It's All in the Approach
Talking to patients and families about the flu
It’s time to get ready for flu season. That means preparing to recommend flu vaccine to your patients. How can you make sure that your recommendation results in your patients saying “YES” to flu vaccine? Here are some important tips from Dr. Kristen A. Feemster – Medical Director- Immunization Program and Acute Communicable Diseases
A Step by Step Guide to Setting Up a Flu Clinic
Flu season will soon begin, and there are many good reasons to make sure all patients get immunized. Influenza vaccination is not just a Physician Quality Reporting System (PQRS) measure; it is good care.
The goal is to administer as many vaccines as possible as efficiently as possible to minimize staff time and maximize the number of vaccinated patients. Setting up an influenza vaccine clinic is a simple way to achieve that goal if the practice is well organized. Here is a step-by-step guide to running a successful flu vaccine clinic.
1. Set dates, times, and a maximum number of patients the clinic will serve. A well-organized clinic can vaccinate as many as 300 or 400 patients in a few hours.
2. Advertise the clinic by making flyers and displaying them in every exam room. Add the information to the practice website and to every patient statement. Offer appointments early and encourage patients to sign up.
3. Begin accepting appointments at least two months before the vaccine clinic date. Most clinics can accommodate as many as eight patients every 15 minutes with one support staff member and one technician.
4. Pull charts and print encounter forms three days before the clinic.
5. Verify the insurance of every patient when the appointment is made. Those without insurance or those whose insurance does not cover the vaccine need to know the cost and the payment process to expect at the time of the visit.
6. Make sure physician orders for each patient are complete and up to date.
7. Copy up-to-date vaccine information statements for vaccines that will be distributed. Find these online.
8. If different doses of the same vaccines are being administered, establish a system to clearly identify and separate each dose.
9. Prepare gloves, alcohol wipes, bandages and sharps containers.
10. Make labels for charts. Be sure to include the date the vaccine was given, vaccine name, manufacturer, lot number, expiration date, vaccination site, and space for the initials of the technician administering the vaccine. In practices using an EHR, ensure that all staff participating in the vaccination clinic can correctly document the vaccination.
11. Prepare vaccine logs so the documentation requirement is easy for staff to complete.
12. If needed, set up a table to receive patients for registration and designate a place for charts.
13. Have another table ready for the vaccine supplies and a chair for patients so that the vaccine can be administered safely and comfortably.
14. After the clinic is completed, charge out encounter forms. Call no-show patients to schedule new appointments.
Common Questions and Answers Providers May Have
What’s new this flu season?
- Flu vaccines have been updated to better match circulating viruses [the B/Victoria component was changed and the influenza A(H3N2) component was updated].
- For the 2018-2019 season, the nasal spray flu vaccine (live attenuated influenza vaccine or “LAIV”) is again a recommended option for influenza vaccination of persons for whom it is otherwise appropriate. The nasal spray is approved for use in non-pregnant individuals, 2 years through 49 years of age. People with some medical conditions should not receive the nasal spray flu vaccine. All LAIV will be quadrivalent (four-component).
What flu vaccines are recommended this season?
For the 2018-2019 flu season, providers may choose to administer any licensed, age-appropriate flu vaccine (IIV, RIV4, or LAIV4).
What viruses will the 2018-2019 flu vaccines protect against?
There are many different flu viruses and they are constantly changing. The composition of U.S. flu vaccines is reviewed annually and updated as needed to match circulating flu viruses. Flu vaccines protect against the three or four viruses (depending on vaccine) that research suggests will be most common. For 2018-2019, trivalent (three-component) vaccines are recommended to contain:
- A/Michigan/45/2015 (H1N1)pdm09-like virus
- A/Singapore/INFIMH-16-0019/2016 A(H3N2)-like virus (updated)
- B/Colorado/06/2017-like (Victoria lineage) virus (updated)
Quadrivalent (four-component) vaccines, which protect against a second lineage of B viruses, are recommended to contain:
- the three recommended viruses above, plus B/Phuket/3073/2013-like (Yamagata lineage) virus
When should I get vaccinated?
You should get a flu vaccine before flu begins spreading in your community. It takes about two weeks after vaccination for antibodies that protect against flu to develop in the body, so make plans to get vaccinated early in fall, before flu season begins. CDC recommends that people get a flu vaccine by the end of October. Getting vaccinated later, however, can still be beneficial and vaccination should continue to be offered throughout flu season, even into January or later.
Children who need two doses of vaccine to be protected should start the vaccination process sooner, because the two doses must be given at least four weeks apart.