reproducing. Flu antiviral medicines can reduce the severity and duration of symptoms. They work best when started within 2 days of becoming sick. Several antiviral medicines are available in pill, liquid, inhaled, and IV form. Flu antiviral medicines only work on the flu virus and are not used for other viral infection.

Will a Flu Vaccine Protect Me from COVID-19?

No. The flu vaccine is specific to flu viruses. They do not protect you from infection from the virus that causes COVID-19. However, because COVID-19 will be spreading at the same time as the flu virus, getting a flu vaccine is extra important this year.

Does the Flu Vaccine Cause Flu Illness?

No, flu vaccines cannot make you sick with the flu. Flu shots are made with only part of the flu virus or with “killed virus” that is not active. The FluMist® nasal spray contains a weakened form of the live virus that cannot cause flu illness.

Why Do You Feel Bad After a Flu Vaccine?

Some people may have mild side effects after a flu vaccine. After a flu shot, there may be temporary redness or swelling at the injection site. Headache, fever, fatigue, nausea, and body aches can sometimes occur after vaccination but should go away within a couple of days. These symptoms are part of the normal immune response as your body begins making antibodies against the flu.

Can You Get the Flu After You Have Had the Flu Vaccine?

Yes, there is a chance you can get the flu even if you got a flu vaccine. However, if you get the vaccine and later get the flu, you’re likely to get less sick than if you had not been vaccinated. The effectiveness of the flu vaccine depends on the match of the vaccine to the type of flu virus infection. You might be infected with a different type of flu virus. There are two main types or strains of flu: Type A (influenza A) and Type B (influenza B). Also, some people have a weaker immune response to the vaccine, and you can lose your protection over time. Even if you do get the flu, your risk for severe illness is lower.

Can You Get a Flu Vaccine if You Have an Egg Allergy?

Yes, completely egg-free flu vaccines are available for patients with an egg allergy. However, most flu vaccines have a small amount of egg protein. In most people with a history of egg allergy, the flu vaccine does not cause an allergic reaction. Some people with a history of egg allergy may need to get the flu vaccine under medical supervision in case a severe allergic reaction occurs. Be sure to let your health care provider know if you have an egg allergy.

How Does the Flu Spread?

Flu spreads easily person to person through droplets in the air when someone coughs or sneezes or by touching surfaces with the virus. You may be able to spread the flu virus before you even know you are sick. You may be contagious for 7 days or longer after becoming sick.

How Do You Prevent the Flu?

The best way to prevent the flu is to get a yearly flu vaccine. Other ways to help stop the spread of flu is by washing hands often, covering coughs and sneezes, and staying away from people who are sick. Wearing a face mask can also help prevent respiratory viruses, including flu and COVID-19.

Who Is at Risk for Flu Complications?

Those at risk for serious illness with the flu include:

  • Children under age 5
  • Adults over age 65
  • People with chronic health conditions

Close monitoring is especially important for people with weak immune systems. However, even healthy children that get the flu can become very sick. Talk to your doctor about any symptoms that worry you.

What Problems Should I Watch for with the Flu?

Most people have mild or moderate flu symptoms. But some people can get very sick. Watch for emergency warning signs such as:

  • Fever above 104°F
  • Trouble breathing
  • Chest pain or pressure
  • Severe muscle pain
  • Confusion or decreased alertness
  • Lips or face turning blue
  • Seizures
  • Dehydration (not urinating, lack of tears)

This list includes some common warning signs, but there may be others. In a medical emergency, go to the emergency room or call 911.

How Do You Treat the Flu?

To help manage symptoms of the flu:

  • Drink plenty of fluids.
  • Rest.
  • Treat symptoms using over-the-counter medicines as recommended by your doctor.
  • Take flu antiviral medicines as prescribed by your doctor.
  • Watch for worsening of symptoms or health problems such as ear infections.
  • Monitor for emergency warning signs such as dehydration, seizures, or breathing problems.

Find More Information About Flu and Flu Vaccines


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Reviewed: October 2020