Who is at high risk for flu complications?

If you are elderly or have certain chronic (long-term) medical disorders, you are at a higher risk of getting complications from the flu. Almost all of the deaths caused by pneumonia and influenza involve people age 65 or older. The chronic medical disorders that increase risk are heart and lung diseases, metabolic diseases, abnormal hemoglobin (the protein in red blood cells that carries oxygen) conditions, an impaired immune system (the body's defense system), and kidney dysfunction.

Some people are at greater risk of serious flu-related complications such as pneumonia or worsening of existing chronic health conditions. If you are at high risk for complications, it's especially important to get vaccinated every year. It's also important to check with a doctor promptly about taking antivirals if flu symptoms develop.

Those at greater risk for flu-related complications include:

  • children younger than age five, but especially children younger than age two
  • adults 65 years of age and older
  • pregnant women (and women up to two weeks postpartum)
  • residents of nursing homes and other long-term care facilities
  • American Indians and Alaskan Natives 

People with certain medical conditions also have a higher risk of flu complications. These medical conditions include:

  • asthma
  • neurological and neurodevelopmental conditions [including disorders of the brain, spinal cord, peripheral nerves and muscles such as cerebral palsy, epilepsy (seizure disorders), stroke, intellectual disability (mental retardation), moderate to severe developmental delay, muscular dystrophy, or spinal cord injury].
  • chronic lung disease (such as chronic obstructive pulmonary disease (COPD) and cystic fibrosis)
  • heart disease (such as congenital heart disease, congestive heart failure and coronary artery disease)
  • blood disorders (such as sickle cell disease)
  • endocrine disorders (such as diabetes mellitus)
  • kidney disorders
  • liver disorders
  • metabolic disorders (such as inherited metabolic disorders and mitochondrial disorders)
  • weakened immune system due to disease (such as HIV/AIDS or cancer) or medication use (such as chronic steroids)
  • people younger than 19 years of age who are receiving long-term aspirin therapy
  • people with extreme obesity (body mass index[BMI] of 40 or more)

If you care for anyone in these high-risk groups, including babies younger than 6 months, it is important to get a flu vaccine. Remember, it's not too late to protect yourself and loved ones from the flu by getting vaccinated.

Dr. Audrey K. Chun, MD
Geriatric Medicine Specialist

Americans age 65 and older are at the highest risk of developing severe complications from influenza, but these same individuals receive less protection from an annual flu shot than others. While annual vaccination remains the best means of protection, a recent brief issued by the National Foundation for Infectious Diseases notes that many people remain unaware of the difficulties surrounding immunization and immune response for adults over age 65.

Certain people or groups have a higher risk for medical complications from the flu:
  • Pregnant women
  • Infants and young children (ages 6 months to 5 years)
  • People younger than 19 years who are receiving long-term aspirin therapy
  • People 65 years of age and older
  • People with chronic health conditions such as heart or lung disease (including asthma), diabetes, and kidney, nerve, or blood disorders
  • People with weakened immune systems from conditions such as human immunodeficiency virus (HIV) or from treatments such as chemotherapy
  • People living in nursing homes or other chronic-care facilities
  • People with obesity
  • American Indians and Alaska natives
If you belong to any of these groups, you have even more reason to get a flu vaccine. If you develop flu symptoms, you might need lab testing to diagnose the type of flu you have. You might also benefit from antiviral medication.
Those at high risk for flu complications include adults over 65, children under 2, pregnant women, and those with various health issues. Watch internal medicine specialist Keri Peterson, MD, discuss these high-risk groups and the complications.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.