首先明白主要有三种病毒, A H3N2, A H1N1 跟B(B系列不止一个，but anyway)
每年CDC流感季节过去了后都会统计一下，今年那种病毒最猖狂 （抱歉无法预知）
其中老年人杀伤力比较大的是H3N2, 2017年的主打。当年死了上千人（澳洲）
当H1N1为主打时候，流感通常对老人没那么大杀伤力
那么vaxx的公司针对老人开发了新的疫苗,使用了新技术激活人体的免疫细胞。
老年人的免疫系统比较僵化，对新抗原不太敏感。就是说，免疫系统变弱，打旧的vax没有什么效果。年轻人相反。
由于种种审批原因，现在针对65+老人的疫苗只有fluad是政府免费的，PBS可以claim. 英国Sequirus 公司开发
这个疫苗2009年在美国批准，2013年在加拿大批准，2017年在澳洲批准（由于2017流感尤其严重，炭包亲自跟Greg Hunt 批款）
还有一种选择是Fluzone, Sanofi开发的，但是要付钱
两个疫苗都是三联的，四联不存在-因为没人开发，而且致命的是H3N2菌株
什么时候打疫苗： 根据GP而定，太早打没有用处，抗体会慢慢消失
每年的流感季节都在八-九月份。
一般不需要一年打两次疫苗
希望2019年病毒主打依然不是H3N2
-source
hospital presentation
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请问楼主是医生吗？对于有免疫系统疾病的人该不该打流感疫苗，比如系统性红斑狼疮病人？
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免疫系统病要case by case,红斑狼疮一般可以打influenza vaccine但是不可以打live attenuated (具体情况问rheumatologist)
如果是新诊断的红斑狼疮最好在吃药治疗前打非“live attenuated" vaccine
source
-美国CDC，澳洲的guideline我会回医院找一找
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Of course,如果之前对flu shots有敏感的人不该打flu vax, etc
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这个是澳洲的immunisation handbook,所有人都可以看的标准
关于免疫系统病的：
People with autoimmune conditions are at higher risk of vaccine-preventable diseases, and associated morbidity and mortality. Examples of these conditions are:
systemic lupus erythematosus
rheumatoid arthritis
inflammatory bowel disease
multiple sclerosis
These people are also at risk of infection as a result of treatment with immunosuppressive agents such as corticosteroids and DMARDs (disease-modifying anti-rheumatic drugs).81 DMARDs encompass a range of anti-inflammatory and immunosuppressing agents. The resulting level and nature of immunocompromise in each person depends on:
the specific agent(s) used
the mechanism of action
the dosage
whether the treatment is combined with other therapies, such as corticosteroids (see People receiving corticosteroid therapy)
People with autoimmune diseases and other chronic conditions are recommended to receive inactivated vaccines to optimise protection against disease. There is potential for reduced immunogenicity of vaccines in these people due to both immunosuppressive treatment and the underlying disease.82-84 Extra vaccine doses, such as for pneumococcal vaccine, may be needed.
However, clinical and laboratory measures of disease activity, and the choice, duration and dose of immunosuppressive therapy, do not always predict who will respond poorly to vaccination.83,85,86
When should people on immunosuppressive therapy receive vaccines
Live vaccines are generally contraindicated in people who are receiving immunosuppressive therapy, such as DMARDs and high-dose corticosteroids. See Use of specific live vaccines in people who are immunocompromised.
However, certain people on DMARDS may receive live vaccines in consultation with a specialist, and with careful consideration of their immune function and current and future disease risk.87 For example, people on low-dose conventional synthetic DMARDs (csDMARDs) may receive zoster vaccine (see Herpes zoster).
People should receive all indicated live vaccines at least 1 month before starting immunosuppressive therapy, if possible.
In general, people who are immunocompromised and receiving biological DMARDs (bDMARDs) or targeted synthetic DMARDs (tsDMARDs) should not receive live vaccines until at least 12 months after therapy has ended. However, seek specialist advice about the most appropriate interval for the person and their individual circumstances.
Infants born to mothers who received bDMARDs during pregnancy
Infants aged <6 months who were born to mothers who received bDMARDs, particularly in the 3rd trimester, are not recommended to receive live vaccines, particularly BCG vaccine.1,88,89 See also Pregnant women and Use of immunosuppressive therapy during pregnancy in Vaccination of women who are planning pregnancy, pregnant or breastfeeding.)
There are no data on the use of other live vaccines in infants born to women who have received immunosuppressive therapy during pregnancy. Theoretically, there is a risk in giving rotavirus vaccines to these infants. Some experts recommend not giving rotavirus vaccine to infants born to mothers who received bDMARDs during pregnancy,90 particularly in the 3rd trimester. Decisions to vaccinate will depend on the nature and timing of the immunosuppressive therapy received during pregnancy. Drug levels may also be measured to guide decision-making.
Infants should receive inactivated vaccines according to the recommended schedule. However, immune responses may be suboptimal. These infants may need extra inactivated vaccine doses — seek expert advice from the treating specialist and an immunisation expert.
Association between vaccines and autoimmune conditions, such as Guillain–Barré syndrome
Overall, theoretical concerns that vaccines exacerbate or cause autoimmune diseases such as rheumatoid arthritis, type 1 diabetes and multiple sclerosis have not been substantiated. Large epidemiological studies have not verified these sporadic case reports.91-94
In almost all cases, people with autoimmune disease can safely receive inactivated vaccines.
In 1976, a small increased risk of Guillain–Barré syndrome (GBS) in the 6 weeks after vaccination was associated with a type of influenza vaccine in the United States. Since then, close surveillance has shown that GBS has occurred at a very low rate of up to 1 per 1 million doses of influenza vaccine, if at all.95
People with a history of GBS whose first episode was not after influenza vaccination have an extremely low risk of recurrence of GBS after vaccination.96-98 Influenza vaccination is recommended for these people.
Influenza vaccination is generally not recommended for people with a history of GBS whose first episode occurred within 6 weeks of receiving an influenza vaccine. There is limited data on the risk of recurrence of GBS in people where the first episode occurred within 6 weeks of influenza vaccination (i.e. the first episode was possibly triggered by the vaccine). In these people, discuss the potential for recurrence if vaccinated, the potential for exacerbation following influenza infection, and other protective strategies (e.g. vaccination of household members). Vaccination can be considered in special circumstances, such as when an alternative cause for GBS, such as Campylobacter jejuni infection, was found or the risk of influenza disease is considered high.
Many well-conducted studies have shown no increased risk of GBS after HPV vaccine.99 One smaller study suggested a possible very small increased risk, but this study had a number of limitations.99 There is ongoing research to monitor whether there is any increased risk of GBS after HPV vaccine.
Narcolepsy (sudden sleeping illness) was associated with AS03-adjuvanted pandemic influenza vaccines in 2009–10. This was mainly seen in the Scandinavian population, and affected children especially.100-102 These vaccines were not used, and are not available, in Australia.
Discuss individual concerns with, and seek expert advice from, the person’s treating physician or an immunisation specialist.
Hypopituitarism
Hypopituitarism is not a contraindication to vaccination if the person is only receiving physiological corticosteroid replacement for their condition. This is because physiological doses of corticosteroids are not considered immunosuppressive.
If the person has been unwell and is on high-dose corticosteroids for more than 14 days, do not give live vaccines for at least 1 month after stopping therapy. See Table. Recommended timing of live vaccine doses in adults and children taking corticosteroids.
Metabolic diseases
People with metabolic diseases should receive vaccines using the routine schedule. Vaccination is generally considered safe in these people.103
Influenza and pneumococcal vaccines are recommended for people with chronic medical conditions, such as metabolic disease.
TL;DR这些人更该打疫苗，因为染病的结果比较可怕，但是不能打活病毒疫苗
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好详细的帖子，赞！
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现在改建议了，由于流感开始流行，建议有需要的人可以开始打，65岁以上跟小孩
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有两种？建议打哪种？
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什么时候打最好？
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现在打，但是6月可能要补
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对疫苗有反应正常吗，比如头疼嗜睡浑身发冷
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有可能出现类似感冒的反应
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请问LZ，治疗已经结束的癌症病人可以打吗？
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这个要具体分析，一般来说癌症病人由于化疗减低免疫力，不能打活体疫苗，在癌症主治医生同意下，可以打非活性疫苗。癌症病人需要问自己的医生的，太多变数
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最近本人医院接到多流感的case， 大多数都是influenza A
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今年流感比2017年还严重，真是迫在眉睫啊
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第二个term，我的reg中招了，我靠
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您觉得今年什么时候打比较好呢？谢谢
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可以打了
end of april/early may
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比较重要，所以复制一下
首先明白主要有三种病毒, A H3N2, A H1N1 跟B
每年CDC流感季节过去了后都会统计一下，今年那种病毒最猖狂 （抱歉无法预知）
其中老年人杀伤力比较大的是H3N2, 2017年的主打。当年死了上千人（澳洲）
当H1N1为主打时候，流感通常对老人没那么大杀伤力
那么vaxx的公司针对老人开发了新的疫苗,使用了新技术激活人体的免疫细胞。
老年人的免疫系统比较僵化，对新抗原不太敏感。就是说，免疫系统变弱，打旧的vax没有什么效果。年轻人相反。
由于种种审批原因，现在针对65+老人的疫苗只有fluad是政府免费的，PBS可以claim. 英国Sequirus 公司开发
这个疫苗2009年在美国批准，2013年在加拿大批准，2017年在澳洲批准（由于2017流感尤其严重，炭包亲自跟Greg Hunt 批款）
还有一种选择是Fluzone, Sanofi开发的，但是要付钱
两个疫苗都是三联的，四联不存在-因为没人开发，而且致命的是H3N2菌株
什么时候打疫苗： 根据GP而定，太早打没有用处，抗体会慢慢消失
每年的流感季节都在八-九月份。
一般不需要一年打两次疫苗
希望2019年病毒主打依然不是H3N2
-source
hospital presentation
评论
新guideline,现在该打疫苗了，多人中招
如果中招，3天内找GP开Tamiflu,否则I can't help you
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要打 每年都要打 而且如果是第一次打要打两次
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说啥了被屏蔽了啊
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