Patients with myalgic encephalomyelitis (ME) or chronic fatigue syndrome are not routinely included in the clinical risk groups for vaccination for H1N1 swine influenza. These conditions are not known to increase the severity or duration of community acquired infections, such as influenza. Therefore, these conditions are not routinely regarded as causing immunosuppression, which is one of the conditions in the clinical risk categories. However, general practitioners (GPs) should take into account the risk of influenza infection exacerbating any other underlying disease that a patient may have, as well as the risk of serious illness from influenza itself. GPs should consider on an individual basis the clinical needs of their patients.