The shot is safe, but you cannot get live viruses while on Remi (which the nasal mist is). Being immune-suppressed, you're 'supposed' to get the shot every year, but it's up to you. I work for a hospital and am required to get it (or provide a doc's note as to why I cannot and my doc thinks I should get it, so that's out). Even though I don't work IN the hospital or with patients (I'm an analyst), it's a company-wide policy. They bring them to our office and we line up and get our jabs.