Table of ContentsView AllTable of ContentsIncreased AttacksMore Severe AttacksRisk of PneumoniaDecreased Asthma ControlFlu PreventionIf Flu Strikes
Table of ContentsView All
View All
Table of Contents
Increased Attacks
More Severe Attacks
Risk of Pneumonia
Decreased Asthma Control
Flu Prevention
If Flu Strikes
Asthma doesn’t place you at greater risk of getting the flu but it does increase your risk of flu complications and hospitalization. The flu risks for people withasthmaare significant, including an increased likelihood ofsevere asthma attacksand potentially serious complications likepneumonia. Getting theannual flu shotis arguably the best way to minimize the risks.
Verywell / Ellen Lindner
Increased Risk of Asthma Attacks
The obstruction of the airways leads to the classic symptoms of anasthma attack, including:
A 2022 study found that among people with asthma, those who are unvaccinated from the flu have nearly twice as many asthma attacks as those who are vaccinated (73% versus 38% respectively).
Increased Severity of Asthma Attacks
Studies have shown that the more severe an asthma attack is, the more likely you are to have repeat attacks. In turn, the more frequently you have attacks, the progressively worse your condition gets, doubling the number of attacks from less than two per week to nearly four.
While multiple factors are involved in the risk of severe asthma—including smoking, poor adherence toasthma medications, and havinggastroesophageal reflux disease (GERD), among others—having a recent upper respiratory infection like influenza nearly quadruples your risk of a severe asthma attack, according to a 2020 study in the journalCureus.
Increased Risk of Pneumonia
People with asthma are at a far greater risk of pneumonia compared to the general population. Among children and adults with asthma, pneumonia remains the leading cause of hospitalization and ICU care overall.
Asthma can also alter a person’s immune response, particularly those withallergic asthma, making them more susceptible to lung infections. Certain asthma drugs, likesteroid inhalers, can do the same.
On average, nearly 10 people die from asthma each day in the United States. In 2022, 3,235 people died from asthma-related complications, most of whom would have survived with the right treatment and care, including flu vaccination.
This includes influenza which causes inflammation in the entire respiratory tract, leading tobronchial hyperresponsiveness(airway oversensitivity) and the overproduction of mucus in people with asthma.
While rescue inhalers (also known asshort-acting beta-agonists) are often all that is needed for people with mild asthma, they may not suffice in the presence of the flu. In such cases, more aggressive treatments may be needed, includinginhaled or oral corticosteroids(steroids).
While asthma control may return after the lung has cleared, people who sustain lung injury due to severebronchitisor pneumonia may have a harder time controlling symptoms and experience an increased frequency of attacks.
For these individuals, treatment changes may be needed, including the regular use of inhaled steroids andlong-acting beta-agonists.
When to Seek Emergency CareIf you have the flu and your symptoms improve but then suddenly worsen, seek immediate emergency care. The same applies if you experience any of the following signs and symptoms:Difficulty breathingRibs pulling in with each breathPersistent dizziness, confusion, or altered mental statePersistent pain or pressure in the chest or abdomenNo urinationSevere muscle painSevere weakness or unsteadinessSeizuresBluish lips or face
When to Seek Emergency Care
If you have the flu and your symptoms improve but then suddenly worsen, seek immediate emergency care. The same applies if you experience any of the following signs and symptoms:Difficulty breathingRibs pulling in with each breathPersistent dizziness, confusion, or altered mental statePersistent pain or pressure in the chest or abdomenNo urinationSevere muscle painSevere weakness or unsteadinessSeizuresBluish lips or face
If you have the flu and your symptoms improve but then suddenly worsen, seek immediate emergency care. The same applies if you experience any of the following signs and symptoms:
Flu Prevention if You Have Asthma
The Centers for Disease Control and Prevention (CDC) recommends annual flu vaccination for all people six months of age and older. The need for vaccination is even greater for those with asthma due to the increased risk of severe attacks and pneumonia.
Any of the available flu vaccines can be used in people with asthma, includingflu shotsand theFluMist nasal spray vaccine.
To further protect yourself against infection, adhere to traditionalpreventive strategieslike:
In the United States, flu vaccination rates for people with asthma are higher than those seen in the general population, although they still fall below 50%.
If you have asthma and develop flu symptoms, call your healthcare provider as soon as possible. They can prescribeantiviral drugsthat may reduce the duration and severity of the infection while lowering the risk of flu complications and hospitalization.
Options include:
The drugs worked best if started within 24 to 48 hours of the first appearance of symptoms.
People with asthmashould notuse the antiviral drugRelenza (zanamivir)because there is a risk it may cause wheezing in people with lung conditions.
People with severe asthma can also opt for antiviral therapy if they believe they were exposed to the flu. Known aschemoprophylaxis, the therapy may avert the infection if started no later than 48 hours of exposure and continued for 10 days to two weeks.
Summary
Influenza poses significant risks for people with asthma, including an increased risk of pneumonia and more frequent or severe attacks. Even people with mild asthma may be affected and find it harder to control asthma symptoms.
Annual flu vaccination, recommended for all adults and children with asthma, can significantly reduce the risk of complications and hospitalization.
20 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Veerapandian R, Snyder JD, Samarasinghe AE.Influenza in asthmatics: For better or for worse?Front Immunol. 9:1843. doi:10.3389/fimmu.2018.01843Dupont A, Couffignal C, Arias C, et al.Outcomes and risk factors with COVID-19 or influenza in hospitalized asthma patients.Respir Res. 2022 Dec 13;23:342. doi:10.1186/s12931-022-02265-6National Heart, Lung, and Blood Institute.Asthma.Castillo JR, Peters SP, Busse WW.Asthma exacerbations: pathogenesis, prevention, and treatment.J Allergy Clin Immunol Pract. 2017;5:918–27. doi:10.1016/j.jaip.2017.05.001Al Kharusi Z, Al Kalbani R, Al-Hadhrami R, et al.Frequency of asthma exacerbations and upper respiratory tract infections among adults with asthma according to vaccination status: does the annual influenza vaccine have a protective effect?Sultan Qaboos Univ Med J. 2024 Feb 28;24(1):70–75. doi: 10.18295/squmj.9.2023.053Allergy & Asthma Network.How severe is my asthma: classifying asthma severity.Nakwan N.Impact of asthma severity as risk factor to future exacerbations in patients admitted for asthma exacerbation.Multidiscip Respir Med. 2021 Sep 1;16(1):780. doi:10.4081/mrm.2021.780Ansair SF, Memon M, Kumar R, Rizwan A.Risk factors associated with frequent acute exacerbations of asthma.Cureus. 2020 Oct 22;12(10):e11090. doi:10.7759/cureus.11090Hooven TA, Polin RA.Pneumonia.Semin Fetal Neonatal Med. 2017;22(4):206-213. doi:10.1016/j.siny.2017.03.002American Lung Association.Pneumonia and asthma… why should I worry?Kwon JH, Wi CI, Seol HY, et al.Risk, mechanisms and implications of asthma-associated infectious and inflammatory multimorbidities (AIMs) among individuals with asthma, a systematic review and case study.Allergy Asthma Immunol Res. 2021 Aug 31;13(5):697–718. doi:10.4168/aair.2021.13.5.697Sado AI, Afzal MS, Kannekanti L, et al.A meta-analysis on predictors of mortality among patients hospitalized for acute exacerbation of asthma.Cureus.2023 Feb 20;15(2):e35225. doi:10.7759/cureus.35225Asthma and Allergy Foundation of America.Asthma facts.Adeli M, El-Shareif T, Hendaus MA.Asthma exacerbation related to viral infections: an up to date summary.J Family Med Prim Care. 2019 Sep 30;8(9):2753–2759. doi:10.4103/jfmpc.jfmpc_86_19Centers for Disease Control and Prevention.Signs and symptoms of flu.Centers for Disease Control and Prevention.Flu vaccine among adults with current asthma.Vasileiou E, Sheikh A, Butler C.Effectiveness of influenza vaccines in asthma: a systematic review and meta-analysis.Clin Infect Dis. 2017;65(8):1388–1395. doi:10.1093/cid/cix524Centers for Disease Control and Prevention.Preventing seasonal flu.Centers for Disease Control and Prevention.What you should know about flu antiviral drugs.Centers for Disease Control and Prevention.Flu & people with asthma.
20 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Veerapandian R, Snyder JD, Samarasinghe AE.Influenza in asthmatics: For better or for worse?Front Immunol. 9:1843. doi:10.3389/fimmu.2018.01843Dupont A, Couffignal C, Arias C, et al.Outcomes and risk factors with COVID-19 or influenza in hospitalized asthma patients.Respir Res. 2022 Dec 13;23:342. doi:10.1186/s12931-022-02265-6National Heart, Lung, and Blood Institute.Asthma.Castillo JR, Peters SP, Busse WW.Asthma exacerbations: pathogenesis, prevention, and treatment.J Allergy Clin Immunol Pract. 2017;5:918–27. doi:10.1016/j.jaip.2017.05.001Al Kharusi Z, Al Kalbani R, Al-Hadhrami R, et al.Frequency of asthma exacerbations and upper respiratory tract infections among adults with asthma according to vaccination status: does the annual influenza vaccine have a protective effect?Sultan Qaboos Univ Med J. 2024 Feb 28;24(1):70–75. doi: 10.18295/squmj.9.2023.053Allergy & Asthma Network.How severe is my asthma: classifying asthma severity.Nakwan N.Impact of asthma severity as risk factor to future exacerbations in patients admitted for asthma exacerbation.Multidiscip Respir Med. 2021 Sep 1;16(1):780. doi:10.4081/mrm.2021.780Ansair SF, Memon M, Kumar R, Rizwan A.Risk factors associated with frequent acute exacerbations of asthma.Cureus. 2020 Oct 22;12(10):e11090. doi:10.7759/cureus.11090Hooven TA, Polin RA.Pneumonia.Semin Fetal Neonatal Med. 2017;22(4):206-213. doi:10.1016/j.siny.2017.03.002American Lung Association.Pneumonia and asthma… why should I worry?Kwon JH, Wi CI, Seol HY, et al.Risk, mechanisms and implications of asthma-associated infectious and inflammatory multimorbidities (AIMs) among individuals with asthma, a systematic review and case study.Allergy Asthma Immunol Res. 2021 Aug 31;13(5):697–718. doi:10.4168/aair.2021.13.5.697Sado AI, Afzal MS, Kannekanti L, et al.A meta-analysis on predictors of mortality among patients hospitalized for acute exacerbation of asthma.Cureus.2023 Feb 20;15(2):e35225. doi:10.7759/cureus.35225Asthma and Allergy Foundation of America.Asthma facts.Adeli M, El-Shareif T, Hendaus MA.Asthma exacerbation related to viral infections: an up to date summary.J Family Med Prim Care. 2019 Sep 30;8(9):2753–2759. doi:10.4103/jfmpc.jfmpc_86_19Centers for Disease Control and Prevention.Signs and symptoms of flu.Centers for Disease Control and Prevention.Flu vaccine among adults with current asthma.Vasileiou E, Sheikh A, Butler C.Effectiveness of influenza vaccines in asthma: a systematic review and meta-analysis.Clin Infect Dis. 2017;65(8):1388–1395. doi:10.1093/cid/cix524Centers for Disease Control and Prevention.Preventing seasonal flu.Centers for Disease Control and Prevention.What you should know about flu antiviral drugs.Centers for Disease Control and Prevention.Flu & people with asthma.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Veerapandian R, Snyder JD, Samarasinghe AE.Influenza in asthmatics: For better or for worse?Front Immunol. 9:1843. doi:10.3389/fimmu.2018.01843Dupont A, Couffignal C, Arias C, et al.Outcomes and risk factors with COVID-19 or influenza in hospitalized asthma patients.Respir Res. 2022 Dec 13;23:342. doi:10.1186/s12931-022-02265-6National Heart, Lung, and Blood Institute.Asthma.Castillo JR, Peters SP, Busse WW.Asthma exacerbations: pathogenesis, prevention, and treatment.J Allergy Clin Immunol Pract. 2017;5:918–27. doi:10.1016/j.jaip.2017.05.001Al Kharusi Z, Al Kalbani R, Al-Hadhrami R, et al.Frequency of asthma exacerbations and upper respiratory tract infections among adults with asthma according to vaccination status: does the annual influenza vaccine have a protective effect?Sultan Qaboos Univ Med J. 2024 Feb 28;24(1):70–75. doi: 10.18295/squmj.9.2023.053Allergy & Asthma Network.How severe is my asthma: classifying asthma severity.Nakwan N.Impact of asthma severity as risk factor to future exacerbations in patients admitted for asthma exacerbation.Multidiscip Respir Med. 2021 Sep 1;16(1):780. doi:10.4081/mrm.2021.780Ansair SF, Memon M, Kumar R, Rizwan A.Risk factors associated with frequent acute exacerbations of asthma.Cureus. 2020 Oct 22;12(10):e11090. doi:10.7759/cureus.11090Hooven TA, Polin RA.Pneumonia.Semin Fetal Neonatal Med. 2017;22(4):206-213. doi:10.1016/j.siny.2017.03.002American Lung Association.Pneumonia and asthma… why should I worry?Kwon JH, Wi CI, Seol HY, et al.Risk, mechanisms and implications of asthma-associated infectious and inflammatory multimorbidities (AIMs) among individuals with asthma, a systematic review and case study.Allergy Asthma Immunol Res. 2021 Aug 31;13(5):697–718. doi:10.4168/aair.2021.13.5.697Sado AI, Afzal MS, Kannekanti L, et al.A meta-analysis on predictors of mortality among patients hospitalized for acute exacerbation of asthma.Cureus.2023 Feb 20;15(2):e35225. doi:10.7759/cureus.35225Asthma and Allergy Foundation of America.Asthma facts.Adeli M, El-Shareif T, Hendaus MA.Asthma exacerbation related to viral infections: an up to date summary.J Family Med Prim Care. 2019 Sep 30;8(9):2753–2759. doi:10.4103/jfmpc.jfmpc_86_19Centers for Disease Control and Prevention.Signs and symptoms of flu.Centers for Disease Control and Prevention.Flu vaccine among adults with current asthma.Vasileiou E, Sheikh A, Butler C.Effectiveness of influenza vaccines in asthma: a systematic review and meta-analysis.Clin Infect Dis. 2017;65(8):1388–1395. doi:10.1093/cid/cix524Centers for Disease Control and Prevention.Preventing seasonal flu.Centers for Disease Control and Prevention.What you should know about flu antiviral drugs.Centers for Disease Control and Prevention.Flu & people with asthma.
Veerapandian R, Snyder JD, Samarasinghe AE.Influenza in asthmatics: For better or for worse?Front Immunol. 9:1843. doi:10.3389/fimmu.2018.01843
Dupont A, Couffignal C, Arias C, et al.Outcomes and risk factors with COVID-19 or influenza in hospitalized asthma patients.Respir Res. 2022 Dec 13;23:342. doi:10.1186/s12931-022-02265-6
National Heart, Lung, and Blood Institute.Asthma.
Castillo JR, Peters SP, Busse WW.Asthma exacerbations: pathogenesis, prevention, and treatment.J Allergy Clin Immunol Pract. 2017;5:918–27. doi:10.1016/j.jaip.2017.05.001
Al Kharusi Z, Al Kalbani R, Al-Hadhrami R, et al.Frequency of asthma exacerbations and upper respiratory tract infections among adults with asthma according to vaccination status: does the annual influenza vaccine have a protective effect?Sultan Qaboos Univ Med J. 2024 Feb 28;24(1):70–75. doi: 10.18295/squmj.9.2023.053
Allergy & Asthma Network.How severe is my asthma: classifying asthma severity.
Nakwan N.Impact of asthma severity as risk factor to future exacerbations in patients admitted for asthma exacerbation.Multidiscip Respir Med. 2021 Sep 1;16(1):780. doi:10.4081/mrm.2021.780
Ansair SF, Memon M, Kumar R, Rizwan A.Risk factors associated with frequent acute exacerbations of asthma.Cureus. 2020 Oct 22;12(10):e11090. doi:10.7759/cureus.11090
Hooven TA, Polin RA.Pneumonia.Semin Fetal Neonatal Med. 2017;22(4):206-213. doi:10.1016/j.siny.2017.03.002
American Lung Association.Pneumonia and asthma… why should I worry?
Kwon JH, Wi CI, Seol HY, et al.Risk, mechanisms and implications of asthma-associated infectious and inflammatory multimorbidities (AIMs) among individuals with asthma, a systematic review and case study.Allergy Asthma Immunol Res. 2021 Aug 31;13(5):697–718. doi:10.4168/aair.2021.13.5.697
Sado AI, Afzal MS, Kannekanti L, et al.A meta-analysis on predictors of mortality among patients hospitalized for acute exacerbation of asthma.Cureus.2023 Feb 20;15(2):e35225. doi:10.7759/cureus.35225
Asthma and Allergy Foundation of America.Asthma facts.
Adeli M, El-Shareif T, Hendaus MA.Asthma exacerbation related to viral infections: an up to date summary.J Family Med Prim Care. 2019 Sep 30;8(9):2753–2759. doi:10.4103/jfmpc.jfmpc_86_19
Centers for Disease Control and Prevention.Signs and symptoms of flu.
Centers for Disease Control and Prevention.Flu vaccine among adults with current asthma.
Vasileiou E, Sheikh A, Butler C.Effectiveness of influenza vaccines in asthma: a systematic review and meta-analysis.Clin Infect Dis. 2017;65(8):1388–1395. doi:10.1093/cid/cix524
Centers for Disease Control and Prevention.Preventing seasonal flu.
Centers for Disease Control and Prevention.What you should know about flu antiviral drugs.
Centers for Disease Control and Prevention.Flu & people with asthma.
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