Chronic respiratory disease

• Chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema; bronchiectasis, cystic fibrosis, interstitial lung fibrosis, pneumoconiosis and bronchopulmonary dysplasia (BPD).
• Asthma - with disease which requires continuous or repeated use of inhaled or systemic steroids or with previous exacerbations requiring hospital admission.
• Children who have previously been admitted to hospital for lower respiratory tract disease.

Chronic heart disease

• Congenital heart disease.
• Hypertension with cardiac complications.
• Chronic heart failure.
• Individuals requiring regular medication and/or follow-up for ischaemic heart disease.

Kidney disease

• Chronic kidney disease.
• Nephrotic syndrome.
• Renal transplantation.

Chronic liver disease

• Cirrhosis.
• Biliary atresia.
• Chronic hepatitis.

Chronic neurological disease

• Stroke.
• Transient ischaemic attack (TIA).

Diabetes

• Type 1 diabetes.
• Type 2 diabetes requiring insulin or oral hypoglycaemic drugs.
• Diet-controlled diabetes.

Immunosuppression

• Immunosupression due to disease or treatment.
• Patients undergoing chemotherapy leading to immunosuppression.
• Asplenia or splenic dysfunction.
• HIV infection.
• Individuals treated with, or likely to be treated with, systemic steroids for more than a month at a dose equivalent to prednisolone at 20 mg or more per day (any age) or, for children under 20 kg, a dose of 1 mg or more per kg per day.
  Some immunocompromised patients may have a suboptimal immunological response to the vaccine.

Pregnancy

• All pregnant women should receive the trivalent seasonal influenza vaccine.