Flu jab and other vaccines

If you have Addison's disease or another form of adrenal insufficiency, which vaccines should you have? Is it safe to be vaccinated? What do you need to know before you go for a jab?

Our medical trustees advise that vaccines are usually safe. There are lots of useful links and some helpful advice below to help you explore any particular concerns and understand what you need to consider.

On this page:

Should people with Addison's and Adrenal Insufficiency have the flu jab?

Everyone with Addison's disease and adrenal insufficiency (so is steroid-dependent), should get their free NHS flu jab to reduce the risk of getting the flu, as flu can trigger an adrenal crisis. You can’t get the flu from the flu jab, but it takes two weeks to work so it’s important to get the flu jab as soon as you can. 

Every year an endocrinologist writes for our website and members magazine, a helpful reminder to book your flu jab and why it is important to get your flu jab for that year.

Read our 2025 Flu Jab Guide

It's also a good idea to put a reminder in your calendar every year to make sure you book your appointment early.

How can I receive an automatic invitation for a flu jab from my GP?

In the UK, those with Addison's and adrenal insufficiency should be automatically invited each year for a free NHS flu jab, usually by text, via the NHS App, or letter. Here is our guidance to make sure you receive your invitation:

  • Check with your GP surgery: GPs computer systems and procedures for issuing invitations vary - there is no single national system. Therefore you'll need to ask about how things work at your local surgery. Your GP surgery should be able to add a marker in their system to show you are eligible for a flu vaccine. This marker is what prompts the automatic flu jab invite.
  • Ensure your medical record is up to date: Ask your GP surgery to confirm that your Addison’s disease or adrenal insufficiency (steroid dependency) is clearly coded on your health record. You can use our Summary Care Record letter template to help with this.
  • Be proactive: If you haven’t heard by late September or early October, contact your GP practice to book your jab, don’t wait for the invitation. You can also book flu jabs online and via the NHS App. You may find that you need to make checking this an annual part of your routine when the flu vaccine programme starts.

    We appreciate this is a frustrating situation and adds to the admin of living with a long-term health condition. Share this flu guide with your healthcare team and let them know about our GP education modules, which will give them more information. It's a good idea to provide feedback to the surgery on any issues you are facing in obtaining the vaccine and see what they are able to do to help.

    Where and when to book your flu jab

    You can book a flu vaccination appointment online or in the NHS App. Appointments will be available from 1 October 2025. Stores such as Boots, Tesco, Superdrug, Asda and Lloyds Pharmacy are also offering online booking services for the vaccines.

    NHS: Book Your Flu Jab

    Children can receive jabs at their GP, school or a community clinic, depending on their age and circumstances. Find out more about vaccines for children at from the NHS website: child flu vaccine

    “My GP won’t give me the free NHS Flu jab" - Next Steps  

    Due to Addison's and adrenal insufficiency being a rare disease, medical professionals don't always have the information they need to make certain decisions. With over 7,000 rare diseases, it isn't possible for your GP to be an expert on your condition and have opportunity to access the latest information. 

    With this in mind, our charity exists to give you the information and support, should you need it, to send to your GP or healthcare professional, so you can work together.  

    If after passing on the information on this webpage, you are still advised you will not receive the free NHS flu jab, here is a guide to the next steps you can follow: 

    1. Endocrinologist Support Letter: Ask your Endocrinologist/ medical team to write a special covering letter/ email referencing the information on this page and in the 'Managing You Addison’s' leaflet to send on to your GP. Points to include are noting your specific medical conditions so it is relevant for your circumstances. If doing by email, be sure to include the endocrinology secretary department as so many endocrinologists are very busy in their NHS roles.
    2. Next steps with GP inc PALs: After sending this email/letter from your endocrinologist to the GP, if the GP still goes on to refuse, ask the GP to answer why they are going against the expert advice and guidance of the Addison's Clinical Advisory Panel (CAP) and your Endocrinologist. This is so you have their response in writing and helps provide clarity. Let your GP know it is your intention to include their answer when writing formally to PALs about their unsafe management of your Addison’s or adrenal insufficiency. 
    3. Care Opinion Website: It can help to post some informal feedback on the Care Opinion website as well as going through the formal trust process via PALs. Every comment on the Care Opinion website that mentions adrenal insufficiency or adrenal crisis – positive or negative – helps to put the needs of adrenal patients on the map, and all patient feedback on their site is searchable as a reference with the aim to contribute to improving standards of care in the future.  

    This is also a reminder that each person with Addison's or adrenal insufficiency needs to have sufficient supplies of medication to cover any period of ill health with flu, including up-to-date supplies of vials for individuals own hydrocortisone emergency injection kit. 

    Should I increase my glucocorticoid dose before having a vaccine?

    Our Addison's Clinical Advisory Panel (CAP) and Society for Endocrinology have advised that there is no need to routinely increase glucocorticoid dose in patients with adrenal insufficiency at the time of vaccination if no significant symptoms. However if you are particularly anxious/ stressed before, this will "use up" your cortisol so you should up-dose in response to how you feel. It's different for everyone, as every body is different - so please listen to your body and do what is right for you.

    If you feel unwell after a vaccination:

    • Check if you have an allergy to any ingredients in the vaccine
    • Increase your glucocorticoid as you would normally for the sick day rules
    • Take paracetamol to help reduce your symptoms making them easier to manage
    • Rest and drink plenty of fluids

    Visit the NHS website to find out more about reactions to vaccines and the Yellow Card scheme for reporting.

    Can I have the COVID-19 booster and flu jab at the same time?

    It is safe to have both vaccines together, but it is advised to get them in different arms. However there is no 'one size fits all' approach. If you're aware from experience that your body requires extra rest after vaccines, you may wish to leave a couple of days between vaccine appointments to suit your circumstances. Visit our COVID vaccine page to learn more about the COVID vaccine.

    COVID vaccines & adrenal insufficiency

    On our online forum, members have been sharing their experiences of receiving both vaccines. So if you'd find it reassuring to hear others' experiences direct, please visit our online forum to join the conversation.

    For general COVID guidance and support if living with adrenal insufficiency, including adjusting your steroid replacement doses if unwell with COVID, please visit our COVID guidance page.

    COVID guidance

    Am I eligible for the Shingles vaccine? 

    People with Addison’s and adrenal insufficiency are only eligible for the shingles vaccine when offered by age. They are not eligible to have the shingles vaccination on the grounds of immunosuppression. To help answer any questions you may have about shingles we spoke to Chair of the Addison's Clinical Advisory Panel (CAP), Professor John Wass, about what this means for those with Addison's and adrenal insufficiency. Read our shingles article.

    Should people with Adrenal Insufficiency have the Pneumonia jab?

    People with adrenal insufficiency who take daily steroids are not currently in an at risk group requiring a pneumonia jab. The pneumovax vaccination available from healthcare professionals and pharmacies does not protect against the viral pneumonia that can be caused by COVID-19. Recent studies have set out to prove definitively if those with adrenal insufficiency are at greater risk of bacterial Pneumonia than those without. There is yet to be any information to change the advice provided the the NHS. If you feel concerned about pneumonia, discuss it with your healthcare team who can advise on risks and vaccine requirements specific to your circumstances. Pneumonia vaccines are available to buy from some pharmacies. NHS advice on Pneumonia vaccines.

    Can vaccines cause bad reactions?

    Everyone is different and some people may have a reaction for example due to an allergy to the ingredients. Always ask your healthcare professionals to discuss the ingredients with you to make sure you are comfortable. For any individual circumstances, for example any conditions you have alongside adrenal insufficiency, always speak with your healthcare team.

    For any further concerns you have, to find out more about reactions to vaccines and the Yellow Card scheme for reporting reactions, please visit the NHS website.

    NHS: Vaccines

    Are people with adrenal insufficiency at greater risk of bad reactions to vaccines? 

    People with adrenal insufficiency are not at an increased risk of having bad reactions to vaccines - but everybody is different, so this will depend on your individual circumstances. Lots of factors at the time of having the vaccine may make it appear a bad reaction is related to the vaccine such as food poisoning or a stomach bug. As with all bouts of illness or physical stress on your body, you should follow the sick day rules. 

    If you feel unwell after a vaccination:

    • Check if you have an allergy to any ingredients in the vaccine
    • Increase your glucocorticoid as you would normally for the sick day rules
    • Take paracetamol to help reduce your symptoms making them easier to manage
    • Rest and drink plenty of fluids
    Side effects, such as feeling tired, are a sign that your immune system is kicking into action to protect you - the vaccine can’t give you flu. Your immune system will be learning to respond to the virus.

    Fludrocortisone and vaccines: Some members have been in touch concerned having read online that you should not have vaccinations if taking fludrocortisone. Our medics have confirmed these rumours are incorrect. When taking fludrocortisone as replacement therapy for Addison's or any form of adrenal insufficiency, you should still receive vaccinations when offered by your healthcare professionals.

    What about live vaccines?

    Live vaccines contain a live version of the virus it is designed to protect you from. According to NICE people receiving immunosuppressive doses of corticosteroids should avoid live vaccines. People who have adrenal insufficiency alone usually take daily doses of steroids that are not immunosuppressive so are on replacement corticosteroids treatment - replacing what your body would naturally produce.

    It’s important to check the latest advice about any other conditions you have in combination with adrenal insufficiency. The flu jab for adults is not a live vaccine. You can check the NHS website for more details about various types of vaccines.

    For more guidance on managing your Addison's disease or adrenal insufficiency, download and read our booklet.

    Whether you're newly diagnosed or have lived with the condition for years - please join our community and support our cause! You'll receive the latest expert advice, guidance and ADSHG news, whilst being part of our inspiring and supportive community. Become a member today! 

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    Author: Philippa Sharman

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