Question

Case Study:

As a corrections nurse in a large, federal penitentiary, one of your responsibilities is to control the spread of communicable diseases. Specifically, your assignment is to provide seasonal influenza vaccine to your team of 500 inmates; over the past 3 years, the average rate of immunization for your team has been 62%; the goal is a minimum of 90%.

1. What data do you need to improve the rate of vaccine adherence?
2. What factors in inmates’ histories might make this a challenge?
3. What environmental factors complicate the immunization process?
4. What strategies might you use to increase influenza vaccine rates?

Answer 1

Seasonal influenza vaccine is an immunization given yearly to protect against seasonal influenza. Flu vaccines lead to immunity in the form of antibodies about 2 weeks after vaccination. This seasonal flu vaccine protect us against the influenza viruses. Every one 6 months of age and older should get an influenza vaccine every season with rare exception. There are different types of seasonal influenza vaccines. They are

* flushot

* Quadrivalent flu vaccine

* Highdose flu vaccine

* Cell based flu vaccine

* Nasal spray flu vaccine

* Flu vaccination by jet injector

* Adjuvanted vaccine

*Recombinant flu vaccine

Datas needed to improve the rate of vaccine adherence

* Providing a clear recommendation

New vaccines often take time to catch on and reach herd immunity ,and providers can play an important role in that process. This is because sometimes a clear recommendation can help patients in their vaccination decisions.

*Adopt an encouraging positive approach with questioning patients.

This can be done by examples ,instead of educating parents about the merits of vaccine safety, providers can also build trust by acknowledging concerns or questions that patients may have and opening the discussions up to them.

*Be proactive in making appointments

When doctors being pro active and scheduling patients to receive there annual flu vaacinations they follow more likely with their vaccination.

* Set reminders for vaccination reviews

Practices should be setup with the patient communication systems to call and mail patients with reminders regarding their vaccination shedules.

*Get more practice members involved

In addition to these physician patient approach, practices are also finding success by empowering additional members of the health care team to oversee and support vaccine screeings and shedules, rather than leaving the responsibilities solely to clinicians.

Factors in inmates history making immunization a challenge

* People with severe life threating allergies to flu vaccine or any ingredient in the vaccine. This might include jelatin, antibiotics or other ingredients.

* People with egg allergy cannot take the vaacine. They should be vaccinated in a medical setting with any licensed, recommended age appropriate influenza vaccine(IIV, RIV4 or LAIV4) that is otherwise appropriate. Two completely egg free flu vaccine options are available. Quadrivalent recombinant vaccine and quadrivalent cell based Vaccine.

*People with Guillain -Barre syndrome should not take flu vaccine.

*People with other conditions such as chronic lung disease, heart disease, kidney disease, liver disorders, neurologic and neuromuscular disorders, blood disorders or metabolic disorders.

*Children 2years through 17 years of age who are receiving aspirin or salicylate containing medications should not take vaccination

* People who have taken influenza antiviral drugs with in previous 48 hours should not take vaacination.

* People with weakened immune system

* Pregnant women, children younger than 2years should not get a nasal spray vaacine

.

Strategies to increase influenza vaccine rates

* Offer influenza vaccination education multiple times during the flu season

* 0ffer opportunities to be vaccinated at multiple times and locations convenient to all workers on all shifts during the flu season

* Educate and vaccinate staff as part of new employe orientations.

* provide free vaccine

* partner with larger healthcare organisation to provide vaacinations.

* Publicaze a vaccine day in combination with education to offer influenza vaccination.

* Emphasize that flu vaccination s protects the employees their loved ones and those they work with

* Track and report vaccination rates to staff and supervisors.

* Remind unvaccinatesd employees with email, letter, encouragement from supervisors and telephone call

* Establish a written influenza vaccination policies for employees.

* work with pharmacy consultants to offer influenza vaccination for facility staff as a standard procedure.