Getting you through the Flu (season)

28 May 2018 

One of the most common questions APNA’s nurse support line has been answering over the past week has been: How do we reduce anxiety in our at risk groups (especially the over 65s) when there’s an influenza (flu) vaccine shortage?


Image: If you can relate to the 'waiting skeleton', we've got some tips for managing the flu vaccine shortage.

 

 

 

 

Find the right information

As information is changing on an almost daily basis, some of the below sources are great resources: 

  • Your State Department of Health

ACT NSW NT QLD
SA TAS VIC WA

 

 

 

 

Management of patient expectations and appointments

Reassure patients

Letting them know that the delay does not mean they cannot be protected this year – in fact the best time to be vaccinated is late May–June to ensure they have full coverage for when the winter/flu season is in full swing (peak influenza circulation in Australia is typically June to September). The flu vaccine is most effective in the first 3–4 months following vaccination1.

Processes management

Ensure all staff in your clinic (receptionists, general practitioners, nurses, other) are aware of and understand the protocol and management of influenza vaccination appointments and the difference between government funded and private stock. This may need to change and be clearly communicated on a daily basis, depending on stock levels and availability.

  • Ensure those at risk (under the National Immunisation Program) are given priority for government-funded vaccines
  • With private stock you many consider looking at other potential at risk groups such as;
    • Those travelling
    • Those in contact with newborns
    • Education workers including teachers
    • Health care workers
  • Influenza clinics: Although throughput of patients is usually managed via flu clinics, in the current landscape where delivery of flu vaccines is uncertain, flu clinics may cause increased work load and stress if patient’s need to be cancelled due to lack of stock. 

Use your local resources

Contact your local pharmacy to see what their supplies and stocks are like.

  • Can you refer patients there? If recommending patients source vaccination from the pharmacy, ensure they are aware to get the full details of the vaccination given by the pharmacist so it can be recorded in their clinical notes.
  • Do you have the capacity to purchase directly from them?
  • This might help alleviate the strain on your backlogged flu clinics

Do any other local general practice clinics have stock available? Often clinics might borrow stock from other clinics if appropriate and/or capacity to do so.

Use alternate vaccines (where able)

The ATGI Influenza fact sheet states it’s perfectly fine to use alternate vaccines for 65+[1]. However, no studies have been conducted on giving the higher-immunogenicity trivalent influenza vaccine (TIV) following quadrivalent influenza vaccines (QIVs). If neither of the recommended TIVs are available, then a QIV should be used. The use of multiple types of vaccines (e.g. an adjuvanted TIV with a standard QIV) has not been studied.

Finally: Remember, prevention is always better than a cure

Use your public health empowerment powers

Remind your patients of other preventative methods they and their family members can take such as:

  • Cough and sneeze etiquette – Nurse Robbie’s Flu Season Etiquette refresher is a great mini tutorial to send out
  • Hand hygiene – Use and carry a small alcohol hand gel to disinfect their hands, particularly if going out
  • Stay home if unwell – Going to work or out and about when sick doesn’t help anyone, and only helps to spread germs
  • Seek medical advice if needed – Remember the nurse is only a phone call away
  • Following general good-health guidelines – This is an important step towards keeping their immune system strong and healthy. As part of this, eating well, with plenty of fruit and vegetables as part of their regular diet will help
  • Getting the flu shot is only a small part of the larger prevention picture – Direct patients to well-regarded websites about getting the flu vaccination and other prevention method’s, such as the Better Health Channel[2]

References

[1] Australian Technical Advisory Group on Immunisation (ATAGI) [Internet] 2018. Available from https://beta.health.gov.au/resources/publications/atagi-advice-on-seasonal-influenza-vaccines-in-2018

[2] You Never Forget the Flu https://www.betterhealth.vic.gov.au/campaigns/you-never-forget-the-flu-b

This article was featured in APNA Connect - 28 May 2018.

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