I had primary stage 1 breast cancer in left breast in 2017 with lumpectomy & radiotherapy. Last year I was diagnosed with DCIS in right breast and had the same treatment to that side. I had my radiotherapy in Dec 22. Please can you confirm if I am eligible for an NHS flu jab. I had my covid jab last week after receiving an NHS email but today visited my GP practice for the flu jab where I was told I wasn’t eligible. After a referal it was agreed that I could have it but the nurse had never come across anyone who couldn’t have it in their arms (I’ve had lymph nodes removed.) I became upset as I seem quite emotional lately so decided not to go ahead in view of all the confusion. Please can you advise what the NHS stance is on this so that I am clear going forward. Many thanks
Hi @TillyG
It could be an admin glitch but the guidelines have changed and frankly they’re confusing . My partner is 58 same as me and was offered and given both Flu + Covid jabs last year but hasn’t been offered either this year.
My friend who had right sided breast surgery and radiotherapy was offered and was given both Flu and Covid jabs last year and has been offered a Covid booster this year but told she’s too young for the Flu jab ( just turned 60). You haven’t given your age or medical history but the Government can pick up info about medical treatments as well as long term conditions so having radiotherapy last year may have made you eligible for a Flu jab then but not now.
I’m always offered both as I’m asthmatic.
It may also depend on how many Covid shots you have had - I think everyone is offered either 3 or 4 ( can’t remember which ). If you missed one for any reason they may have had you down to catch up.
Last year I was a bit paranoid and wary that someone would inject me quickly without me having chance to say don’t use my right side . I also felt a bit emotional , it’s a reminder after all - if we ever needed one !
The friend who had right breast surgery had one of her jabs in her leg. I’m thinking of asking for my Flu jab to be put in my leg as well as I have a long term shoulder injury on my non- operated side and having the Flu jab aggravated it.
I’m assuming that whoever gave your Covid jab must have used a different site . The fact that this Nurse didn’t want to consider this is not good enough in my opinion - I’m not surprised you became upset.
Would it be possible for you to remake the appointment when whoever gave you the Covid jab is doing them ?
Alternatively you could opt to pay for it at a Pharmacy which is what my friend as mentioned above has done .
Sorry it’s not a definitive answer - if you post in the Ask The Nurses Section they could probably give you the official guidelines and further advice.
Best wishes
Joanne. X
I have had a right mastectomy with only SLNode removal. Was told it is not NHS protocol for NHS nurses to take blood from my masectomy side due to chance of Lyphodema on that side. However a nuclear medicine nhs employee told me as i only had my sentinal lymph node removed it should be ok.
I have had my flu and covid jab in same arm, same day, no reaction.
The fact you have had a double mastectomy with lymph removal I believe is the reason nurses wont do it. However a DR can agree, why dont you book appt with your dr explaining situation 
xx
Hi TillyG,
So sorry to hear of the messing about you’re getting over your flu jab and the anxiety that it will no doubt add to! I recently had my flu jab (in my good arm) at Boots using a voucher from my employer (for which I know I am very lucky), the pharmacist suggested I may have been eligible on the NHS but we didn’t discuss further. It may be worth popping in to a local friendly pharmacy & asking to have a private chat with the pharmacist, even if you aren’t eligible on the NHS, they may be willing to administer it, Boots charge just short of £20. I hope you manage to get it sorted out soon x
Just to chip in - I have been told by pharmacists that they are only licensed to do vacs in the arm. So to have it given in the leg (which I prefer) it needs to be given by a nurse. I’ve had nurses say that its best to avoid the arm if node surgery was a full clearance. I’ve had full ANC on one side and “just” SNB several years ago on the other - it seems ok now to use that arm if needed.
I had just an SNB and I’m really not keen on having a jab in that side at all . I have intermittent discomfort not just in the axilla but in my upper arm as well . Recently I’ve also had persistent itching in my axilla as well though it’s improved after I went back to Dove deo .Having said that it’s only 18 months since surgery so maybe it will settle down more in years to come .
As a Health Care Professional I’ve always been told not to use an affected arm whenever possible but also told more recently that in most cases the risk is theoretical rather than actual . I do feel that if anyone wants to have a vaccination jab in the leg for any reason and not the arm and the person delivering the vaccine is qualified to do that then that’s what should be done .
Joanne
Hi @TillyG and everyone else
Ok so I do know at least one person who was given either a Flu or Covid vaccination in a leg , possibly more - it may depend on the training and experience of the person doing the injecting. However it seems that I’m incorrect in thinking that your Nurse would have been trained to do this - I apologise.
I have a Nurse friend who gives Flu jabs every Autumn so I decided to see what they had to say about this . The reply was that the official manual from Gov . UK on which all the training is based states that the deltoid muscle at the top of the arm is the correct site for injection and that all the training is concentrated on this .
They are often administering jabs in large clinics where there is very little privacy for anyone needing to expose their thigh to be injected - though this would probably not be the case at the GP surgery. They suggested asking your GP for advice on this matter .
I know that the leg is a viable site for other injections into the muscle but there may be reasons why the deltoid is preferred for vaccinations - I’m not sure exactly what they are.
Sorry this is not more helpful
Joanne. X
Hello TillyG
Thank you for your post asking about your eligibility for the flu jab and your concerns about having the injection in your arm after having surgery to both breasts.
It sounds like you may have had a sample of lymph nodes removed (sentinel lymph node biopsy) from each side. There’s no strong evidence that having injections, taking blood, taking a blood pressure reading or having intravenous fluids in your ‘at risk’ arm or arms will cause lymphoedema. However, many prefer not to use their ‘at risk’ arm or arms.
As @BluebellTime says, it may be ok to have your flu jab in the side that you had surgery to in 2017. However, as you are concerned about using either of your arms to have injections, speak to your GP about the using your leg to have the flu jab, as @JoanneN and @Teresa_Jones have suggested. And @MillieBa says, you could also talk to a local pharmacist or pharmacist at the hospital about this.
You may also find it helpful contact the Lymphoedema Support Network.
You do not mention your age, however this year the flu jab is being routinely offered to anyone over 65 now. If you are under 65, there are certain situations where someone may be eligible. You may already have seen GOV.UK’s information about this year’s eligibility criteria for having the flu vaccine and NHS.UK’s information. These include a list of medical conditions that might put someone at an increased risk of the effects from the flu. It may help to know that radiotherapy treatment to the breast does not lower your immune system, so having radiotherapy would not be a reason for needing the flu jab.
It sounds like this has been upsetting and confusing for you. Do talk about your concerns with your GP or breast care nurse (if you’re still in contact with her). They may be able to arrange for you to have some talking therapies to help you through this difficult time.
You’re also welcome to call our helpline if you would like to talk this through or have any further questions. The helpline team have time to listen to your concerns, talk things through and signpost you to more support and information. Your call will be confidential, and the number is free from UK landlines and all mobile networks. The number is 0808 800 6000, (Relay UK -prefix 18001).
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Best wishes
Teresa
Breast Care Nurse
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