Non-communicable diseases like cardiac and respiratory disease, neurological and immunocompromising conditions, diabetes and other metabolic disorders, renal disease and haematological disorders combined with influenza can increase a person’s risk of serious illness from influenza. In addition, influenza can also make chronic health conditions worse. For example, people with asthma may be more likely to experience asthma attacks while they have the flu, and if people with chronic congestive heart failure get sick with the flu, they could experience a worsening of this condition.

Common medical non-communicable diseases that may increase the risk of problems with influenza.

Click on the heading to find recent articles on the topic. This list is updated monthly.  

Non-communicable diseases – general articles
Cardiovacular diseases
Chronic gastrointestinal diseases
Chronic musculoskeletal diseases
Chronic respiratory diseases
Haematologic diseases
Immunocompromised diseases
Kidney diseases
Metabolic disorders
Neoplasms
Neurodevelopmental and Neurological Conditions

Non-communicable diseases

Loubet P. et al. Seasonal influenza vaccination of high-risk adults. Expert Rev Vaccines. 2016 May 27:1-12.
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Zhong Y. et al. Avian influenza virus infection risk in humans with chronic diseases. Sci Rep. 2015 Mar 10;5:8971.
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Cardiovacular Diseases

Clar C. et al. Influenza vaccines for preventing cardiovascular disease. Cochrane Database Syst Rev. 2015 May 5;5:CD005050.
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Barnes M. et al. Acute myocardial infarction and influenza: a meta-analysis of case-control studies. Heart. 2015 Aug 26. pii: heartjnl-2015-307691307691
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Estabragh ZR, Mamas MA. The cardiovascular manifestations of influenza: a systematic review. Int J Cardiol. 2013 Sep 10;167(6):2397-403.
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Foster ED. et al. Acute myocardial infarctions, strokes and influenza: seasonal and pandemic effects. Epidemiol Infect. 2013 Apr;141(4):735-44.
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Hebsur S. et al. Influenza and coronary artery disease: exploring a clinical association with myocardial infarction and analyzing the utility of vaccination in prevention of myocardial infarction. Rev Cardiovasc Med. 2014;15(2):168-75.
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Kawada J. et al. Clinical characteristics of influenza virus infection in juvenile idiopathic arthritis patients treated with tocilizumab. Mod Rheumatol. 2013 Sep;23(5):972-6.
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Kwok CS. et al. Influenza, influenza-like symptoms and their association with cardiovascular risks: a systematic review and meta-analysis of observational studies. Int J Clin Pract. 2015 May 4.
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Lavallée PC. et al. Influenza vaccination and cardiovascular risk in patients with recent TIA and stroke.Neurology. 2014 May 27;82(21):1905-13.
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MacIntyre CR. et al. Influenza vaccine as a coronary intervention for prevention of myocardial infarction. (Australia, USA) Heart. 2016 Sep 29. pii: heartjnl-2016-309983.
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Macintyre CR. et al. Ischaemic heart disease, influenza and influenza vaccination: a prospective case control study. Heart. 2013 Dec;99(24):1843-8.
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Rogawski E. et al. Ischaemic heart disease, influenza and influenza vaccination: a prospective case control study. Heart. 2014 Mar;100(6):517-8.
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Udell JA. et al. Does influenza vaccination influence cardiovascular complications? Expert Rev Cardiovasc Ther. 2015 Jun;13(6):593-6.
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Udell JA. et al. Association between influenza vaccination and cardiovascular outcomes in high-risk patients: a meta-analysis. JAMA. 2013 Oct 23;310(16):1711-20.
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Van Ermen A. et al. Double dose vs. standard dose influenza vaccination in patients with heart failure: a pilot study. Eur J Heart Fail. 2013 May;15(5):560-4.
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Veljkovic V. et al. Influenza vaccine as prevention for cardiovascular diseases: Possible molecular mechanism. Vaccine. 2014 Jul 19. pii: S0264-410X(14)00933-5
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Warren-Gash C. Influenza and ischaemic heart disease: research challenges and future directions. Heart. 2013 Dec;99(24):1795-6.

Chronic Gastrointestinal Diseases

Banaszkiewicz A. et al. Influenza vaccination coverage in children with inflammatory bowel disease. Influenza Other Respir Viruses. 2014 Jul;8(4):431-5.
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Benchimol EI. et al. Safety and utilization of influenza immunization in children with inflammatory bowel disease. Pediatrics. 2013 Jun;131(6):e1811-20.
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Matsumoto H. et al. Booster influenza vaccination does not improve immune response in adult inflammatory bowel disease patients treated with immunosuppressives: a randomized controlled trial. J Gastroenterol. 2015 Feb 12.
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Naganuma M. et al. Incidence and characteristics of the 2009 influenza (H1N1) infections in inflammatory bowel disease patients. J Crohns Colitis. 2013 May;7(4):308-13.
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Chronic Musculoskeletal Diseases

Aikawa NE. et al. Effective seroconversion and safety following the pandemic influenza vaccination (anti-H1N1) in patients with juvenile idiopathic arthritis. Scand J Rheumatol. 2013;42(1):34-40.
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Kobashigawa T. et al. Vaccination against seasonal influenza is effective in Japanese patients with rheumatoid arthritis enrolled in a large observational cohort. Scand J Rheumatol. 2013;42(6):445-50.
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Milanovic M. et al. Influenza vaccination in autoimmune rheumatic disease patients. Tohoku J Exp Med. 2013;229(1):29-34.
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Touma Z, Gladman DD, Urowitz MB. Vaccination and auto-immune rheumatic diseases: lessons learnt from the 2009 H1N1 influenza virus vaccination campaign. Curr Opin Rheumatol. 2013 Mar;25(2):164-70.
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Chronic Respiratory Diseases

Boikos C. et al. Safety of live-attenuated influenza vaccination in cystic fibrosis. Pediatrics. 2014 Oct;134(4):e983-91.
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Cates CJ, Rowe BH. Vaccines for preventing influenza in people with asthma. Cochrane Database Syst Rev. 2013 Feb 28;2:CD000364.
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Ernst P, Ariel A, Suissa S. Differences between asthmatics and nonasthmatics hospitalised with influenza A infection. Eur Respir J. 2013 Apr;41(4):772-4.
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Greenhawt MJ. Influenza vaccination in asthmatic patients. J Allergy Clin Immunol. 2014 Apr;133(4):1233-4.

Lall D.  et al. Effectiveness of Influenza Vaccination for Individuals with Chronic Obstructive Pulmonary Disease (COPD) in Low- and Middle-Income Countries. COPD. 2015 Sep 29:1-7.
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Myles P. et al. Differences between asthmatics and nonasthmatics hospitalised with influenza A infection. Eur Respir J. 2013 Apr;41(4):824-31.
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Park YB. et al. Asthma and severity of the 2009 novel H1N1 influenza: a case-control study. J Asthma. 2014 Feb;51(1):69-74.
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Vasileiou E. et al. Effectiveness of influenza vaccination for preventing influenza-related complications in people with asthma: a systematic review protocol. BMJ Open. 2016 Mar 29;6(3):e010133.
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Watanabe A. A randomized double-blind controlled study of laninamivir compared with oseltamivir for the treatment of influenza in patients with chronic respiratory diseases. J Infect Chemother. 2013 Feb;19(1):89-97.
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Yeganeh B. et al. Asthma and influenza virus infection:focusing on cell death and stress pathways in influenza virus replication. Iran J Allergy Asthma Immunol. 2013 Mar;12(1):1-17.
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Yokouchi Y. et al. Protective effects of influenza A (H1N1) pandemic 2009 vaccination against the onset of influenza-like illness and asthma exacerbation in Japanese children. J Asthma. 2014 Oct;51(8):825-31.
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Haematologic Diseases

Cherif H, Höglund M, Pauksens K. Adjuvanted influenza a (H1N1) 2009 vaccine in patients with hematological diseases: good safety and immunogenicity even in chemotherapy-treated patients. Eur J Haematol. 2013 May;90(5):413-9.
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Immunocompromised Diseases

Beck CR. et al. Influenza vaccination for immunocompromised patients: summary of a systematic review and meta-analysis. Influenza Other Respir Viruses. 2013 Sep;7 Suppl 2:72-5.
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Ceravolo A. et al. Influenza vaccination in HIV-positive subjects: latest evidence and future perspective. J Prev Med Hyg. 2013 Mar;54(1):1-10.
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Eliakim-Raz N. et al. Influenza vaccines in immunosuppressed adults with cancer. Cochrane Database Syst Rev. 2013 Oct 29;10:CD008983.
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Fabbiani M. et al. HIV-infected patients show impaired cellular immune response to influenza vaccination compared to healthy subjects. Vaccine. 2013 Jun 19;31(28):2914-8.
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Garg S. et al. Randomized Controlled Trial to Compare Immunogenicity of Standard-Dose Intramuscular Versus Intradermal Trivalent Inactivated Influenza Vaccine in HIV-Infected Men Who Have Sex With Men in Bangkok, Thailand. Clin Infect Dis. 2016 Feb 1;62(3):383-91.
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Kotecha RS. et al. Immunogenicity and clinical effectiveness of the trivalent inactivated influenza vaccine in immunocompromised children undergoing treatment for cancer. (Australia) Cancer Med. 2016 Feb;5(2):285-93.
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Madhi SA. et al. Efficacy and immunogenicity of influenza vaccine in HIV-infected children: a randomized, double-blind, placebo controlled trial. AIDS. 2013 Jan 28;27(3):369-79.
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Onlamoon N. et al. Immune activation and viral replication after vaccination with an influenza A H1N1 2009 vaccine in HIV-infected children receiving antiretroviral therapy. Dis Markers. 2013;35(4):221-7.
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Remschmidt C, Wichmann O, Harder T. Influenza vaccination in HIV-infected individuals: Systematic review and assessment of quality of evidence related to vaccine efficacy, effectiveness and safety. Vaccine. 2014 Aug 12. pii: S0264-410X(14)01083-4.
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Seo YB. et al. Safety and immunogenicity of influenza vaccine among HIV-infected adults: Conventional vaccine vs. intradermal vaccine. Hum Vaccin Immunother. 2015 Oct 2:0.
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Kidney Diseases

Chen CI. et al. Influenza Vaccination is Associated with Lower Risk of Acute Coronary Syndrome in Elderly Patients with Chronic Kidney Disease. (Taiwan) Medicine (Baltimore). 2016 Feb;95(5):e2588.
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Esposito S. et al Influenza immunization in hemodialyzed or kidney transplanted adolescents and young adults. Expert Rev Vaccines. 2014 Aug;13(8):1059-66.
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Krairittichai U, Chittaganpitch M. Efficacy of the trivalent influenza vaccination in Thai patients with hemodialysis or kidney transplant compared with healthy volunteers. J Med Assoc Thai. 2013 Mar;96 Suppl 3:S1-7.
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Kumar D. et al. Randomized Controlled Trial of Adjuvanted Versus Nonadjuvanted Influenza Vaccine in Kidney Transplant Recipients. Transplantation. 2015 Sep 2.
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Liao Z. et al. Effect of a booster dose of influenza vaccine in patients with hemodialysis, peritoneal dialysis and renal transplant recipients: A systematic literature review and meta-analysis. Hum Vaccin Immunother. 2016 Jul 8:1-7.
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Mastalerz-Migas A, Bujnowska-Fedak M, Brydak LB. Immune efficacy of first and repeat trivalent influenza vaccine in healthy subjects and hemodialysis patients. Adv Exp Med Biol. 2015;836:47-54.
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Mastalerz-Migas A, Gwiazda E, Brydak LB. Effectiveness of influenza vaccine in patients on hemodialysis--a review. Med Sci Monit. 2013 Nov 18;19:1013-8.
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Patel K. et al. Pharmacokinetics and safety of oseltamivir in patients with end-stage renal disease treated with automated peritoneal dialysis. Br J Clin Pharmacol. 2014 Oct 7.
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Remschmidt C, Wichmann O, Harder T. Influenza vaccination in patients with end-stage renal disease: systematic review and assessment of quality of evidence related to vaccine efficacy, effectiveness, and safety. BMC Med. 2014 Dec 19;12(1):244.
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Wang IK. et al. Effectiveness of influenza vaccination in patients with end-stage renal disease receiving hemodialysis: a population-based study. PLoS One. 2013;8(3):e58317.
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Wang IK. et al. Seasonal influenza vaccination is associated with reduced morbidity and mortality in peritoneal dialysis patients. Nephrol Dial Transplant. 2015 Oct 8. pii: gfv360.
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Washio M. et al. Influenza Vaccination and Other Factors Related to the Development of Influenza-Like Illness Among Patients on Chronic Hemodialysis in a Japanese Dialysis Facility. Ther Apher Dial. 2016 Mar 2.
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Metabolic Disorders

Achtymichuk KA. et al. Characteristics and health behaviors of diabetic patients receiving influenza vaccination. Vaccine. 2015 Jul 9;33(30):3549-55.
Vaccine. 2015 Jul 3. pii: S0264-410X(15)00905-6.
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Esposito S. et al. Preliminary data on immunogenicity, safety and tolerability of trivalent inactivated influenza vaccine in children with inborn errors of metabolism at risk of decompensation. Vaccine. 2013 Oct 25;31(45):5149-51.
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Lau D. et al. Effectiveness of influenza vaccination in working-age adults with diabetes: a population-based cohort study. Thorax. 2013 Jul;68(7):658-63.
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Seo YB. et al. Long-Term Immunogenicity and Safety of a Conventional Influenza Vaccine in Patients with Type 2 Diabetes. Clin Vaccine Immunol. 2015 Nov;22(11):1160-5.
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Vamos EP. et al. Effectiveness of the influenza vaccine in preventing admission to hospital and death in people with type 2 diabetes. CMAJ. 2016 Oct 4;188(14):E342-E351.
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Wang IK. et al. Effectiveness of influenza vaccination in elderly diabetic patients: a retrospective cohort study. Vaccine. 2013 Jan 11;31(4):718-24.
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Neoplasms

Ariza-Heredia EJ. et al. Influenza Vaccination in Patients With Cancer: Factors Associated With Vaccination Practices for Patients and Their Household Members. Infect Control Hosp Epidemiol. 2015 Jul 1:1-3.

Choi KH. et al. Influenza Vaccination and Associated Factors among Korean Cancer Survivors : A Cross-Sectional Analysis of the Fourth & Fifth Korea National Health and Nutrition Examination Surveys. J Korean Med Sci. 2014 Aug;29(8):1061-8.
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Chu CS. et al. Immunologic consequences of chemotherapy for ovarian cancer: impaired responses to the influenza vaccine. Vaccine. 2013 Nov 4;31(46):5435-42.
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Freedman JL. et al. Quality improvement initiative to increase influenza vaccination in pediatric cancer patients.Pediatrics. 2015 Feb;135(2):e540-6.
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Goossen GM1, Kremer LC, van de Wetering MD. Influenza vaccination in children being treated with chemotherapy for cancer. Cochrane Database Syst Rev. 2013 Aug 1;8:CD006484.
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Kersun LS. et al. Protecting pediatric oncology patients from influenza. Oncologist. 2013;18(2):204-11.
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Kotecha RS. et al. Immunogenicity and clinical effectiveness of the trivalent inactivated influenza vaccine in immunocompromised children undergoing treatment for cancer. Cancer Med. 2015 Dec 29.
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McManus M. et al. Safety of high dose trivalent inactivated influenza vaccine in pediatric patients with acute lymphoblastic leukemia. Pediatr Blood Cancer. 2014 May;61(5):815-20.
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Nakashima K. et al. Immunogenicity of trivalent influenza vaccine in patients with lung cancer undergoing anticancer chemotherapy. Hum Vaccin Immunother. 2016 Nov 7:0.
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Oh MG. et al. A Population-Based, Nationwide Cross-Sectional Study on Influenza Vaccination Status among Cancer Survivors in Korea. Int J Environ Res Public Health. 2015 Aug 21;12(8):10133-49.
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Sanada Y. et al. A prospective study on the efficacy of two-dose influenza vaccinations in cancer patients receiving chemotherapy. Jpn J Clin Oncol. 2016 Mar 13. pii: hyw020.
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Waqar SN. et al. Immunogenicity of Influenza Vaccination in Patients With Cancer. Am J Clin Oncol. 2015 Dec 14.
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Wumkes ML. et al. Serum antibody response to influenza virus vaccination during chemotherapy treatment in adult patients with solid tumours. Vaccine. 2013 Dec 16;31(52):6177-84.
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Yöntem Y. et al. Analysis of fatal cases of pandemic influenza A (H1N1) virus infections in pediatric patients with leukemia. Pediatr Hematol Oncol. 2013 Aug;30(5):437-44.
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Neurodevelopmental and Neurological Conditions

Asghar Z, Coupland C, Siriwardena N. Influenza vaccination and risk of stroke: Self-controlled case-series study. Vaccine. 2015 Aug 18. pii: S0264-410X(15)01127-5.
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Burton C. et al. Burden of seasonal influenza in children with neurodevelopmental conditions. Pediatr Infect Dis J 2014 Jul;33(7):710-4
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Havers F. et al. Influenza vaccination and treatment in children with neurologic disorders. Ther Adv Vaccines. 2014 Jul;2(4):95-105.
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Pellegrino P. et al. Efficacy of vaccination against influenza in patients with multiple sclerosis: The role of concomitant therapies. Vaccine. 2014 Aug 20;32(37):4730-4735.
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Smith M. et al. Influenza vaccination in children with neurologic or neurodevelopmental disorders. Vaccine. 2015 May 11;33(20):2322-7.
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