Friday, September 15, 2023

Flu Shots For Hospice Patients

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Patients With Egg Allergy History

Two nurses fired for refusing flu shot

As is the case for all vaccines, influenza vaccines contain components that might cause allergic and anaphylactic reactions.Not all such reactions are related to egg proteins however, the possibility of reactions to influenza vaccines in patients who are egg allergic might be of concern to these patients and vaccine providers.Currently available influenza vaccines, with the exceptions of recombinant influenza vaccine and cell-culture-based inactivated influenza vaccine , are prepared by propagation of virus in embryonated eggs and might contain trace amounts of egg proteins, such as ovalbumin.Severe allergic reactions to vaccines, although rare, can occur at any time, even in the absence of a history of previous allergic reaction. Therefore, all vaccine providers should be familiar with the office emergency plan and be certified in cardiopulmonary resuscitation. For patients who report a history of egg allergy, the CDC’s Advisory Committee on Immunization Practices recommends patients with a history of egg allergy who have experienced only urticaria after exposure to egg should receive influenza vaccine. Any licensed, recommended influenza vaccine that is otherwise appropriate for the recipient’s age and health status may be used.

A previous severe allergic reaction to influenza vaccine, regardless of the component suspected of being responsible for the reaction, is a contraindication to future receipt of the vaccine.

Can I Get Vaccinated If I Dont Like Needles

Rachel Roper, PhD, associate professor at the East Carolina University Medical School said, Yes, there is a flu mist nasal vaccine. The flu injection/shot is a killed virus, but the flu nasal spray vaccine is a live attenuated virus. It is a severely weakened virus that will cause a small brief infection in your nasal passages. Most people dont even notice it.

Because the flu nasal vaccine is a live virus, people who have conditions that affect their immune systems may not be able to take it.

Roper said the flu nasal spray has been approved for healthy people 249 years old, but theres actually a of people who shouldnt get the live flu mist vaccine.

Special Consideration Regarding Egg Allergy

People with egg allergies can receive any licensed, recommended age-appropriate influenza vaccine that is otherwise appropriate. People who have a history of severe egg allergy should be vaccinated in a medical setting, supervised by a health care provider who is able to recognize and manage severe allergic reactions. Two completely egg-free flu vaccine options are available: quadrivalent recombinant vaccine and quadrivalent cell-based vaccine.

It takes about two weeks after vaccination for antibodies that protect against flu to develop in the body.

Its best to be vaccinated before flu begins spreading in your community. September and October are generally good times to be vaccinated against flu. Ideally, everyone should be vaccinated by the end of October. However, even if you are not able to get vaccinated until November or later, vaccination is still recommended because flu most commonly peaks in February and significant activity can continue into May.

Additional considerations concerning the timing of vaccination for certain groups include:

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Who Should Get A Flu Vaccine This Season

Everyone 6 months and older should get a flu vaccine every season with rare exceptions. Vaccination is particularly important for people who are at higher risk of serious complications from influenza. A full listing of people at Higher Risk of Developing Flu-Related Complications is available.

Flu vaccination has important benefits. It can reduce flu illnesses, doctors visits, and missed work and school due to flu, as well as prevent flu-related hospitalizations and deaths.

Different flu vaccines are approved for use in different groups of people.

There are many vaccine options to choose from. CDC does not recommend any one flu vaccine over another. The most important thing is for all people 6 months and older to get a flu vaccine every year.

If you have questions about which flu vaccine to get, talk to your doctor or other health care professional. More information is available at Who Should Get Vaccinated.

Seasonal Flu Shot Side

Vaccines for Palliative &  Hospice Patients

Immunisation against seasonal influenza usually causes no problems. You may have a temporary mild soreness at the injection site. Sometimes, it can cause a mild raised temperature and slight muscle aches for a day or so. This soon settles and does not lead to flu or other problems.

Serious reactions have been reported but are rare. For example, a severe allergic reaction, inflammation of nerves and inflammation of the brain are very rare reactions.

Children are given the vaccine by nasal spray. It contains a live but weakened form of the flu virus. It will not cause flu in a healthy child. However, if a healthy child lives with someone who does not have a healthy immune system , they should have the other type of vaccine. The live, weak form of vaccine has been shown to be more effective in preventing flu in children.

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Why Do I Need To Get A Vaccine Every Year

Viruses change because the genes for that virus change. Some viruses change very little and others, like influenza, change frequently and sometimes in many genes.

Roper explained, Influenza viruses belong to the orthomyxovirus family of viruses. They are very unusual because they have eight different genome segments, eight different pieces. Most viruses have one piece of genome, but flu has eight.

Because of this, flu can reassort genome pieces with other related viruses and make a whole new strain. This happens frequently, every year, so we have to make a whole new vaccine each year because the flu genome changes so dramatically, Roper said.

Other viruses that have one genome piece slowly mutate and evolve over time, Roper added. Thats why our vaccines for measles, mumps, rubella, and chickenpox have worked for decades because those viruses mutate more slowly.

Who Should Not Receive A Flu Shot:

Most people should be vaccinated for influenza each year, But some people should not be vaccinated, or should not receive some types of influenza vaccines, depending upon things such as their age, health and whether they have certain allergies.

Information about who cannot get a flu vaccine and who should talk to their doctor before getting a flu vaccine is available at Who Should & Who Should NOT Get Vaccinated.

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Whats New And Resources For The 2021

The CDC maintains a page dedicated to the current flu season. There is a section for the public and also a section for providers. This is a good place to get up-to-date information on influenza and influenza vaccination. You can find it here:

Note that the CDCs Flu FAQ page currently includes lots of information about influenza and COVID-19, such as how to tell them apart, why its safe to be vaccinated for both at the same time, and more.

The CDC also provides information specific to older adults here:

What We Know About Covid

What is the ICD-10 Code for Flu Shots?

Q: How are COVID-19 and influenza similar and how are they different?

A: COVID-19 and influenza have many similarities, but also many differences.

The main similarities are:

  • Both viruses are mostly spread through an airborne route. This means that steps you take to protect yourself from COVID-19, such as social distancing measures and avoiding crowded indoor spaces, will likely reduce your risk of catching influenza as well.
  • The initial symptoms of infection have a lot in common. Namely, both often start with upper respiratory symptoms such as cough, runny nose, fatigue, fever, and body aches. This means it will be difficult to tell the two conditions apart, unless laboratory testing is used.
  • Both are more likely to cause severe illness in people who are older or frail.

Even though both viruses often cause viral pneumonia, there are significant differences between the two. They are actually quite different types of viruses. The differences include:

In short, influenza and COVID-19 are similar in terms of how they spread and common initial symptoms. But COVID-19 has so far caused more serious disease, and at this time, remains harder to treat, in part because it seems to affect the body in more significant ways than influenza usually does.

For more on the similarities and differences between influenza and COVID-19:

Q: Is it possible to get influenza and COVID-19 at the same time? How do they affect each other?

Read Also: Number Of Flu Cases 2021

Vaccines For Hospice Patients

The goal of hospice care is to give patients the highest possible quality of life for the remainder of their lives. There are two vaccines for hospice patients that can help with this.

Influenza Vaccine

The influenza vaccine can help hospice patients by preventing the flu from shortening their lives and providing great discomfort. There is no risk of contracting the flu from the influenza vaccine, but it can reduce the risk of flu-related complications and even death.

Pneumococcal Vaccine

If a patient has a documented history of pneumonia, the hospice team may also recommend the pneumococcal vaccine. The vaccine will help protect the patient from 13 types of pneumococcal bacteria that cause serious infections in adults and children including pneumonia, septicaemia, and meningitis. It can also help prevent ear infections and pneumonia caused by those bacteria.

Potential Options For Providing Vaccination For Staff

The nature of shift working and the likely high proportion of part-time workers, makes achieving high uptake amongst care home staff, personal assistants, domiciliary staff, and hospice staff challenging.

A multi-component approach is recommended to ensure all staff have easy access to the vaccine. In addition to being eligible for a free vaccination because they are care workers, some staff may also be eligible for free vaccination via their general practice because they are in an existing clinical at risk group. It is especially important that these staff are vaccinated early to protect themselves from serious illness associated with flu infection. Further information is available on NHS.UK.

* experience of medicine ordering and cold chain maintenance

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Why End Of Life Matters

Certainly, you might hear the occasional gripe that people who already receiving end-of-life care may not need a flu shot. After all, if someone only has a few months to live, the thinking can go that theyre not going to need something that will last until next fall so may as well save it for someone else. Plus, theyre already expecting death, so death from flu or death from another condition doesnt matter, right?

The truth is that these types of statements are insensitive, cruel and simply incorrect.

Generally, people receiving hospice care may have been told that they have limited time left due to a deteriorating health condition. This doesnt mean they want to do anything deliberately to reach their end sooner than they have to.

If someone is trying to make the most of their remaining days theyll likely be trying to do things like complete manageable bucket list items, spend quality time with loved ones, complete their final arrangements, and try and come to peace with whats ahead. So coming down with the flu could derail or disrupt these plans.

Because of their already weak physical health, flu could knock someone down for days, maybe even weeks. This could make them unhappy as well as cause feelings of depression to emerge especially if they had plans for what to do in their last days and enjoyed being as independent as possible.

If they get the flu, they may need more care and feel worse. It could further harm an already weak immune system.

Agreeing To Be Vaccinated

Vaccines for Palliative &  Hospice Patients

Its important that as many health and social care workers as possible get the vaccine it protects you, your family, and the people you care for from the flu but if you dont want to have the vaccine for whatever reason, you dont have to have it.

  • All frontline health and social care workers who are directly involved in the care of clinically vulnerable patients/clients, and who are at increased risk from exposure to influenza, should receive a vaccination this season. This should be provided by their employer, in order to meet their responsibility to protect their staff and patients and ensure the overall safe running of services. Employers should commission a service which makes access easy to the vaccine for all frontline staff, encourage staff to get vaccinated, and monitor the delivery of their programmes.

    Where employee-led occupational health services are not in place, the NHS will continue to support vaccination of social care and hospice workers employed by registered residential or domiciliary care providers, as well as those employed through Direct Payment and/or Personal Health Budgets to deliver domiciliary care to patients and service users. Vaccination will be available through community pharmacy or their registered general practice. This scheme is intended to complement, not replace, any established occupational health schemes that employers have in place to offer flu vaccination to their workforce.

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    What If I’m A Mass Immunizer

    Mass immunizers may use a roster bill or submit a traditional claim form, such as a CMS-1500 form or the 837P electronic format. CMS systems will accept roster bills for 1 or more patients that get the same type of shot on the same date of service.

    Medicare-covered vaccines are exempt from the HIPAA electronic billing requirement. This exemption applies to providers submitting mass immunization claims on paper. When you submit roster bills, dont list other covered services with the flu or pneumococcal shot and administration. If you have other services to bill, use normal claims filing procedures and forms.

    Roster Billing Requirements

    • Licensed in states where you operate.
    • Enrolled in the Medicare Program*.
    • Accept assignment on shots and their administration. This means that you accept Medicare payment as payment in full. You cant collect a deductible, copayment, or coinsurance on these services.
    • Submit separate roster bill claims for flu and for pneumococcal shots.
    • Bill a MAC.
    • Bill only flu and pneumococcal shots and administration using this process. We pay both administration fees if you give both shots on the same visit. Use separate administration codes for the seasonal flu shot and pneumococcal shot .

    * To enroll in the Medicare Program solely as a Mass Immunization Roster Biller , complete a Medicare Enrollment Application:

    Where Should I Go To Get A Flu Shot

    Roper said you can get a flu shot at your doctors office, public health clinics, many pharmacies, and even some grocery stores.

    She recommends that everyone has a primary care physician for things like vaccines and common illnesses.

    If you have a physician, you can get help when you need it. If you dont have a physician, it can be really difficult to find an appointment when you need one. Just go make an appointment with a physician for a check-up and flu shot so you will have an existing relationship with one where they have your info on file. It could save your life, said Roper.

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    Who Is Most At Risk For Flu Complications

    Certain people are more at risk for developing complications when they have flu, including:

    • Children younger than 5 years old.
    • Adults 65 years old and older.
    • Pregnant women.
    • Residents of nursing home facilities and long-term care facilities.
    • People with other medical conditions, including asthma, chronic lung disease, heart disease, diabetes, kidney and liver disorders.

    How To Submit Professional Claims

    New flu vaccine guidelines for children

    You may use roster billing format, or submit individual claims using the CMS-1500 form or the 837P electronic format. CMS systems will accept roster bills for 1 or more patients that get the same type of shot on the same date of service.

    How Do I Submit a Professional Claim?

    Electronic Claims: to electronically submit professional claim roster billing directly to your MAC.

    Paper Claims:

  • Roster bill for patients .
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    Staying Healthy During Flu Season

    If you are unable to get a flu shot , double-down on other prevention strategies that can go a long way in helping you stay well:

    • Wash your hands: Other than getting a flu vaccine, washing your hands frequently is the single most effective thing you can do to prevent the flu and stay healthy. Make sure you are doing it properly, so you get the full benefit and actually get the germs off your hands.
    • Avoid touching your face as much as possible: If you touch your face, eyes, nose, or mouth after you have touched anything that has germs on it , you are introducing those germs into your body.
    • Steer clear of sick people: As much is realistic, keep your distance if someone around you is exhibiting symptoms of a cold or the flu.

    If you do notice symptoms that you think could be caused by influenza, talk to your healthcare provider right awayespecially if you are at high risk for complications from the flu or you live with someone who is. Antiviral medications can be prescribed to reduce the severity of your symptoms and the duration of your illness, as well as reduce the chance that you pass it to someone else.

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