Medical Matters > Vaccinations: Flu (Influenza) 2023-24

ME Essential Autumn 2023


Can you help me reach an informed decision about the 2023-24 Flu vaccination?


Flu vaccination is important because although Flu is often unpleasant, it can also be dangerous. This is especially so for anyone with certain chronic health conditions, including ME/CFS. And, with Covid still around, a combination of Flu and Covid could be even more serious. To avoid becoming seriously ill, it’s advised that people in high-risk groups receive the Free NHS Flu vaccine before Flu season begins.

There is no simple yes/no answer as to whether everyone with ME/CFS should have a Flu vaccine, but we have produced a detailed review of your options including an assessment of the risks and benefits. The following information is a summary of that review:

  • Flu can lead to serious complications, such as bronchitis and pneumonia. It may also worsen pre-existing health conditions and lead to dangerous complications in pregnancy.
  • The Flu virus exists year-round, but outbreaks are most common in the winter and early spring. It’s thought that the flu virus survives for longer in cold, dry air, and that it spreads more easily in the winter months as we spend more time inside in close contact with one another.
  • Though December-March is the peak season for flu, outbreaks can occur as late as May. Flu viruses can also begin to spread in early autumn, usually from October onwards.
  • It’s also worth noting that – although the Flu is far more common during the autumn and winter – you can contract the virus at any time of the year if you come into contact with someone who is infected.

To receive a free flu vaccination you need to meet one of the following criteria:

  • are 65 and over (including those who will be 65 by 31 March 2024).
  • have certain health conditions – including chronic neurological disease.
  • are pregnant.
  • are in long-stay residential care.
  • receive a carer's allowance or are the main carer for an older or disabled person who may be at risk if you get sick.
  • live with someone who is more likely to get a severe infection due to a weakened immune system, such as someone living with HIV, someone who has had a transplant, or is having certain treatments for cancer, lupus, or rheumatoid arthritis.

In relation to pre-existing long-term health conditions, several specific diseases are covered. These include:

  • Respiratory conditions, such as asthma (needing a steroid inhaler or tablets), COPD, emphysema, and bronchitis.
  • Diabetes.
  • Heart conditions, such as coronary heart disease or heart failure.
  • Being very overweight – having a body mass index of 40 or above.
  • Chronic kidney disease.
  • Liver disease, such as cirrhosis or hepatitis.
  • Neurological conditions, such as Parkinson's disease, Motor Neurone Disease, Multiple Sclerosis, or Cerebral Palsy.
  • A learning disability.
  • Problems with your spleen like Sickle Cell disease, or if you've had your spleen removed.
  • A weakened immune system because of conditions such as HIV and AIDS or taking medicines such as steroid tablets or chemotherapy.

Although the neurological conditions shown above do not include ME/CFS as a specific example, the accompanying NHS guidance states that you can, “talk to your doctor if you have a long-term health condition that is not in one of these groups. They should offer you a Flu vaccine if they think you're at risk of serious health problems if you get Flu.”

This means that if you live in England, Wales, Scotland, and Northern Ireland you should be able to have a Free NHS Flu vaccination if you choose to do so because ME/CFS is classified as a neurological disease in the SNOMED CT electronic classification system (which is used by the NHS) and by the World Health Organisation in the International Classification of Diseases (ICD10; G93.3).

We have produced a Template letter that you can use when speaking with a GP if you have ME/CFS and decide to try and get a Free Flu vaccine on the NHS. Please note that feedback from previous years indicates that pharmacies are normally very willing to provide a free NHS Flu vaccine to people with ME/CFS.

More information


Information provided by The ME Association should not be construed as medical advice. Don't assume any new or worsened symptoms are simply the result of having ME/CFS or Long Covid. We recommend that any information you deem relevant is discussed with your NHS GP as soon as possible. It is important that you seek personalised medical advice from the GP who is in charge of your care and who knows you well.

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