Risk Reduction Recommendations for Specific Patient Groups

Asthma
Get vaccinated for seasonal flu as soon as the vaccine is available. Children ages 6 months to 8 years who have never had seasonal flu vaccine need 2 doses.
Persons 6 months to 64 years of age should get the 2009 H1N1 vaccine by injection as soon as it is available where they live
Persons with asthma should not take the intranasal (FluMist) vaccine.
Oseltamivir is recommended for patients with asthma who get 2009 H1N1 infection; it should be started within 48 hours of onset of symptoms if possible.
Diabetes
Patients with diabetes should get both seasonal flu vaccine and H1N1 vaccine.
Diabetes care: Continue insulin or oral hypoglycemics even if the patient cannot eat; monitor blood glucose every 4 hours and record; drink extra calorie-free liquids; weigh daily.
Health provider should be alerted for temperature > 100°F, blood glucose <> 300 mg/dL, moderate or large amount of urine ketones, change in mental status, dyspnea, weight loss of 5 lbs or more, or onset of severe diarrhea.
Pregnancy
Pregnant women are at high risk for serious influenza complications.
Pregnant women should get both seasonal flu vaccine and 2009 H1N1 flu vaccine, both by IM injection when the vaccines become available. Pregnant women should not get the intranasal LAIV (FluMist) vaccine.
Pregnant women with established or suspected influenza should be treated with oseltamivir or zanamivir, preferably within 2 days of the onset of symptoms.