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Here I am, just finished a full day vaccinating at a Flu shot clinic where we vaccinated another 500 people. Although that does not seem like a lot, over the last 5 weeks of Flu shot season, the “Flu Team” (A group of Public Health Nurses and Community Health Nurses) have vaccinated over 19,000 people. That’s more than double our numbers from last year. A massive increase.

            One of the reasons for this increase is likely due to the elimination of the flu vaccine fee for physicians. Several of the people I spoke with today mentioned that they usually receive the vaccine from their family physicians, however this year they were forced to attend the pubic flu clinics. Many were surprised with how easy and efficient it was to walk in and receive their vaccine. No appointments, short wait times and smiling faces. While in a previous post I questioned the decision of pulling the fee from physicians, I never questioned the ability of the Public Health program to pull off successful clinics (we did get through H1N1, remember?). I still don’t believe that halting normal public health programming to man Flu clinics is appropriate, but it was nice to hear the positive reviews from the public today on how well the clinics have been running.

            Another possible reason for the increase in the uptake from our public health clinics could be related to the reporting of a terrible flu season in Australia. This year Australia reported one of the worst outbreaks on record, with over 70, 000 infected, and over 30, 000 becoming infected in one month alone, (Dunlevy, 2017). The flu vaccine that is prepared for North America is usually based off the Flu strain that is most common in the Southern Hemisphere, particularly Australia. One of this year’s strain was H3N2 and is known for its higher mortality rates (Zamon, 2017). Public Health officials in Canada are strongly encouraging the public to vaccinate this year due to this, which is why we could be seeing more numbers in our clinics.

            A third reason is, sadly, there have already been 4 deaths in Alberta related to influenza (Tucker, 2017). Although the average, relatively healthy person is able to fight off the flu without medical assistance or hospitalization, those who are more at risk, such as the elderly, immunocompromised or infants are more likely to have more difficulty fighting the virus and therefore higher mortality rates. Once the public becomes aware of any deaths related to influenza it tends to cause anxiety and an increase in Flu vaccine uptake.

            Whatever the reasons, it’s good to see the increase and the positive response of the public, and the season isn’t over yet. Clinics will continue into the spring, although peak season is late December, all that Christmas cheer!

So, if you haven’t yet, get out, roll up your sleeve and get your flu shot! It won’t hurt (that much!)

  References:

Dunlevy S. (August 15, 2017) Australia hit by worst flu outbreak on record in 2017. News Corp Australia Network. Retrieved from:

            http://www.news.com.au/lifestyle/health/health-problems/australia-hit-by-worst-flu-outbreak-on-record-in-2017/news-story/56d9f7266bcc8a0a7ceacd5298e06d88

  Tucker E. (November 9, 2017) Alberta records 4 flu deaths in 2017-    18 season as Calgary cases rise. Global News. Retrieved from:

            https://globalnews.ca/news/3853381/alberta-records-4-flu-deaths-in-2017-18-season-as-calgary-cases-rise/

  Zamon R. (October 2, 2017) Getting A Flu Shot For 2017 Is Being Strongly Urged By Health Professionals. The Huffington Post. Retrieved from:

            http://www.huffingtonpost.ca/2017/10/02/flu-shot-2017_a_23229786/

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Can the flu shot give you the flu?

  We hear this all the time don’t we? “I’m not getting the flu shot, the last time it gave me the flu.” Well, although this is certainly not true, there are side effects of the flu shot that can feel like “flu-like” symptoms. Side effects of the influenza vaccine include:

Redness, Soreness, swelling at the site of injection

muscle aches

low grade fever

fatigue and headache.

Many of these symptoms can be believed to be influenza, however they usually only last for about 24-48 hours.

  A true Influenza infection would span over one or more weeks and would be more severe than the side effects from the flu shot. They would include:

cold-like symptoms (runny nose, sore throat, sneezing, cough etc.)

high fever

malaise

loss of appetite

muscle and joint pain

headache

diarrhea

  Then why did I get sick following my Flu Shot?

  Sometimes an individual could already have been exposed to the virus prior to receiving the flu shot and being to have Flu-like symptom following the vaccine. However, it is important to note that although it appeared the symptoms of Influenza appeared around the same time, it is highly unlikely that the vaccine caused the flu.

  The Flu shot contains an inactivated vaccine made of a killed virus. As the virus is inactivated the shot won’t cause you to get the flu but it will allow your body to develop the antibodies necessary to fight off any influenza viruses.

  So, although you may have heard from others that the flu shot made them ill, you can be assured this is not the case. You are much safer receiving the vaccine than not. So head out, roll up your sleeve and get vaccinated!

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Pharmacist Administered Flu Shots

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Flu Season is Upon us - Tips to Keep Your Children Safe

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The Flu Clinic schedule for Eastern Health came out this week and there are lots of them! There are more clinic this year than every before. Flu clinics will be easily accessible throughout Newfoundland and Labrador and from my experience are run very smoothly. Each clinic, in the Eastern Region of Newfoundland at least, are run by Public Health and Community Health Nurses from the area.

  The Influenza vaccine this year contains 4 strains of the Influenza virus, including H1N1. In previous years, only the high risk populations were recommended to receive the vaccine:

Persons of any age with chronic conditions who require regular medical or hospital care, such as respiratory disorders, cardiac disease, renal disease, metabolic disorders and mobility impairment

Persons in residential care, nursing homes and other chronic care facilities

Persons age 60 and over

Children age 6 months to 4 years

Pregnant women

Persons who are morbidly obese

Health care workers, including those in the community or chronic care facilities

Essential service workers such as, but are not limited to, police, ambulance personnel, and firefighters

Aboriginal peoples

Household contacts of people at high risk of influenza-complications

Poultry and swine industry workers 

These groups are still considered high risk, however in the last 5-7 years the vaccine is now recommended to all members of the general population free of charge.

  Children under 9 who have not been previously vaccinated will require 2 doses in their first year. These children will be re-booked on site when they receive their first dose, so there’s no having to remember it. And the appointment will be made at a site close to you at a date and time that’s most convenient.

  The flu clinics will begin on October 23 and will run until into the New Year, however it is recommended to receive the vaccine in the fall or early winter to help your body build up an immunity before the virus begins to circulate.

  So after Oct 23, head out, roll up your sleeve and get your flu shot! Here’s the schedule:

http://www.easternhealth.ca/OurCommunity.aspx?d=2&id=1624&p=1620

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Influenza Vaccination – Who Are We Really Protecting?

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Influenza and Breastfeeding

              It’s World Breastfeeding Week (WBW) in Canada, or National Breastfeeding week as the rest of the world celebrates in August. In Canada WBW is celebrated the first week of October and this year’s theme is “Sustaining Breastfeeding Together."

    Breastfeeding is one of the most important ways to protect a newborn from diseases and infections, influenza included. Breastfeeding and breastmilk can protect a baby’s health during flu season as it contains antibodies and other substances that will help the baby flight off infections.

Once a child hits 6 months it is safe for them to receive the influenza vaccine, however Infants younger than 6 months of age are unable to receive the flu vaccine, so what are some ways we can protect them?

First and foremost, continue breastfeeding when possible

Always practise good hygiene including handwashing with soap and water or alcohol-based hand sanitizer

Cover your mouth when sneezing or coughing, with a tissue or your sleeve

Request that family members delay visits with Mom and Babe if they are not feeling well

Keep babe close and avoid contact with visitors and non-caregivers

Avoid taking your baby out into crowds

Have close family members and care-givers vaccinated

    If a breastfeeding Mom is feeling ill and experiencing influenza-like symptoms the most important thing is to continue breastfeeding as much as possible as this is the best way to protect the babe. If they are not well enough to breastfeed, breastmilk can be expressed with assistance and given to the baby via bottle, cup, spoon, syringe or eye dropper. If the baby is ill, it is still best to keep breastfeeding as this will help increase fluid intake and can also assist with clearing the respiratory tract.

 Breastfeeding takes a village and during influenza season when both Mom and Babe are at increased risk of infection it is especially important to assist and support new mothers to initiate and sustain breastfeeding.

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Eliminating fee for influenza immunization - what's the right decision?

It’s getting close to that time of year again, and no, I don’t mean the holiday season. Although, Influenza and Christmas do tend to go hand in hand. But, yes, Flu season. The time of year us Public Health Nurses both dread and sort of enjoy. Dread because there is always the huge increase to our workloads. Enjoy because we get a little break from the busyness of our day-to-day work and get to spend and day or two chatting with adults who will happily roll up their sleeves and sit still while we administer them a flu shot. (A stark contrast to wrestling with infants and children who either have no idea what is coming until they are stabbed or who scream bloody murder only to realize that it’s not that bad once it’s all over!)

  The 2017-2018 Flu season has seen some changes here in NL. The main one being that Doctors will no longer be funded thorough MCP to administer the flu vaccine. In the past, physicians have been provided with free flu vaccine that they then would charge MCP to administer. Many physicians would hold their own flu clinics and charge per dose of vaccine given, I believe at a rate of approximately $17.00. These clinics would mostly be held outside of their regular clinic hours, perhaps on a weekend or evening. Any client seen during regular clinic hours for another concern could receive the vaccine and the regular clinic visit charge would apply. Government feels this fee code elimination could save them $517,000 and plan to use this savings towards implementing the HPV immunization program for males. Sounds wonderful…or does it?!

  The provincial government is encouraging anyone who would like to receive a flu shot to go to the public health clinics that will be offered in their area. Eastern Health and the 3 other health authorities will be offering clinics throughout various cities and towns across the province. The various public health programs have been advised to gear up and prepare for an onslaught of people looking to receive the vaccine. In order to prepare for this, for the first three weeks of “the season” all Public Health Programs are reduced to business continuity only. In this case business continuity means only Child Health Clinics (infants and child from 2-18 months) and postnatal visits only. Meaning a loss of some of the core Public Health programs for that time period.

  Currently the public health program has no “Influenza budget” and are taking on this massive program with little to no extra funding. Those in charge of preparing the clinics have to find places that are easily accessible, free for use and can accommodate the massive set up required to run a proper flu clinic. That sounds impossible in itself but add in the fact that of course these clinics will also need to be staffed by RN’s, LPN’s, clerical and volunteers when available. Attempting to make all of this happen with no money is attempting the impossible.

  In addition to all of this, Physicians are concerned for the well-being and health of their clients. Most physicians have a close relationship with their patients. They are trusted and looked to for advice. For this reason, they may be more likely attend one of their Family Doctor run flu clinics. The provincial government feels that 75% of individuals who were vaccinated by their physician will attend the publically funded clinic, whether this means the other 25% will not get vaccinated at all or they will be done by their doctor during a routine visit is not clear, but it is an interesting fact to note.

  I haven’t fully decided whether the decision is the right one or not. The savings alone would make one question why there ever was a fee code, however, if Flu shot uptake decreases because of this there may be an increased cost due to the added strain on the health care system from Influenza itself. As an immunizer and someone who will be working the clinics, I’ll be interested to see what number of attendance we will see at the clinics and how well they are received. One thing I do know for sure, the Public Health program will not be able to continue to drop to business continuity every fall, some change to the program will have to happen for Public Health to continue to take control of the flu clinics.

  References:

  Quinn, M (2017) Cutting funding for doctor-delivered flu shots bad decision, says medical

 association. CBC news. Sept 7, 2017. Retrieved from:

http://www.cbc.ca/news/canada/newfoundland-labrador/flu-shot-funding-cut-nlma-hpv-

1.4277685

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Flu vs. Cold – What’s the Difference?