Winter flu jab

This page sets out information about the flu and the flu vaccine so people with M.E. can make an informed decision about whether or not to have the vaccine this winter. Please note we are not medically qualified to advise anyone making an individual decision on this. Please speak to your doctor or pharmacist.

Below you will find information under the following headings:

What is the flu?
Is the vaccination safe?
Research on the flu jab and M.E.
Getting a flu jab which includes a link to our template letter, Why I'm eligible for the free flu vaccine
The flu jab and the Covid-19 booster

What is the flu?

Flu is an acute viral infection of the respiratory tract and symptoms include fever, aching muscles, chills, headache, joint pain and fatigue. It can be particularly serious in older people, very young children and people with underlying health conditions.

Flu vaccination is important because:

if you're at higher risk from coronavirus, you're also more at risk of problems from flu
it'll help to reduce pressure on the NHS and social care staff who may be dealing with coronavirus

if you get flu and coronavirus at the same time, you may be more seriously ill.

The NHS says: “Flu vaccination is important because:

more people are likely to get flu this winter as fewer people will have built up natural immunity to it during the COVID-19 pandemic
if you get flu and COVID-19 at the same time, research shows you're more likely to be seriously ill
getting vaccinated against flu and COVID-19 will provide protection for you and those around you for both these serious illnesses.

“If you've had COVID-19, it's safe to have the flu vaccine. It will still be effective at helping to prevent flu. Some people may be eligible for both the flu and the COVID-19 booster vaccines. If you are offered both vaccines, it's safe to have them at the same time."

It's important to note here that this is general advice directed at the general population. For someone with a long-term chronic condition like M.E., you should consider how you have tolerated vaccines in the past, and the impact of having both vaccines at the same time.

Is the vaccination safe?

Flu vaccines have a good safety record and millions of people every year are vaccinated against flu. Dr Vanessa Saliba, Head of Flu at Public Health England, says: “The flu vaccine is the best defence we have against what can be a serious and even deadly illness.”

Many people mistakenly believe you can catch flu from the vaccine. This is a myth: there are no active viruses in the vaccine.

It can take 10 to 14 days for your immunity to build up after you have the flu vaccination.

There can be side effects, which usually last one or two days. The most commonly reported are pain, swelling, bruising, hardness or redness at the site of injection; a slightly raised temperature, headache, sweating, aching joints, shivering, tiredness and feeling generally unwell.

Severe allergic reactions are rare. The main allergen in flu jabs is egg so you should always mention to the pharmacist or nurse if you are allergic to egg, although the jab should still be safe unless your allergy is particularly severe.

Research on the flu jab and M.E.

Some people don't want to have the vaccine because they were worried about its effect on them.

Writing on her blog about research into the flu jab and M.E., pharmacist Emily Beardall says: "Several studies (Can J Infect Dis. 2000; Annals of the NY Academy of Sciences 2009; International Journal of Clinical Medicine 2012; BMC Immunology 2012) have examined the immune response by CFS patients (CDC criteria) compared with healthy controls following flu vaccination. The blood tests of the CFS patients showed a slightly heightened immune response to the vaccine compared with the healthy controls but this did not translate into self-reported worsened side effects, or a relapse."

"The vaccine successfully achieved the desired antibody response in the CFS patients, so it would be as effective against flu as in the healthy controls. In one study (Annals of the NY Academy of Sciences 2009); both the placebo and the active jab groups self-reported quadruple the number of side effects than healthy controls and on analysis, these were actually CFS symptoms which were reported as side effects."

Though there isn’t much research and the studies are small and outside the UK, they conclude that the advantages of having the flu vaccination in protecting against flu and related complications, still outweigh the risk for people who have M.E.

Getting a flu jab

The Government has pledged to roll out the most comprehensive flu programme in UK history this winter, with providers working to vaccinate more than 30 million people.

The expanded programme is part of plans to ready the NHS both for the risk of a second peak of Coronavirus cases and to relieve winter pressures on A&E and emergency care.

In all regions of the UK, the vaccine is free from your GP practice or community pharmacy for:

anyone caring for an elderly or disabled person
anyone aged 65 or over (later in the year, subject to availability, free vaccinations will be extended to over 55s in Scotland and over 50s in England, Wales and Northern Ireland).

Eligibility based on other criteria varies in each region; we have shared details relating specifically to M.E./neurological conditions, but you may also be eligible for other reasons (eg. other health conditions or circumstances).

In all regions of the UK, people with neurological conditions are eligible for free flu vaccinations. See 2021 information for England, Scotland, Wales and Northern Ireland.

Given that M.E. is listed as a neurological condition by NHS England, SNOMED (the system used by GPs in England for electronic health records) and the World Health Organisation, it therefore follows that people with M.E. should be eligible for a free flu jab.

However, this isn’t quite as straightforward as it should be, and we do hear from people whose GPs consider them not eligible. We have produced a resource you can share with your health professional about this, Why I'm eligible for the free flu vaccine; this also signposts to further information for doctors, including an online learning module about M.E.

If you need to book and pay for a vaccination yourself, there are numerous pharmacies offering low-cost flu jabs.

Most offer an online booking system and store locator so you can find your nearest branch offering this service. Many independent pharmacies also offer vaccinations, and prices may be cheaper. If you’re planning a walk-in appointment, you may want to call ahead to check availability.

The flu jab and the Covid-19 booster

A September 2021 paper published by the Combining Influenza and COVID-19 Vaccination (ComFluCOV) study team tested the impact of receiving two vaccines on the same day, one in each arm. More than 750 people took part, aged 18 years and over, and “participants with other co-morbidities that made them eligible for routine influenza vaccine were included.”

The most common side effects were pain at the vaccination site and tiredness. These were mainly mild or moderate. More people experienced side effects when the two vaccines were given together than when the two vaccines were given separately, but the difference between the groups was small.

The BMJ reports: "A strength of the study was that it did not exclude people who were pregnant, had severe uncontrolled medical problems, were immunocompromised, or aged 65 or over, so it was representative of the population who were most likely to receive both flu and Covid vaccines.