4 Types of Nerve Damage Caused by the Flu Shot

While most flu vaccinations do not result in any damage to the patient, the vaccine is not without risk.

By far the most common flu shot-related injury is shoulder damage related to the actual injection. This can cause shoulder and neck pain after flu shot. This type of vaccine injury is called SIRVA or Shoulder Injury as a Result of Vaccine Administration. However, the flu shot can cause serious nerve injuries causing paralysis or death.

The most common type of nerve damage from the flu shot is Guillain-Barré syndrome (GBS). GBS is a rare but serious condition in which the body’s immune system attacks the nervous system, causing weakness and paralysis. Other types of vaccine injury-related nerve damage linked to the flu shot include transverse myelitis (TM) and impact-related nerve damage. TM is a rare neurological condition that results in inflammation of the spinal cord. Impact-related nerve damage causes loss of sensation and pain.

Other complications may result in an injury that affects the nervous system. Patients may be able to recover from these nerve injuries after a regimen of physical therapy. In the interim, however, nerve damage from flu vaccinations can drastically impact the patient’s quality of life and ability to complete their daily activities.

Here is a list of 4 potential types of nerve damage that can result from the flu vaccine:

• Brachial Neuritis
• Guillain-Barre Syndrome
• Shoulder Nerve Damage
• Transverse Myelitis

Brachial Neuritis or Parsonage-Turner Syndrome

This illness primarily affects the nerves in the arm and hand. It will generally impact one side of the body, although in rare cases, it can impact both sides. Brachial neuritis is caused when there is damage to the nerves that carry messages from the spinal cord to the arms and hands.

The progression of brachial neuritis is the opposite of other neurological conditions that result from vaccinations. Here, patients will start with severe shoulder pain, which is then followed by weakness. The weakness then extends down the arm and into the hand. The arm will feel numb and tingly, and the patient may have difficulty moving it. In extreme cases, brachial neuritis can lead to paralysis of the affected arm.

Patients with brachial neuritis generally recover within 6 to 12 months. However, some patients may experience long-term nerve damage, which can cause chronic pain. Treatment for brachial neuritis focuses on managing the pain and helping the patient regain function in the affected arm. Physical therapy is often recommended to help stretch and strengthen the muscles in the arm. In some cases, surgery may be necessary to relieve pressure on the nerves.

While PTS can be treated, the symptoms will generally linger. It takes several months to several years for patients to make a recovery from PTS. Generally, the treatment for PTS will involve some sort of combination of steroids and physical therapy. If these are not effective, then surgery may be necessary.

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Guillain-Barre Syndrome

Guillain Barre Syndrome is a rare but serious complication of flu vaccination. This illness usually occurs in the wake of an infection in the body. The immune system will work to fight off the infection. However, in the process, the immune system will also turn against the nervous system and damage the body’s nerves. There is no single theory as to why the flu vaccine can increase the risk for GBS, but the vaccination does introduce strains of infection into the body.

GBS varies in its severity. The disease can lead to a loss of feeling and movement in extremities. Since the nervous system is at issue, there can also be a loss of reflexes, and some patients report incontinence. In a more severe manifestation of GBS, the patient’s respiratory function may be affected, which can lead to death.

There have been several documented fatalities from GBS in patients who have received a flu vaccination. Rates of GBS will vary each year, depending on the content of that year’s flu vaccine. While the connection between receiving a flu vaccine and developing GBS is not certain, there is at least some interrelation between the two. Some who suffer from GBS may never fully recover, while others can mostly recover with physical therapy.

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Shoulder Nerve Damage and Impact Related Nerve Damage

Can a shot hit a nerve? Flu shots can cause damage to the axillary, radial, ulnar, and median nerves.

Sometimes, an error in the method of injection can damage the nerves in the shoulder. Like SIRVA, when the injection is given to the wrong part of the shoulder, it can have adverse effects that result in a loss of motion in the shoulder. Patients will feel a tingling and weakness in the shoulder that will progress to sharp pain.

This type of nerve damage will also result from the injection being administered too high on the shoulder. In one case of axillary nerve damage, a man received a vaccination at a drive-through clinic. Within days, he began to experience weakness in his shoulder that degenerated over time. After five weeks, it was discovered that his deltoid muscle had atrophied.

Patients will generally require physical therapy to regain the full use of their shoulders. Patients who do not respond to physical therapy may need surgery to correct the problem. Many patients will regain most or all of the use of their shoulder, although some may have permanent symptoms.

What is axillary nerve damage?

The axillary nerve is a nerve that runs through the shoulder. It controls the muscles in the shoulder and allows for sensation in the upper arm. Axillary nerve damage can occur as a result of an injury or surgery to the shoulder, or it can be caused by compression or inflammation of the nerve. Symptoms of axillary nerve damage include weakness in the muscles controlled by the nerve, loss of sensation in the upper arm, and pain in the shoulder.

What is radial nerve damage?

The radial nerve is a nerve that runs down the arm. It controls the muscles in the hand and allows for sensation in the fingers. Radial nerve damage can occur as a result of an injury or surgery to the arm, or it can be caused by compression or inflammation of the nerve. Symptoms of radial nerve damage include weakness in the muscles controlled by the nerve, loss of sensation in the fingers, and pain in the arm.

What is ulnar nerve damage?

The ulnar nerve is a nerve that runs down the arm. It controls the muscles in the hand and allows for sensation in the fingers. Ulnar nerve damage can occur as a result of an injury or surgery to the arm, or it can be caused by compression or inflammation of the nerve. Symptoms of ulnar nerve damage include weakness in the muscles controlled by the nerve, loss of sensation in the fingers, and pain in the arm.

What is median nerve damage?

The median nerve is a nerve that runs down the arm. It controls the muscles in the hand and allows for sensation in the fingers. Median nerve damage can occur as a result of an injury or surgery to the arm, or it can be caused by compression or inflammation of the nerve. Symptoms of median nerve damage include weakness in the muscles controlled by the nerve, loss of sensation in the fingers, and pain in the arm.

Read more about Shoulder Injuries After Vaccination
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Transverse Myelitis

This is a serious side effect of a flu vaccination where part of the spinal cord becomes inflamed causing severe pain and disability.

The inflammation of the spinal cord damages the nerve cell’s insulation called myelin, interrupting the ability of the spinal cord to send messages throughout the body. As with anything that impacts the spine, there is the possibility of lasting damage, including the loss of the use of hands, arms, legs, and/or feet.

The symptoms of transverse myelitis can come on suddenly after the influenza vaccine or develop over a few days after the vaccine. Symptoms may include:

• Back pain or stiffness
• Numbness or weakness in the legs
• Loss of bowel or bladder control
• Difficulty walking or moving the legs
• Sexual dysfunction
• Pain in the trunk or back

Most often, transverse myelitis will impact the legs or feet. In a more severe case of transverse myelitis, the patient will experience a complete loss of the use of arms and legs or complete paralysis.

There will also be neuropathic pain, abnormal sensations, and possible incontinence. In the most severe cases, the patient will need emergency surgery when they experience compression of the spinal cord.

While transverse myelitis is a rare vaccine injury, there are roughly one to two cases for every million vaccinations. Given the number of flu vaccinations in the United States every year, there may be several hundred additional cases of transverse myelitis that result from this vaccination.

Learn more about Transverse Myelitis
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When you have experienced any one of these complications as a result of flu vaccination, you must consult with an attorney to find out if you may be eligible for compensation. The attorneys at Sadaka Law are well versed in these cases and can advise you on the specifics of the Vaccine Injury Compensation Program. Our attorneys can guide you through the process of filing a claim for your injuries.

What is the National Vaccine Injury Compensation Program?

The National Vaccine Injury Compensation Program is a no-fault program that was created to provide compensation to those who have been injured by a vaccine. The program is administered by the U.S. Department of Health and Human Services and is funded by a tax on vaccines. The program covers injuries caused by vaccines that are recommended by the Centers for Disease Control and Prevention (CDC) for routine administration to children, adolescents, and adults.

Learn more about VICP program

Do flu shots hurt?

The most common side effect of the flu shot is an injection site reaction, soreness, or redness at the injection site. Some people may also experience a low-grade fever, headache, or muscle aches. You may want to ask your doctor or nurse if you can have it done in your non-dominant arm. That way, if you do feel any discomfort, it will be in the arm that is less used for everyday activities.

How are flu shots administered?

Flu shots are usually given as an injection (shot) in the upper arm into the muscle or intramuscular injection. They can also be given as a jet injector, which is a needle-free device that uses high pressure to push the vaccine through your skin into the muscle.

Can vaccines cause other nerve injuries?

YES.  Vaccines can cause Bell’s palsy and other nerve injuries.

10 Flu Shot Side Effects

Ahh, flu season. It happens every year. Influenza, commonly referred to as the flu, is a serious disease caused by influenza viruses. In some cases, the flu can lead to hospitalization and worse, death. The best way to protect yourself is by getting vaccinated. As important as that is, it’s totally reasonable to worry about potential flu shot side effects.

First, know that the vaccine works really well, with various estimates showing its effectiveness in reducing the risk of life-threatening disease somewhere in the range of 40 to 60 percent, and as high as 75 percent among children.

Worried about catching the flu from getting jabbed? Rest assured, it is not possible to contract influenza from the vaccine, says Michael Hanak, MD, the associate chief medical officer for Population Health. “The vaccine is made from inactivated viral particles, which do not cause illness.”

That said, many people do experience mild flu-like symptoms after vaccination, which is a sign that your body is producing antibodies and generating an immune response. And that’s a good thing!

Flu viruses typically spread in fall and winter, peaking between December and February, according to the FDA. Every flu season is different, and the health impact vary widely from year to year. Because of that, the flu vaccine is updated every year to protect against new flu virus strains that are expected to circulate and cause illnesses.

Meet the experts: Amesh A. Adalja, MD, is an infectious disease physician and a senior scholar at Johns Hopkins University for Health Security. His work is focused on emerging infectious disease, pandemic preparedness, and biosecurity.

Michael Hanak, MD, is a family medicine physician and an associate professor in the department of family & preventive medicine at Rush Medical College.

Soma Mandal, MD, is an internist at Summit Medical Group in Berkeley Heights, New Jersey.

It’s more important than ever to get vaccinated this year.

We are in the midst of a significant and early uptick in cases and severity, says Dr. Hanak. “The CDC reported the most flu-related hospitalizations at this point in the year since the pandemic, with an estimated 880,000 cases of flu nationwide,” he notes. Influenza is responsible for thousands of hospitalizations and hundreds of deaths each year, and while the flu vaccine does not protect 100 percent of people from actually contracting the flu, much like the COVID vaccine, it can prevent severe illness.

And side effects are transient and typically last one to two days after vaccination, says Sindhu Aderson, MD, the medical director of Northwestern Medicine Immediate Care. People who are vaccinated and get sick anyway tend to experience less severe symptoms as well as decrease their risk of hospitalization. “This is why the flu shot is an incredibly important tool to keep ourselves and those around us safe,” she says.

If you are thinking of getting a flu shot this year, plan accordingly. The vaccine can take 14 days to take full effect, according to Dr. Hanak, so take into account any holiday plans or upcoming travel.

Since the vaccine is not immediately effective, many people who receive the vaccine but shortly before or after being exposed to influenza or another virus (i. e., a cold) will become ill from that. And that’s completely unrelated to their vaccination.

Another thing to note? Talk of the flu shot’s many side effects is greatly exaggerated. The flu shot can’t actually give you the flu, and while there are some possible side effects, infectious disease expert Amesh A. Adalja, MD, a senior scholar at the Johns Hopkins Center for Health Security, says most are rare.

If you’re particularly wary of needles, you may prefer the nasal influenza spray (Flumist) over an injection, says Soma Mandal, MD, an internist at Summit Medical Group in Berkeley Heights, New Jersey. Potential nasal spray side effects include runny nose, wheezing, headache, vomiting, muscle aches, fever, sore throat, and cough.

“Not everyone should get the nasal flu spray due to factors like age and underlying health conditions, though, so talk to your doctor to determine if it’s the best option for you,” she says.

The flu shot is still worth it despite potential side effects.

Here are the flu shot side effects to be aware of this season, from common soreness and redness to rare effects like Guillain-Barre syndrome. After you’ve read through them, roll up your sleeve because flu season is coming. And guess what? The vaccine is still your best stay-healthy defense.

1. Shoulder soreness

If you receive the flu shot as an intramuscular injection (a.k.a. in your arm, typically), you have a 10 to 64 percent chance of experiencing some muscle soreness in your upper arm, according to the CDC.

That’s because the needle is injected directly into the muscle, causing microscopic damage to the cells, and is designed to cause an inflammatory immune system response. You can take an OTC pain reliever while you wait for the soreness to fade, but if the pain is very noticeable or decreasing your mobility, Dr. Adalja recommends checking with your doctor.

What to do: If you are experiencing shoulder soreness, especially at the injection site, Dr. Hanak recommends taking Tylenol. “I generally recommend using Tylenol to address post-vaccine symptoms, as other anti-inflammatory medications can potentially interfere with the vaccine and immune response process.”

2. Redness or swelling at the injection site

Anytime you pierce the skin and put something into the body it can cause a topical reaction, says Dr. Adalja. This is just a sign that your immune system is activating.

But this redness and swelling where you get your shot is a common side effect that only typically lasts a few days. It’ll go away on its own, but if it’s really bugging you, you can take ibuprofen (Advil) or acetominophen (Tylenol).

What to do: You can use topical creams to mitigate any redness or swelling, says Dr. Hanak. He also advises avoiding activities involving the shoulder and to take Tylenol as needed. You may even want to schedule your flu vaccine before a weekend or a day off from the gym to avoid having to use your arm, which may be sore post-vaccination.

3. Body aches

Any vaccine can cause body aches because of the way in which they activate the immune system, says Dr. Adalja.

Related Story

• Should Pregnant People Get The Flu Shot?

If you’re feeling sore in places other than your arm, it’s usually nothing to worry about, though Dr. Adalja notes that the flu shot does take two weeks to become fully effective—so your body aches could be a sign of the actual flu, since viral strains are probably circulating around the time you get the vaccine.

What to do: Hydrate with plenty of water and to take Tylenol is your best bet at relieving body aches.

4. Itching at the injection site or a full-body rash

This would signal an allergic reaction, but “it’s very rare to have an allergic reaction to the flu shot,” Dr. Adalja notes. “There are lots of myths about egg allergies and the vaccine,” he explains—because most flu shots and nasal sprays are manufactured using technology that involves small amounts of egg proteins, per the CDC.

Related Story

• How Long Does a Virus Last?

“If you can eat scrambled eggs, you’re not going to have a problem with the flu shot,” Dr. Adalja says. If you have a confirmed egg allergy, you can likely still get the shot, the CDC says.

The caveat: If you experience severe itching at injection site, a rash all over your body, or signs of anaphylactic shock, seek immediate medical attention. And if you’ve had an allergic reaction to the flu shot in the past, you are among those few groups of people who the CDC recommends skip the flu shot.

What to do: Dr. Hanak recommends taking an allergy medication like Benadryl or using any anti-itch creams or lotions like a topical Benadryl cream to help with the discomfort.

5. Fever

You probably won’t get a fever because of the vaccine, but if you do, it should be low-grade (i.e. less than 101 degrees). If it’s higher than that, don’t blame your flu shot—you probably have a totally unrelated illness. “Remember that you’re getting the vaccine at the height of respiratory virus season,” says Dr. Adalja. “So you may have been incubating another virus [without knowing it].”

And once again (for the people in the back!): The flu shot cannot give you the flu. While some flu vaccines contain virus strains, they’re not live strains, so they can’t get you sick. Meanwhile some flu shots don’t contain the virus at all (they only contain a specific protein from the influenza virus), per the CDC.

What to do: Drink cold fluids, stay hydrated, and take Tylenol until the fever subsides, says Dr. Hanak.

6. Dizziness or fainting

This is less a side effect of the vaccine itself and more a side effect of a needle phobia, says Dr. Adalja. If you think you might have a stress reaction or faint, give your health care provider a heads up so they can make sure you stay seated after the shot to prevent injury.

What to do: Dr. Hanak advises monitoring your blood pressure and reporting to your doctor. You will also want to stay hydrated.

7. Headache

An aching head is included in the CDC’s official list of potential side effects, but Dr. Adalja says it’s nbd. “It is just part of the immune reaction to the vaccine,” he says, adding that it usually goes away pretty quickly and can “easily” be treated with acetaminophen (aka Tylenol). FWIW: Some of the headaches could just be due to anxiety about getting a shot, Dr. Piedra says. “People could receive a placebo shot and get headaches as well,” he says.

What to do: Drink plenty of fluids and take some Tylenol until your headache subsides.

8. Nausea

This is another one listed by the CDC that Dr. Piedra says is likely due to anxiety. “There are people that, when they get an injection of whatever type, can have some gastrointestinal manifestations afterward, including nausea,” he says. “It’s often attributed to anxiety.” It’s possible to have a little nausea as a larger part of your body’s response to the flu vaccine, Dr. Adalja says, but it doesn’t last long. Dr. Piedra agrees: “It will flee rapidly.”

What to do: Take some supplements or OTC meds to tame your stomach, such as B6 supplements, Dramamine, ginger supplements, and Pepto-Bismo. You may even want to make some dietary changes depending on what types of beverages and foods your stomach can handle.

9. Guillain-Barre syndrome

Guillain-Barre syndrome (GBS) is an auto-immune disorder that’s triggered by a wide variety of things, from vaccines to viral infections.

Related Story

• ‘My Fever Turned Out To Be A Bladder Infection’

GBS causes damage to the nervous system, resulting in symptoms like muscle weakness, numbness, difficulty walking or an odd gait, and even paralysis, says Dr. Adalja. While 70 percent of people fully recover from the disorder, the recovery period can range from weeks to even years, according to the National Institute of Neurological Disorders and Stroke.

But he also says the connection between GBS and the flu vaccine has been overhyped: “People should remember that influenza itself is much more likely to cause GBS than the vaccine. ”

And since no more than one or two cases per million people vaccinated will have this side effect, it’s better to take your (super small) chances with GBS than with one of the many common, severe complications that often come with the flu itself.

What to do: Studies have shown that the likelihood of contracting GBS is actually higher after having influenza than after receiving the influenza vaccine, notes Dr. Hanak. “On average we see one to two cases per million vaccinations, but the evidence is not clear yet as to how strong a link exists.” For example, a recent study published in JAMA reported that 13 million older adults showed no increase in GBS following flu vaccination. If you experience any of the symptoms of GBS, it’s best to check in with your doc about next steps.

10. Severe allergic reaction

Any medication or vaccination has the potential for adverse effects including severe life-threatening reactions, says Dr. Mandal. Severe allergic reactions typically occur within a few hours of receiving the vaccine. These include hives, wheezing, shortness of breath, fast heart rate and dizziness.

“It is important to seek immediate medical attention if you develop any of these symptoms,” she says. It’s definitely scary, but know that this side effect is super rare.

What to do: Take an allergy medication, such as Benadryl, and contact your primary care physician. In some instances, you may even need to go to a clinic or emergency room for steroids or other treatments to help quell these flu shot side effects if they are severe.

11. Fatigue

Another flu shot side effect is fatigue and a runny nose, notes Dr. Hanak. “These are usually short-lived symptoms anyhow,” he says.

What to do: If the side effects are bothersome, drink plenty of fluids, rest, and use nasal decongestants for nasal symptoms.

Why do some people get side effects and others don’t?

It is estimated that up to 20 percent of people with influenza do not exhibit symptoms, which further shows everyone needs to get vaccinated, explains Dr. Hanak. “Similarly, varying levels of immune response occur with the flu vaccine, which can produce a wide variety of symptoms, including none at all,” he says.

Many factors can play a role, including age, medications taken regularly, other health conditions, and timing (i.e., receiving the shot when you have seasonal allergies or other ongoing illnesses).

The flu vaccine is designed to stimulate your immune system to build antibodies against the virus, and the thought here is that those people having side effects from the flu shot are those whose bodies are having a robust response to the vaccine, says Dr. Aderson.

As with many things in life, everybody and every body will respond differently to the flu shot depending on many different factors.

The bottom line: For most everyone, the flu shot is safe and only causes mild symptoms that are pretty much just annoying. The benefits of not getting the flu (and not spreading it to others who may be more vulnerable to the illness) far outweigh the risks of getting the shot.

The doctor warned about dangerous symptoms after a flu shot – Gazeta.Ru

September 10, 2020, 15:37
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Chief specialist of the First Moscow State Medical University. I. M. Sechenov, Doctor of Medical Sciences Vladislav Zhemchugov spoke about the dangerous symptoms after a flu shot, writes “Ridus” .

The expert noted that the symptoms were mild or severe. The former include a slight increase in body temperature, redness at the injection site and general malaise, while the latter include high temperature, suppuration at the injection site, pulsation and swelling.

Zhemchugov added that there is no need to worry about mild symptoms, but for serious ones, you need to contact Rospotrebnadzor and the hospital, in extreme cases, call an ambulance.

RELATED NEWS:

— Flu vaccination started in the Moscow region

— More than 350,000 Muscovites were vaccinated in the first week of large-scale flu vaccination

— The doctor explained why the simultaneous infection with influenza and coronavirus is dangerous

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See also

To be vaccinated or not against the flu?

Should I get vaccinated against the flu or not?

Today the question of whether to be vaccinated or not has divided society into two irreconcilable groups: supporters and opponents of vaccination. At the same time, there are those who are undecided and are confused about what to do or not? Who to trust? Where to find reliable information about vaccines, in a continuous stream of scientific, pseudoscientific and pseudoscientific information.

We say yes!

In addition to the main problem “Should I get the flu shot?”, the following questions are also asked:

• · What is the purpose of the flu vaccination?
• · What is in the influenza vaccine?
• · Why do I have to get vaccinated every year?
• · 3 years ago I got the flu vaccine and last year I got seriously ill and was diagnosed with the flu. What does it say?
• · If I get the flu shot, will I get the flu?
• · Can the flu vaccine cause the flu?

We will try to answer each question in detail and clearly.

What is the purpose of influenza vaccination?

The main purpose of influenza vaccination is to protect the population from the massive and uncontrolled spread of infection, from the influenza epidemic. It is important to understand that by vaccinating the population, doctors save the lives of those who are at risk of dying from complications. Risk groups include young children whose immunity is in the process of formation, the elderly, those who suffer from chronic diseases, people with immunodeficiency conditions.

Influenza is an infection, in most cases it is severe, there is simply no easy course of influenza.

If the majority are vaccinated, the minority, those who do not receive the vaccine for one reason or another, have a minimal chance of becoming infected. And that’s what herd immunity is for. The vaccinated population does not allow the virus to spread. We all know that the flu virus spreads very quickly.

What is in the flu vaccine?

The flu vaccine protects against influenza viruses that epidemiologists predict will be the most prevalent in the coming season. Traditional influenza vaccines (“trivalent” vaccines) are designed to protect against three influenza viruses;

• Influenza A (h2N1)
• influenza A (h4N2) virus
• and influenza B virus

There are also vaccines designed to protect against the four influenza viruses (“quadrivalent” vaccines). They protect against the same viruses as the trivalent vaccine and contain an additional B virus.

Why do I get vaccinated every year?

Annual vaccination is due to the constant variability (mutation) of influenza viruses. As such, vaccine formulations are updated as needed to keep up with changes in influenza viruses.

3 years ago I got the flu vaccine and last year I got seriously ill and was diagnosed with the flu. What does it say?

This fact confirms the need for influenza vaccination every year. First, virus strains change very quickly. Secondly, the body’s immune response to vaccination weakens over time. In your case, vaccination three years ago does not imply any protection for the body.

Can you get the flu from a vaccine?

It is not possible to get the flu from the vaccine, however, some vaccinated people do not feel well for some time immediately after vaccination. This reaction is not common, but it is normal. May be disturbed by weakness, muscle pain, a short-term rise in temperature to 37 ^about C, pain at the injection site.

Such a reaction may signal that the body has entered the fight against the introduced viral particles and antibodies are being produced at the moment. Thus, the immune system prepares the body’s defense against influenza viruses.

NO! Even if you are among those who feel great after a vaccine, it does not mean that your immune system is not responding or the flu vaccine is not working.

If I get the flu shot, will I get the flu?

Even if you get the flu, after being vaccinated against the flu, you will get the disease in a mild form and without complications, and for this purpose vaccination is carried out. Protecting a person 100% from the flu is a secondary goal. Either way, the flu vaccine works!

Flu vaccines are safe! Don’t miss your chance to protect yourself from the flu!

Where can I get a flu shot?

Vaccinations for children attending kindergartens and schools are carried out by medical workers directly at the preschool institution or school, after the written consent of the parents for vaccination. Unorganized children are vaccinated in the clinic at the place of residence.

The adult working population belonging to the occupational risk group (medical workers, employees of educational organizations, transport, public utilities, poultry, pig breeding, zoos, etc.) are vaccinated against influenza at the place of work when the heads of institutions and enterprises provide surname lists of their employees in territorial polyclinic at the place of its activity.

Vaccination of students of primary, secondary and higher vocational education institutions is carried out at the place of study.

In the polyclinic at the place of residence, persons with medical risks (chronic lung diseases, cardiovascular diseases, metabolic disorders and obesity), persons over 60 years of age and pregnant women, children from 6 months who do not attend organized groups are vaccinated.

Immunization against influenza of adults who are not included in the list of contingents of the National Immunization Schedule is carried out through the allocation of funds for the purchase of influenza vaccines by employers – heads of enterprises, organizations and institutions.