For many of us it probably feels like flu season of 2020-21 never quite ended. Pharmacies across America have been vaccinating what seems like nonstop, fighting a novel respiratory bug that has tested our agility and resolve as healthcare professionals. COVID-19 undoubtedly changed the way we operate in more ways than one, and it will certainly impact how we approach our annual battle against the well-known influenza virus. Our conversations with patients may sound and feel a bit different compared to years prior for obvious reasons, and we owe it to our patients to be ready for those conversations and the difficult questions that may come along with them. With that being said, I’d like to share my two cents with you all today: some food for thought and tips to help us all navigate flu season in these unprecedented times. And please, share your thoughts, tips, tricks, and success stories in the comments as well!
Some important CDC recommendations I feel we should keep in mind as we continue to vaccinate our communities against COVID-19, include the following:
*Routine vaccination is an essential preventive care service for children, adolescents, and adults that should not be delayed because of the COVID-19 pandemic. The complete CDC Interim Guidance for Immunization Services During the COVID-19 Pandemic is at this link: www.cdc.gov/vaccines/pandemic-guidance/index.html
*Influenza vaccine is recommended for all individuals ages 6 months and older. Reducing the overall burden of respiratory illness while COVID-19 may be circulating is paramount to protecting our most vulnerable members of the community.
My two cents…
I feel the statement above regarding the need to reduce overall burden of respiratory illness, perhaps now more than ever, reinforces the need not only for the annual flu shot, but also pneumococcal vaccination. We need to be ready to make appropriate recommendations to those at risk and implement efficient methods of screening patients for vaccines they may be eligible to receive beyond COVID-19 and influenza, including pneumococcal (PPSV-23 & PCV-13) vaccination among others. For updated guidance on pneumococcal vaccines, namely changes from ACIP’s November 2019 recommendation regarding routine vaccination with PCV-13 in adults, I highly recommend the following resource: https://www.immunize.org/askexperts/experts_pneumococcal_vaccines.asp#pcv13_adults
Breaking the ice…
How do we break the ice? How do we have meaningful conversations with our patients that lead to actionable interventions. Furthermore, what do we say to our patients who may be hesitant to accept our advice? For me, I’ve always found honesty is the best policy. I must say, I did not anticipate vaccination to become such a polarizing topic in today’s media. While there is much misinformation being spread about the COVID-19, the available vaccines, and unapproved treatments, I feel it is particularly important that for us as healthcare professionals to meet opposing views from our own with courtesy and respect. More importantly, we should be ready to confidently explain our WHY behind the healthcare decisions we make for ourselves and our families, in addition to the recommendations we ask our patients to accept. This area is open to interpretation, and I’d love to hear the opinions of my fellow colleagues on this! What have been some of your most memorable and impactful conversations with your patients concerning the COVID-19 vaccines this past year?
In closing, I’ve provided some summary points for common vaccines that I hope may be useful to those of you out there gearing up for vaccine season! Remember too, as we work though the social determinants of health (SDOH) progression of Flip the Pharmacy, how you might be able to impact your at risk patients this flu season? Whether providing vaccine home delivery, or even simply screening and scheduling a patient for a catch-up vaccine that may end up saving them a trip to the doctor’s office, I encourage you all to take advantage the opportunities you have this flu season to make targeted and meaningful interventions while continuing to provide the high-level of care you are all so well-known for.
Godspeed and good luck!
Evan Turco, PharmD
Supplemental Vaccine Info and Additional Resources:
Some additional vaccines and dosing schedules we should all consider recommending for special populations we are likely to encounter have been listed below.
Pneumovax-23 (PPSV-23): 1 dose
Cigarette smokers
Cirrhosis
CHF
COPD, Asthma
Diabetes
Generalized malignancy
HIV infection
For more information: https://www.immunize.org/askexperts/experts_pneumococcal_vaccines.asp#ppsv23_rec
Hepatitis B: Commonly a 3 dose series (Twinrix, Engerix-B), given at 0, 2, and 6 mos.
People with HCV infection
People with HIV infection
Diabetes
Current or recent IVDU
ESRD
Patients seeking evaluation/treatment for STD’s
***Any person who wishes to be immune to hepatitis B
For more information: https://www.cdc.gov/mmwr/volumes/67/rr/pdfs/rr6701-H.pdf
Hepatitis A: 2 dose series (Havrix, Vaqta) given at 0 and 6-12 (-18 Vaqta) mos.
HIV infection
Illegal drug use, injectable or noninjectable
Homeless and or unstable living arrangements
Travel
Chronic liver disease
***Any person who wishes to be immune to Hepatitis A
FYI!
Twinrix (HAV & HBV) is NOT interchangeable with Havrix or Vaqta.
Havrix and Vaqta may be interchanged for dose 2 of the series.
For more information: https://www.cdc.gov/mmwr/volumes/69/rr/pdfs/rr6905a1-H.pdf
Tetanus, diphtheria, and pertussis (Tdap): Booster every 10 years (Boostix, Adacel)
Pregnancy 27-36 weeks’ gestation
For more information: https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6903a5-H.pdf
Vaccine Shortages:
For more information on vaccine shortages: https://www.cdc.gov/vaccines/hcp/clinical-resources/shortages.html
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