Influenza Resources for Healthcare Professionals

Flu severity varies from year to year, but the flu always poses serious consequences. Deaths from pneumonia and influenza combined are the 9th leading cause of death among Hispanics.

Recommended Immunizations for Adults

Routine annual influenza vaccination is recommended for all persons aged ≥ 6 months who do not have contraindications. Emphasis should be placed on vaccination of high-risk groups and their contacts/caregivers, such as children aged 6 through 59 months, adults aged ≥ 50 years, and those with chronic medical conditions.[11]

Source: Center for Disease Control. Recommended Adult Immunization Schedule, United States, 2021. Feb. 2021, Accessed 26 Oct. 2021.

Increasing Vaccination Coverage in the Hispanic Population

Hispanics are the largest ethnic or racial minority group in the United States, representing 62 million or 18.7% of the nation’s population.[1] Despite improved access to health care services by the Affordable Care Act, Hispanics face challenges of mistrust or working for employees that cannot afford insurance and have high rates of being uninsured. Other barriers arise from social determinants of health and lack of healthcare services that are culturally competent. Cultural and linguistic barriers, as exacerbated by a shortage of Hispanic health care providers relative to their growing patient population, as well as underinsured and uninsured status remain as major obstacles to health care access.[2]

 

The World Health Organization (WHO) acknowledges immunization as one of the most successful and cost-effective public health interventions, preventing between two to three million deaths every year.[3] Although racial/ethnic disparities in childhood vaccination coverage have improved throughout the past decade, substantial disparities among adults aged 65 years and older have persisted.[4] Deaths from pneumonia and influenza combined are the 11th leading cause of death among Hispanics.[5] In addition, the data states that the Hispanic population has been disproportionately affected by COVID-19 pandemic.[6]

Immunization Standards

The National Vaccine Advisory Committee (NVAC) revised the Standards for Adult Immunization Practice in 2013.[7] These standards require that ALL health care professionals, whether routinely administering vaccines or not, to take steps to ensure that adult patients are fully immunized.

 

The Advisory Committee on Immunization Practices (ACIP) updated its seasonal influenza vaccination recommendations because of COVID-19.  The common symptoms of COVID-19 (e.g., fever and cough) can also occur with influenza illness. As such, during the continued circulation of COVID-19 with the influenza virus in the fall and winter, ACIP suggests that influenza vaccination of persons of more than 6 months in age can “reduce prevalence of illness cause by influenza, and can also reduce symptoms that might be confused with those of COVID-19.”[8] ACIP further recommends that for persons who have acute illness with suspected or laboratory-confirmed COVID-19, “clinicians can consider delaying influenza vaccination” until patients are no longer acutely ill.  

 

Nevertheless, patients should be reminded to return for the influenza vaccination once they have recovered. The influenza vaccine should be administered by the end of October, but vaccination should continue to be offered as long as influenza viruses are circulating locally and unexpired vaccine is available.[9] Additionally, as FDA-approved COVID-19 vaccines are now available, the COVID-19 and the influenza vaccine are able to be administered during the same visit.[10]

 

See the following for more information:

CDC: Factsheet on Vaccine Documentation

CDC: Samples Vaccine Administration Record

AMA: Adult Vaccinations: Team-Based Immunization

Flu Vaccination

Flu severity varies from year to year, but the flu always poses serious consequences.[12] Although the effectiveness of the flu vaccine may vary, the vaccine lowers the risk of influenza-related illness, hospitalization, and death.[13]
For more information, see the following:

Vaccination for Adults with Diabetes

Adults with diabetes have three times higher risk of death and six times increased risk of hospitalization. The annual flu vaccine significantly reduces admission rates for stroke, heart failure, and all-cause death during the flu seasons in adults with type 2 diabetes. They are also at an increased risk for renal and cardiovascular complications. Health care professionals should inform their patients with diabetes about the dangers of the flu and strongly recommend they get vaccinated each year after thoughtful and shared decision making with the provider and patient.[14]

 

See the following for more information:

Vaccination for Adults with Cardiovascular Disease

People with heart disease and those who have had a stroke are at a higher risk of developing complications from the flu.[15] A 2020 study that looked at more than 80,000 U.S. adults hospitalized with influenza over multiple flu seasons (2010-11 to 2017-18) found that sudden, serious heart complications were common and occurred in 1 out of 8 patients.[16] These startling figures demonstrate the importance of providers discussing the benefits and risk of the flu vaccine with patients, especially those with underlying heart disease.

 

See the following for more information:

Vaccination Coverage and Safety

NHMA is committed to empowering physicians to lead efforts that improve the health of Hispanics regardless of insurance coverage and status. Most state and local public health departments, Federally Qualified Health Centers (FQHCs), and free clinics offer free or reduced-cost services and vaccines. Pharmaceutical companies may also provide vaccines and other medications for reduced or at no cost regardless of insurance status. If your patient does not have health insurance, please visit: www.healthcare.gov to learn more about affordable health coverage options.

Vaccine Safety

The public continues to raise concerns about vaccine necessity and safety. Myths and misinformation about vaccine safety can confuse those trying to make a sound decision. The U.S. Department of Health and Human Services has launched several information/education outreach efforts, including [1] Additionally, the CDC continuously monitors vaccine safety. Vaccines are rigorously tested for years before they are granted licensure, and after a vaccine is licensed, the CDC continues to monitor its use, efficacy, safety, and side effects.

Effective outreach and education about vaccines requires knowledge of your population and individual community, reliability, and trustworthiness. For Hispanic communities, culturally competent communication is essential and includes access to patient-oriented resources in both English and Spanish. Below are links to key websites and brochures.

Paying for the Flu Vaccine

NHMA is committed to empowering physicians to lead efforts that improve the health of Hispanics regardless of insurance coverage and status. Most state and local public health departments, Federally Qualified Health Centers (FQHCs), and free clinics offer free or reduced-cost services and vaccines. Pharmaceutical companies may also provide vaccines and other medications for reduced or at no cost regardless of insurance status. If your patient does not have health insurance, please visit: www.healthcare.gov to learn more about affordable health coverage options.

[1] “Influenza (Flu) Including.” Centers for Disease Control and Prevention, 26 Sept. 2019, http://www.flu.gov/.

Tools for Patients and Providers

In 2021, approximately 85% of Hispanics utilized smartphones. Many health providers are taking advantage of new technological resources available to improve patient care.

CDC ‘I Get It’ Campaign

The CDC released its Digital Media Toolkit for 2021-22 Flu Season. Known this season as the ‘I Get It’ campaign, the Digital Media Toolkit is designed to assist partners in communicating about the importance of the influenza vaccination. Social media has become an effective tool for expanding providers’ reach within the Hispanic community, as well as for fostering engagement and increasing access to credible, science-based health messages. The Digital Media Toolkit provides various resources for social media, including: social media frames, social stories panels, social media graphics, and sample posts for social media accounts.

CDC: Herramientas de Comunicación en Español:

[1] O’Dea, S. “Smartphone Ownership in the US by Ethnicity 2021.” Statista. Statista Inc., 12 May 2021. Web. 24 Sept. 2021. https://www.statista.com/statistics/195001/percentage-of-us-smartphone-owners-by-ethnicity/

Health care provider/clinician apps: 

The CDC website has links to free mobile apps for health care providers. Many apps are available for download, including:

The CDC offers numerous education and training programs for health care professionals

The CDC has created a CDC Vaccine Schedules app for iOS and Android to track vaccines.

NHMA thanks Sanofi Pasteur for their support and funding on this project.

Citations

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