Can I get a flu shot if I'm HIV positive?

Dear Reader,  

It’s not a flu-ke! The influenza (flu) vaccine is typically considered safe and effective for people who live with human immunodeficiency virus (HIV). In fact, it’s specifically recommended for people with HIV to be vaccinated, as they have a greater risk of experiencing more severe flu symptoms.  

Keep in mind, there’s a lot of misinformation about the efficacy of vaccines and potential side effects. When you see claims about the vaccine, consider looking into the legitimacy of the source and finding others that support that claim. This helps address misinformation. 

Can you get the flu vaccine if you have HIV?  

Yes! If you’re HIV-positive, getting the flu vaccine is the best way to reduce risk of serious illness or hospitalization for yourself and your community. In fact, the flu vaccine is the most studied vaccine for people with HIV. 

Although many people recover from the flu quickly, it contributes to a significant number of hospitalizations in the United States each year. Small children, adults 65 and older, pregnant people, and people who are immunocompromised (including those with HIV) are at greatest risk of severe illness or hospitalization. These groups are considered high-priority groups for vaccination. 

How do flu vaccines work when you have a weaker immune system? 

Vaccines build up the body’s immune defenses by exposing the immune system to a weakened or inactive form of the virus. However, special considerations are required for those who are immunocompromised, like people living with HIV. When your immune system is suppressed, introducing a weakened form of the virus may cause disease. The good news is, the standard flu vaccine contains an inactive form of the virus, and research shows that the flu vaccine won’t cause the flu.  

There is also a live attenuated influenza vaccine (LAIV) or nasal spray (called FluMist) that has a live form of the virus. So, this isn’t typically recommended for people with HIV. 

There are additional considerations when you have HIV. Before getting vaccinated, you might consider discussing your specific situation with a health-care professional. For example, you mention that you have a high T-cell count and aren’t on medication. However, many healthcare providers will recommend that people with a low T-cell count start antiretroviral therapy (ART) before getting vaccinated. If you have a low T-cell count, your body may not develop as strong or as long of an immune response to the vaccine.  

A health care professional might also recommend that you don’t measure your viral load within four weeks of getting the vaccine. Some research suggests vaccination might slightly increase your viral load for a short period of time, but it’s not confirmed. Either way, there's no evidence that people with HIV have more negative effects to the vaccine than people in the broader population. 

Is the flu vaccine effective?  

The flu vaccine is an effective way to lower your risk of getting the flu, as well as your risk of severe illness, hospitalization, or death. Flu vaccines are updated each year to protect against circulating strains. The United States transitioned to developing flu vaccines that protect against three circulating strains (also called trivalent). Some regions continue to use four-strain vaccines (also called quadrivalent). Since flu viruses change quickly, in some years the vaccine is more effective than others. However, even if the vaccine doesn’t align perfectly with circulating strain, it can still provide protection and reduce risk of severe illness.  

It’s possible to still get the flu, even with the vaccine. In this case, you’re more likely to have a shorter, less severe illness. It also takes around two weeks for the flu vaccine to be fully effective, so you can contract the flu during this period. 

How can you find accurate information about vaccines?  

You mention that you’ve heard that flu vaccines “aren’t all they're cracked up to be.” Although it’s good to seek out information when making health decisions, there’s a lot of misinformation about vaccinations available. While encountering sources about vaccines, you might consider taking a moment to check the legitimacy of the source. You might also attempt to fact-check the claim with other sources. Some considerations when assessing sources about vaccines include:  

• Does the source note that it has been reviewed by other scientists or experts?  
  • When a study is reviewed by other scientists before publication, it's called “peer reviewed.” During the peer review process, the reviewers assess whether the methods and data collection are in line with commonly accepted practices. They also assess whether the study’s findings are significant enough to support its conclusions. Therefore, peer reviewed studies are considered more credible than non-peer reviewed studies.
  • If the source doesn’t cite any data or research, it may not be a credible source. 
• Do other sources support this source’s findings?  
  • Scientific consensus is formed when conclusions are supported by multiple types of evidence that address the question from different perspectives and methods. 
• Who funded the research?  
  • An organization’s funding sources can potentially influence how the organization interprets data and presents conclusions.  
• Can you identify the source’s biases?  
  • Every source has a purpose, and some may introduce biases. Being able to identify the motive (whether it’s education, persuasion, or financial profit) may help you figure out if that source is sharing evidence-informed information. Using these questions together may help you parse through the information you receive to make an informed choice.  

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If you’re feeling overwhelmed or confused with the amount of information available about vaccines, consider reaching out to a health care professional. You also might find it helpful to rely on expert, reviewed sources like the American Academy of Pediatrics, Immunize.org, and the National Network for Immunization Information. 

Give it your best shot,