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How to encourage flu vaccine uptake among patients
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The 2017-2018 influenza season continues to take an unusually strong toll, with CDC attributing 53 pediatric deaths to influenza.
In the week ending Jan. 27, CDC officials said there were 51.4 hospitalizations due to influenza per 100,000 people in the U.S. If this rate is maintained through the end of the season, it would be the highest rate of influenza-related hospitalizations since the CDC changed the way it tracks them in 2010, when it started using representative surveillance data from around a dozen sites in the country.
In the Q&A below, Shane Speights, DO, ABOFP, ABFM, dean and associate professor of Medicine, New York Institute of Technology College of Osteopathic Medicine at Arkansas State University, and Jennifer Caudle, DO, associate professor of family medicine, Rowan University School of Osteopathic Medicine, Stratford, New Jersey, provide answers to questions patients may have about influenza to encourage influenza uptake, ways to prevent the spread of the disease and more. – by Janel Miller
Q: How can PCPs explain to patients why there are more cases of influenza this year?
Speights: There are several types of flu and they all act differently. In the past several years the “normal” flu strain has been a seasonal H1N1. The current strain this season that is causing so much trouble is H3N2. Historically, that particular strain has proven difficult in terms of creating a “perfect match” vaccine, with its effectiveness at about 38%. In addition, the H3N2 seems to cause more severe symptoms, especially in vulnerable populations (elderly, children, chronic medical conditions, etc.).
Q: What can you advise a PCP to tell a patient who uses that ineffectiveness as a pushback for not getting an influenza vaccine?
Speights: It’s a huge mistake to assume that the vaccine won’t work just because the effectiveness is lower with this current strain. Although the vaccine may not be as effective as other years, it still offers protection from both the severity of illness and the length of the illness. Getting the vaccine or not can be the difference between being mildly ill or hospitalized. I can’t emphasis that enough.
Caudle: Any protection is better than no protection. Patients need to be told that if they do get the flu shot, and they get the flu, the flu shot will likely lower the duration of the flu and cut down on the severity of flu symptoms, so it’s still important to stress flu vaccination. I tell patients while they may experience some minor discomfort such as swelling or redness at the vaccination site, that’s nothing compared to the symptoms they might have to battle if they contract the flu.
Q: What if a patient thinks it’s too late to get the influenza vaccine?
Caudle: The flu season technically goes from October to May, and it’s best to get the flu shot as early as possible in the flu season so you can be protected. That said, even though we’re already in February, it’s still not too late to get a flu vaccine. The height of the flu season is typically from December through February, so it’s not too late. I still encourage people to get it.
Speights: At this point there are still areas of the country that have not “peaked” in terms of flu activity. The vaccine starts working upon administration and typically reaches maximum effectiveness by two weeks. With the severity of this season I still encourage patients and providers, as does the CDC, to get the flu shot. I don’t see that recommendation changing anytime soon.
Q: There was a recent study that suggested breathing can transmit influenza . How can a PCP alleviate patient s’ concerns about this report?
Caudle: We need more research into this subject matter, but in the meantime, we need to remind patients how contagious the flu can be. We believe that the flu can spread up to 6 feet away by respiratory droplets spread through coughing and sneezing, and it can live on surfaces for hours. We also know that a person can spread the flu for up to a day before they actually start experiencing symptoms themselves. This is why it is so important to stress not only vaccination, but the importance of utilizing hygiene practices as well. Making sure [to] wash your hands in warm, soapy water for about 20 seconds — about the amount of time it takes to sing “Happy Birthday-“ is very important. Patients should use an alcohol-based sanitizer when they are not able to wash their hands and they should stay home from school or work if they are feeling sick. Other things that may help include disinfecting shared surfaces and of course, avoiding others who might be ill.
Speights: The flu is a respiratory virus meaning that it lives and reproduces in the lungs and airways of the body. Any movement of air (i.e. coughing, sneezing, breathing) from the lungs of an infected individual out into the environment has the potential to spread the disease. Typically, the flu can live for about 24 hours outside the body on surfaces like desks, door knobs, smart phones, etc. Using commercially available disinfectants in high traffic areas is a good idea and I couldn’t agree more with Dr. Caudle. Handwashing is the single best way to prevent the spread of disease.
Q: If a patient asks if he or she should start wearing surgical masks to stop the spread of influenza, what would you advise?
Caudle: When it comes to the flu, not everyone has the same underlying medical conditions. Some patients are at higher risk for having complications related to the flu, such as the elderly, children less than 5 years old, pregnant women and patients whose immune systems may be compromised for one reason or another. I cannot say that everyone should start wearing surgical masks because this should be an individual decision made based on risk factors, etc., but this may be appropriate for some. .
Speights: That is not a current recommendation and not one that I advise. The practice of wearing a mask is used in hospitals, urgent cares, and physician offices to reduce the spread of disease between those that are ill and those that are not. The general population should not subscribe to that.
Q: What other resources are available for PCPs and patients regarding influenza?
Speights: The CDC does an excellent job providing information for patients and health care professionals and should be the “go to” for anything flu. Its website provides the most up-to-date medical evidence and guidance during the flu season and can address the myths, misconceptions and blatant lies about the flu and the flu vaccine.
For more information: CDC.gov. "Influenza (Flu)." www.cdc.gov/flu/index.htm. Accessed Feb. 5, 2018.
Disclosure: Neither Caudle nor Speights report any relevant financial disclosures.