| People at High Risk of Influenza Complications . |
|---|
| Children <5 y, and especially those <2 y,a regardless of the presence of underlying medical conditions |
| Adults ≥50 y, and especially those ≥65 y |
| Children and adults with chronic pulmonary disease (including asthma and cystic fibrosis); hemodynamically significant cardiovascular disease (except hypertension alone); or renal, hepatic, hematologic (including sickle cell disease and other hemoglobinopathies), or metabolic disorders (including diabetes mellitus) |
| Children and adults with immunosuppression attributable to any cause, including that caused by medications or by HIV infection |
| Children and adults with neurologic and neurodevelopment conditions (including disorders of the brain, spinal cord, peripheral nerve, and muscle, such as cerebral palsy, epilepsy, stroke, intellectual disability, moderate to severe developmental delay, muscular dystrophy, or spinal cord injury) |
| Children and adults with conditions that compromise respiratory function or handling of secretions (including tracheostomy and mechanical ventilation)124 |
| Women who are pregnant or post partum during the influenza season |
| Children and adolescents <19 y who are receiving long-term aspirin therapy or salicylate-containing medications (including those with Kawasaki disease and rheumatologic conditions) because of increased risk of Reye syndrome |
| American Indian/Alaska Native peopleb |
| Children and adults with obesity (ie, BMI ≥40 for adults and based on age for children) |
| Residents of chronic care facilities and nursing homes |
| People at High Risk of Influenza Complications . |
|---|
| Children <5 y, and especially those <2 y,a regardless of the presence of underlying medical conditions |
| Adults ≥50 y, and especially those ≥65 y |
| Children and adults with chronic pulmonary disease (including asthma and cystic fibrosis); hemodynamically significant cardiovascular disease (except hypertension alone); or renal, hepatic, hematologic (including sickle cell disease and other hemoglobinopathies), or metabolic disorders (including diabetes mellitus) |
| Children and adults with immunosuppression attributable to any cause, including that caused by medications or by HIV infection |
| Children and adults with neurologic and neurodevelopment conditions (including disorders of the brain, spinal cord, peripheral nerve, and muscle, such as cerebral palsy, epilepsy, stroke, intellectual disability, moderate to severe developmental delay, muscular dystrophy, or spinal cord injury) |
| Children and adults with conditions that compromise respiratory function or handling of secretions (including tracheostomy and mechanical ventilation)124 |
| Women who are pregnant or post partum during the influenza season |
| Children and adolescents <19 y who are receiving long-term aspirin therapy or salicylate-containing medications (including those with Kawasaki disease and rheumatologic conditions) because of increased risk of Reye syndrome |
| American Indian/Alaska Native peopleb |
| Children and adults with obesity (ie, BMI ≥40 for adults and based on age for children) |
| Residents of chronic care facilities and nursing homes |
Adapted from Grohskopf LA, Alyanak E, Ferdinands JM, et al. Prevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices—United States, 2021–22 influenza season. MMWR Recomm Rep. 2021;70(5):1–28
The CDC recommendations state that although all children younger than 5 y old are considered at higher risk for complications from influenza, the highest risk is for those younger than 2 y old, with the highest hospitalization and death rates among infants younger than 6 mo old.
American Indian/Alaska Native (AI/AN) children have higher rate of influenza complications.125–128 Most at-risk AI/AN children will also qualify in other high-risk categories to receive appropriate antiviral treatment. In the setting of a shortage, AI/AN children should be prioritized to receive influenza vaccine or antiviral medications according to local public health guidelines.