Protecting extended care residents from flu

The F-883 tag is meant to help lower the risk of residents acquiring, transmitting or experiencing complications from flu by ensuring that the resident:

• Is informed about the benefits and potential risks of immunization
• Is immunized between October 1 and March 31 (unless the resident is medically contraindicated, refuses immunization or was already immunized that year)
  • The Centers for Disease Control and Prevention (CDC) recommends giving the flu vaccine when it becomes available rather than on a specific date
• Has documentation in their medical record that they received information about the benefits/risks of immunization and either received or refused/have medical contraindications to the vaccine(s)
  • Surveyors will review resident records for this information

• There are three general presentations:
  • Intranasal sprays (preservative-free)
  • Multi-dose vials (contain preservatives)
  • Pre-filled syringes (preservative-free)
• There are two general culture media:
  • Egg-based – more cost effective; most prevalent vaccine until recently
  • Cell/DNA-based – higher effectiveness, as the virus has no opportunity to interact with poultry egg
• There are two general target populations:
  • General population: from ages 6 months and up
    • No restriction on maximum age
  • Geriatric population: aimed at patients 65 years and older
    • Vaccines are specially formulated for compromised immune systems and use either higher dose concentration or adjuvants to create stronger immune response

• Over-communicate with your flu vaccine provider as the date for vaccine delivery approaches
  • Our Flu Connection team contacts customers upon vaccine shipment, with detailed information about arrival times
• Designate a single individual, or small group of employees, as designated “vaccine handlers” who will take receipt of vaccine deliveries
  • Don’t allow unspecified staff to sign for vaccines
• Keep vaccines in a dedicated refrigerator (preferably with an external display thermometer) within the target maintenance temperature range of 36-46°F²
  • Don’t allow newly received vaccines to stay in non-refrigerated areas longer than necessary
• Provide a consistent organization model for vaccine storage²
  • Use separate bins or shelves for vaccines
  • Stock vaccines according to expiration date, beginning with batches closest to expiration
  • Keep vaccines in their original boxes to prevent light exposure

• For new residents, review their vaccination history in case they received the flu vaccine prior to being admitted to your facility
• Screen residents for contraindications and precautions before administering vaccines, even if the resident received the same vaccine before; a resident’s health status or the recommendations for contraindications/precautions could have changed since they were last vaccinated
• Provide comprehensive vaccine information to the resident and the resident’s representative with immunizations & allow for questions
• Use aseptic techniques and follow infection prevention guidelines to help maintain vaccine integrity when transferring from a vial to a syringe
• Follow the recommended administration route and site for vaccines, found on the manufacturer’s package insert; not following the recommended route may reduce vaccine efficacy or increase local adverse reactions
• Monitor residents for side effects such as injection site pain, fever or fussiness after immunization
• Record the vaccine education and immunization in the resident’s medical record (can be in electronic or paper form); documentation is required by law

1: https://www.cdc.gov/flu/about/keyfacts.htm
2: https://www.cdc.gov/vaccines/hcp/admin/storage/index.html