Oct 25 2004
This year's supply of flu vaccine is limited. It is important that people at highest risk of serious illness or death from the flu get a flu shot. Complete this CDC form to see if you or your child should or should not get a flu shot.
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NO |
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Are you 65 years of age or older? |
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Do you have a long-term health problem such as: heart disease, kidney disease, lung diseases like asthma, metabolic diseases like diabetes, blood disorders like anemia, or a weakened immune system caused, for example, by cancer or cancer treatment, HIV/AIDS, or steroid therapy? |
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Are you pregnant or do you plan to become pregnant in the near future (October 2004 through March 2005)? |
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Do you live in a nursing home or long-term-care facility? |
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Are you a healthcare worker involved in direct, hands-on, face-to-face patient care? |
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Do you live with or care for one or more children less than 6 months of age? |
If you checked "YES" to ANY of the questions in this section you SHOULD get a flu shot.
Parents or legal guardians of a child—answer these questions
If you checked "YES" to ANY of the questions in this section your child SHOULD get a flu shot.
Adults and parents—answer these questions
If you checked "YES" to ANY of the questions in this section you or your child SHOULD NOT get a flu shot.
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