The new strain of influenza virus, or the “flu,” called H1N1 (formerly called the “swine flu”) can be dangerous for some people. People with cancer and cancer survivors should talk with their doctor about getting vaccinations for both the H1N1 and seasonal flu. Also, ask your doctor about vaccinations for people you live with, including family members, friends, and caregivers.

Symptoms and risks of H1N1

The symptoms of H1N1 are similar to those of the seasonal flu and include a fever, cough, sore throat, stuffy or runny nose, body aches, chills, fatigue, and headache. Some people may have vomiting and diarrhea. Most people feel better within a week.

Like the seasonal flu, H1N1 in some instances can be severe, and even deadly. The risk of complications from either type of flu is higher for some people, including those with cancer. If you have cancer now or had it in the past, and you get H1N1, you are more likely than other people to be sicker and to need hospitalization. Young children and older adults also tend to have more severe illness from H1N1.

Yet, unlike with seasonal flu, people 65 years and older are least likely to contract the H1N1 virus. This new strain of influenza virus has occurred in people only since April 2009. Doctors do not know yet whether people with cancer are more likely than others to get H1N1.

Getting flu vaccinations

The Centers for Disease Control and Prevention (CDC) recommends that people with cancer and survivors of cancer get the 2009 H1N1 flu shot as soon as it becomes available to them.

Those with cancer should not get the H1N1 nasal spray (mist) vaccine. It uses a weak but live virus. The shot (given in the arm with a needle) contains a dead virus.

If you are about to receive cancer treatment that will suppress your immune system (such as chemotherapy or radiation therapy), it is best to get the H1N1 flu shot before treatment. To get the best response to the vaccine during cancer treatment, get the shot when your blood cell counts are near normal, not at their lowest (usually seven to 14 days after treatment).

This year’s seasonal flu vaccine will not protect against the H1N1 flu, so people with cancer need both vaccinations. You can get both shots at the same time. Family members and caregivers of people with cancer also should get both flu vaccines if they can.

If you are allergic to eggs or had a bad allergic reaction to a past flu shot, ask your doctor if you should not receive flu shots. There are other reasons why some people should not get a flu shot, so it is always a good idea to check with your doctor first.

Safety of H1N1 flu shots

Although no vaccine is 100% safe, the vaccine for the H1N1 flu is made the same way as past seasonal flu vaccines. According to the CDC, this vaccine is safe and is the best tool to guard against getting the H1N1 virus. Talk with your doctor if you have any concerns.

Where to get the H1N1 flu shot

People under age 65 who are living with cancer are among the groups that the CDC says should have first priority for the H1N1 flu shot. Call your local health department to find out where to get the H1N1 flu vaccine.

After you get the shot, it takes about two weeks to develop antibodies that can protect you from the H1N1 virus.

Reduce your risk for H1N1 and seasonal flu

The H1N1 flu spreads like other flu viruses: through coughing, sneezing, and sometimes touching objects that the virus is on. Fortunately, there are many things you can do to reduce your risk of getting both types of flu.

• Wash your hands often with soap and warm water. Use an alcohol-based hand sanitizer if you can’t wash your hands.
  
  
• Do not get close to someone who is sick or appears ill.
  
  
• Ask people to not visit you if they are sick or live with someone who has the flu.
  
  
• If you must be around someone who has a cold or flu, ask that person to cough and sneeze into a tissue or into his or her sleeve.
  
  
• Using soap or alcohol, wipe off the phone and other items that a sick person touches before you use them. The virus can live up to eight hours on the surface of objects.
  
  
• Try not to touch your nose, mouth, and eyes after touching shared objects or shaking hands with someone.
  
  
• Talk with your doctor about whether you need the H1N1 flu shot and a prescription antiviral drug (Tamiflu or Relenza).
  
  
• Avoid using products that are not likely to prevent H1N1 flu. The U.S. Food and Drug Administration (FDA) lists products that make fraudulent (deceitful) claims about H1N1.

What to do if you “catch” the flu

If you have cancer and develop flu symptoms, call your doctor’s office right away and follow your doctor’s advice. You may need an antiviral drug. These drugs can make the flu milder and go away faster. They work best if you take them within 48 hours after your symptoms start.

If you are receiving chemotherapy and you have the flu, let your treatment center know. You may need to postpone treatment until you feel better.

Take care to not spread your germs. Other than going to the doctor, stay home and rest. You should not go out for 24 hours after your fever goes away.

Visit the CDC’s 2009 H1N1 Flu website often to receive updated information.

More Information

Cancer and the Winter Months

When to Call the Doctor During Cancer Treatment

Utility of Influenza Vaccination for Oncology Patients, a review article in the Journal of Clinical Oncology

Novel influenza A (H1N1) in three patients, a Diagnosis in Oncology report in Journal of Clinical Oncology

Additional Resources

CDC: Cancer, the Flu, and You

Last Updated: June 22, 2010