Can I get the flu and pneumonia vaccine while being sick?

Influenza and Pneumonia Vaccination During Illness

Patients with minor illnesses, including mild upper respiratory infections with or without fever, can safely receive influenza and pneumonia vaccines, but those with moderate to severe febrile illness should defer vaccination until symptoms resolve.

General Recommendations

Vaccination status is an important consideration for all patients, especially those with medical illnesses. Guidelines from major medical societies provide clear direction regarding vaccination during illness:

For Minor Illnesses

• Patients with minor illnesses, including mild upper respiratory infections or allergic rhinitis, can safely receive influenza and pneumonia vaccines 1
• The presence of nasal congestion or runny nose alone is not a contraindication for vaccination
• Minor illnesses with or without fever do not contraindicate the use of influenza vaccine 1

For Moderate to Severe Illnesses

• For patients with moderate to severe febrile illness, vaccination should be deferred until resolution of the illness 1
• Patients with an acute fever should not be vaccinated until their fever has resolved 1
• This recommendation is based on two considerations:
  1. Avoiding confusion between vaccine side effects and worsening of the underlying illness
  2. Preventing misattribution of a febrile reaction to immunization with recurrent/superinfection pneumonia 1

Special Considerations for Different Vaccine Types

Inactivated Influenza Vaccine (IIV)

• Can be administered to persons with minor acute illnesses 1
• Should be deferred in persons with moderate to severe acute febrile illness until symptoms have abated 1

Live Attenuated Influenza Vaccine (LAIV)

• May be administered to persons with minor acute illnesses (e.g., diarrhea or mild upper respiratory tract infection with or without fever) 1
• If nasal congestion is present that might impede delivery of the vaccine to the nasopharyngeal mucosa, deferral of administration should be considered until resolution of the illness, or IIV should be administered instead 1

Simultaneous Administration of Vaccines

• Influenza and pneumococcal vaccines can be safely administered at the same time in different arms 1
• Studies have shown that simultaneous administration of these vaccines does not increase side effects and is both safe and effective 2, 3
• The target groups for influenza and pneumococcal vaccination overlap considerably, making co-administration practical and efficient 1

Potential Side Effects and Reactions

When receiving vaccines during minor illnesses, patients should be aware of potential side effects:

• Local reactions (soreness, redness at injection site)
• Low-grade fever
• Muscle aches
• Fatigue

For LAIV, common reactions include runny nose or nasal congestion, headache, decreased activity or lethargy, and sore throat 1.

Important Caveats and Contraindications

While vaccination during minor illness is safe, there are some important contraindications to be aware of:

• History of severe allergic reaction (anaphylaxis) to previous doses of influenza vaccine or vaccine components 1
• For those with a history of Guillain-Barré syndrome (GBS) within 6 weeks of a previous influenza vaccination, vaccination should be approached with caution 1
• Severely immunocompromised individuals should receive inactivated vaccines rather than live attenuated vaccines 1

Conclusion

The benefits of timely vaccination against influenza and pneumococcal disease generally outweigh the theoretical risks of vaccination during minor illness. Deferring vaccination only for moderate to severe illness ensures that protective immunity can be established without unnecessary delays.