Say No to Flu! Book your Flu Jab Today

People who have Addison's disease, adrenal insufficiency or who are steroid-dependent for another reason should get a free NHS flu jab. This is to reduce the risk of getting the flu, as they are particularly vulnerable to serious complications if they get flu. 

We also recommend that you take up the offer of the COVID vaccine. Read on for more information about receiving both jabs.

The flu jab can protect you against the most common types of flu currently around. As this changes each year, it means you need a new jab each year too. You can’t get the flu from the flu jab, but it takes two weeks to work so you could still get the flu during that time. That’s why it’s important to get the jab as soon as you can (September onwards), including if you’re pregnant.

Flu can make your Addison's and adrenal insufficiency harder to manage, giving unstable cortisol levels and potentially triggering an adrenal crisis. The flu jab is the best way of protecting yourself against flu and reducing your risk of having to go to hospital.

Dr Alessandro Prete, Consultant Endocrinologist, explains more about the importance of getting your flu jab when you are steroid-dependent.

“Do not underestimate the flu. For people who are steroid-dependent, catching the flu can have serious consequences such as developing a life-threatening adrenal crisis. A 2013 ADSHG member survey showed that one in four adrenal crises were triggered by the flu or flu-like illnesses. Most flu infections recover fully within a few days, but it is imperative that people who are steroid-dependent follow the sick day rules."

"If you have a temperature, feel poorly or weak, double your daily steroid dose until you are better. If your temperature is above 39 degrees, treble your steroid dose. If you don’t feel better after 48 hours, continue to take extra steroids and speak to your GP or your endocrine nurse/doctor for more advice. If you feel very unwell with vomiting, diarrhoea or can’t keep your tablets down, you should inject yourself with 100mg of hydrocortisone and seek medical advice immediately."

"Prevention is better than cure, therefore we strongly recommend that anyone who is steroid-dependent get their free NHS flu jab to reduce their risk of getting the flu and precipitating an adrenal crisis. So, don’t delay – make your appointment!"

“Most people tolerate the flu jab well; however, some may develop temporary side effects such as headache, fever, nausea, muscle aches, and fatigue, which usually resolve within 24 hours. If you are prone to developing these side effects, you may want to take an extra dose of steroids (e.g., 10mg of oral hydrocortisone) about an hour before getting the jab. You should also take some extra steroids and drink plenty of fluids if you were to develop a temperature and keep doing so until you feel better.”

Where and when to book your flu jab

You should book your annual flu vaccination for early autumn if possible (September onwards). Contact your GP to book your jab if they haven't already been in touch.

It may be quicker and easier to get one from your local pharmacy. Asda, Lloyds Pharmacy, Tesco or Boots are also all offering online booking services for the flu vaccine.

Children can receive the flu jab at their GP, school or a community clinic, depending on their age and circumstances. Find out more about vaccines for children at Child flu vaccine - NHS (www.nhs.uk)

Flu jab and COVID booster jab

People with Addison’s disease are eligible for the autumn COVID booster jab, as well as the flu vaccine. 

It’s important that people with Addison's and adrenal insufficiency take up the offer of both the flu and coronavirus jabs. Getting both jabs will reduce your risk of becoming ill with both coronavirus and flu at the same time. 

It’s perfectly safe to have both the coronavirus boosters and flu vaccines together, but you might want to get them in different arms. Find out more about the covid vaccine booster. If you have coronavirus, you shouldn’t have the flu jab until you’re better. 

Should I increase my glucocorticoid dose before having a vaccine?

Our Addison's Clinical Advisory Panel (CAP) and Society for Endocrinology have advised that there is no need to routinely increase glucocorticoid dose in patients with adrenal insufficiency at the time of vaccination if no significant symptoms as most people tolerate the flu jab well. However if you know you are prone to developing side effects, or are unsure, you may want to take an extra dose of steroids (e.g., 10mg of oral hydrocortisone) about an hour before getting the jab and rest well following your vaccine.

Vaccines are different for everyone, as everybody is different - so please listen to your body and do what is right for you. Those who are particularly anxious/ stressed before a vaccination for example will "use up" more cortisol so may find they have to up-dose in response to how they feel for that reason.

If you were to feel unwell after vaccination, check if you have an allergy to any ingredients in the vaccine, increase your glucocorticoid (sick day rules), take paracetamol to help reduce your symptoms making them easier to manage, rest and drink plenty of fluids. Visit the NHS website to find out more about reactions to vaccines and the Yellow Card scheme for reporting.

“My GP won’t give me the free NHS Flu jab" - Next Steps  

Due to Addison's and adrenal insufficiency being a rare disease, healthcare professionals don't always have the information they need to make certain decisions regarding the management of this rare condition. With this in mind, our charity exists to give you the information and support, should you need it, to send to your GP or healthcare professional, so you can work together.  

If after passing on the information on this webpage and noting to your healthcare professional it is the recommendation of the Addison's Clinical Advisory Panel (CAP) to receive the free NHS flu jab, you are still advised you will not receive the jab, please visit our Flu Jab and Other Vaccines page for a guide on the next steps you can follow. 

Read our Vaccine Guide

For more information, our ADSHG Clinical Advisory Panel have put together guidance about the flu vaccination in our 'Managing Your Addison's' leaflet. You can download the 'Managing Your Addison's' leaflet for free here.

Our thanks to Dr Alessandro Prete Consultant Endocrinologist, University Hospitals Birmingham NHS Foundation Trust.

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