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  1. #1

    2020-21 influenza vaccine

    So last week my daughter and I went to get our flu shots at CVS. Nevada has finally allowed kids 3 and older to get flu shots from a pharmacist. So much better than having to drag her into the peds office. I think NC it’s still 10 and older which is a shame but I believe an emergency measure was put into place this year to allow all states to do 3 and older for flu shots. Of course the AAP is angry about this measure which in turn angers me. The AAP advocates for increased vaccine rates and this is an easy way to help with those numbers. I suspect they will be missing that $40 reimbursement but patient health comes first

    The point of all this is to check with your local pharmacy and get your kids vaccinated in a much more convenient way.

  2. #2
    Join Date
    Feb 2007
    Location
    Chesapeake, VA.
    There are actually other reasons that pediatricians want the children to be seen at their provider's office, especially right now.
    A lot of children have become behind in their routine vaccinations and visits for chronic conditions because of the pandemic.

    While there may be some doctors who are driven by profit I think it is always dangerous to paint with that broad a brush.

  3. #3
    Quote Originally Posted by rsvman View Post
    There are actually other reasons that pediatricians want the children to be seen at their provider's office, especially right now.
    A lot of children have become behind in their routine vaccinations and visits for chronic conditions because of the pandemic.

    While there may be some doctors who are driven by profit I think it is always dangerous to paint with that broad a brush.
    Ok, true. Maybe I was a bit harsh on that end but I still think expanding access to the influenza vaccine is a net positive. I recently switched jobs but I used to be the clinical system analyst for 25 clinics in Las Vegas where I basically designed and built the electronic medical record. We had A LOT of clinics in low income communities but our peds office was in a particularly poor part of town. No show rates some days would reach 50%. Schedule 250 patients for the day and only have 125 walk through the door.

    One thing I am particularly proud of is my build for our peds flu clinic. 5 clicks in the system and the the visit was completed and the claim sent out. We could rip through a ton of patients in a day. It was very rewarding to see the high volume plus the provider/nurse satisfaction and that’s the reason I got into EMR building.

  4. #4
    I know people have been beating the drum about the co-incidences of Covid-19 and Influenza being a potential disaster, but isn't it likely that this flu season will be much less severe, given that people are (for the most part) social distancing, not going to classes, washing hands, not hugging friends and family, etc? I would think the spread would be far less likely than most years.

  5. #5
    Quote Originally Posted by rsvman View Post
    There are actually other reasons that pediatricians want the children to be seen at their provider's office, especially right now.
    A lot of children have become behind in their routine vaccinations and visits for chronic conditions because of the pandemic.

    While there may be some doctors who are driven by profit I think it is always dangerous to paint with that broad a brush.
    Our pediatrician's office is doing a drive thru flu clinic this year. A doctor isn't even seeing them. Just nurse. Kids don't even need to get out of the car.

    Regulations like this drive me batty. There is no reason a pharmacist can't give a flu shot to a child (that I know of). (disclaimer: heard this from my wife whose 7 year old was given a flu shot by a pharmacist) I actually believe that kids can get a flu shot from a pharmacist with a doctor's Rx. Though, if you went to the Dr to get an Rx, why didn't you just get the flu shot...?

  6. #6
    Join Date
    Feb 2007
    Location
    Washington, D.C.

    Yep

    Quote Originally Posted by Mtn.Devil.91.92.01.10.15 View Post
    I know people have been beating the drum about the co-incidences of Covid-19 and Influenza being a potential disaster, but isn't it likely that this flu season will be much less severe, given that people are (for the most part) social distancing, not going to classes, washing hands, not hugging friends and family, etc? I would think the spread would be far less likely than most years.
    I think that's probably right. Supposedly the flu season in the Southern Hemisphere has not been very bad at all, probably because of social distancing. But if you do get the flu, the spread of the coronavirus definitely could complicate your medical treatment.

    Accordingly, I got my flu shot at a CVS Pharmacy today. If there's a CVS Pharmacy near you, you might want to schedule an appointment for your shot. You can do it here:

    https://www.cvs.com/immunizations/fl...home-hero1-flu

    I was able to plug in my health insurance information and other relevant data, so that I didn't have to do any paperwork at the pharmacy. I scheduled it last night for 9 a.m. this morning, and was out of the pharmacy by 9:10 a.m. (Because it's a CVS Pharmacy inside a Target store, I also got a $5 coupon from Target.)

  7. #7
    Join Date
    Feb 2007
    Location
    Hot'Lanta... home of the Falcons!
    Quote Originally Posted by MChambers View Post
    I think that's probably right. Supposedly the flu season in the Southern Hemisphere has not been very bad at all, probably because of social distancing. But if you do get the flu, the spread of the coronavirus definitely could complicate your medical treatment.
    https://www.advisory.com/daily-brief...s-restrictions

    in the Southern Hemisphere—where winter began to descend nearly two months ago—the annual influx of flu and respiratory virus patients "never came," the Wall Street Journal's David Luhnow and Alice Uribe report.

    According to Luhnow and Uribe, Chile has recorded 1,134 seasonal respiratory infections so far this year, compared with 20,949 such infections during over the same time period last year. And in the first two weeks of July, which typically is the height of flu season in the Southern Hemisphere, Chile reported no new cases of the flu.

    Similarly, in Brazil, even though the country has seen a large number of coronavirus-related deaths, officials reported 2,085 hospitalized flu patients in week 27 of the country's flu season, which is down significantly from the 3,445 hospitalized flu patients the country reported during the same week last year.

    The number of lab-confirmed cases of the flu also plummeted by 64% in Argentina, Luhnow and Uribe report, dropping from 420,737 between January and June of 2019 to 151,189 cases in the same time frame this year.
    Why are you wasting time here when you could be wasting it by listening to the latest episode of the DBR Podcast?

  8. #8
    Join Date
    Mar 2008
    Location
    Sewanee, Tennessee

    Quality of CVS shot?

    My spouse has a sometimes-suspicious cast of mind...she worries that the flu shot at CVS might be of lesser quality than at the doctor's office. Can someone help me set this straight?

  9. #9
    Join Date
    Feb 2007
    Location
    Chesapeake, VA.
    Quote Originally Posted by TNDukeFan View Post
    My spouse has a sometimes-suspicious cast of mind...she worries that the flu shot at CVS might be of lesser quality than at the doctor's office. Can someone help me set this straight?
    They are the same shots.
    "We are not provided with wisdom, we must discover it for ourselves, after a journey through the wilderness which no one else can take for us, an effort which no one can spare us, for our wisdom is the point of view from which we come at last to regard the world." --M. Proust

  10. #10
    Join Date
    Feb 2007
    Location
    Westport, CT
    Curious to hear rsvman's comments on this question:

    I am recommending to my patients to WAIT to get the flu shot this year until at least October so that they are covered for peak flu season well into March/April.

    RSVMAN???

  11. #11
    Quote Originally Posted by MChambers View Post
    I think that's probably right. Supposedly the flu season in the Southern Hemisphere has not been very bad at all, probably because of social distancing. But if you do get the flu, the spread of the coronavirus definitely could complicate your medical treatment.

    Accordingly, I got my flu shot at a CVS Pharmacy today. If there's a CVS Pharmacy near you, you might want to schedule an appointment for your shot. You can do it here:

    https://www.cvs.com/immunizations/fl...home-hero1-flu

    I was able to plug in my health insurance information and other relevant data, so that I didn't have to do any paperwork at the pharmacy. I scheduled it last night for 9 a.m. this morning, and was out of the pharmacy by 9:10 a.m. (Because it's a CVS Pharmacy inside a Target store, I also got a $5 coupon from Target.)
    I got a better deal at the Publix Pharmacy -- they gave me a flu shot, a pneumonia shot, and a $10 Publix gift card. (I should note that I have Medicare and a supplement plan.) As for timing, I was planning to wait until October, but was advised by a medical professional I trust to go ahead and get the flu shot in early September.

  12. #12
    Quote Originally Posted by fisheyes View Post
    Curious to hear rsvman's comments on this question:

    I am recommending to my patients to WAIT to get the flu shot this year until at least October so that they are covered for peak flu season well into March/April.

    RSVMAN???
    I do this too...and wonder if I'm right.

  13. #13
    Join Date
    Mar 2008
    Location
    Sewanee, Tennessee
    Quote Originally Posted by rsvman View Post
    They are the same shots.
    Thank you.

  14. #14
    Join Date
    Feb 2007
    Location
    Steamboat Springs, CO
    Quote Originally Posted by TNDukeFan View Post
    My spouse has a sometimes-suspicious cast of mind...she worries that the flu shot at CVS might be of lesser quality than at the doctor's office. Can someone help me set this straight?
    In the future it looks like the big pharmacy chains (CVS, Walgreen's and Rite-Aid) will be hiring doctors and offering medical services. Then they will be the same.

    From a July story in the Wall Street Journal (how the heck did I get access?):

    The largest U.S. drugstore chain by stores is pairing with primary-care provider VillageMD to open 500 to 700 clinics at Walgreens sites across the country over the next five years. Walgreens will pay VillageMD $1 billion in equity and debt over the next three years in exchange for a 30% stake in the Chicago-based startup by the end of that term.

    Walgreens and rival CVS Health Corp. are in a race to become go-to treatment centers, particularly for patients with costly, hard-to-manage chronic conditions. Both chains are seeking new ways to counter smaller revenue from prescription drugs, which drive the bulk of their sales. They also are battling online rivals such as Amazon.com that have drawn shoppers away from physical stores.
    Sage Grouse

    ---------------------------------------
    'When I got on the bus for my first road game at Duke, I saw that every player was carrying textbooks or laptops. I coached in the SEC for 25 years, and I had never seen that before, not even once.' - David Cutcliffe to Duke alumni in Washington, DC, June 2013

  15. #15
    Join Date
    Nov 2007
    Location
    Vermont
    Quote Originally Posted by rsvman View Post
    They are the same shots.
    Good to hear...but I'll never berate someone for being suspicious of CVS...the only place I know where you could actually trip over your four foot long receipt.

  16. #16
    Join Date
    Feb 2007
    Location
    Washington, D.C.

    CVS

    Quote Originally Posted by budwom View Post
    Good to hear...but I'll never berate someone for being suspicious of CVS...the only place I know where you could actually trip over your four foot long receipt.
    I completely agree about skepticism as to CVS.

    My neighborhood is lucky. We recently had a small form Target open and it includes a CVS pharmacy run by a pharmacist who is unfailingly pleasant, helpful, and efficient. It does seem to me me that the CVS stores in the DC area have improved their customer service in recent years (before that, they were awful), but this location almost makes me like going to the pharmacy.

  17. #17
    Join Date
    Feb 2007
    Location
    Chesapeake, VA.
    Quote Originally Posted by fisheyes View Post
    Curious to hear rsvman's comments on this question:

    I am recommending to my patients to WAIT to get the flu shot this year until at least October so that they are covered for peak flu season well into March/April.

    RSVMAN???
    No simple answer to this one, unfortunately.

    Generally speaking, although vaccine immunity does wane some over time (certainly antibody titers wane some over time), the durability of flu-shot based immunity is better than most people think it is. And on the front end, it takes a good 3-ish weeks to really build up a good immune response.

    The timing of the influenza epidemic isn't as predictable as we would like it to be, although it most frequently peaks in February in the North America. Sometimes activity is pretty heavy even in late October, and on rare occasions flu activity persists until the late spring. Add into the equation the question as to whether the SARS-CoV-2 pandemic will alter the timing of the flu epidemic (nobody really knows, although I suspect it won't).

    From a public health standpoint, the most important thing is to get as many people vaccinated as possible, and that is accomplished by widening the window of vaccination as wide as it will possibly go; that's why we advocate for flu vaccine from the time it is available (usually in late August or early September) all the way through nearly the end of the flu season. Optimal timing of the vaccine for any one individual is an entirely separate issue; from the public health perspective, aiming for optimal timing for everybody would inevitably lead to a worse outcome for the collective, both because it narrows the window for vaccination and because it would over-stress the delivery and administration infrastructure.

    So...the "correct" answer to your question is "get it whenever it is available." Ideally, though, one would get the vaccine about one month prior to the onset of heavy flu activity in one's area; that would maximize the chance of being protected throughout the entire season. Most years, that would mean getting the vaccine sometime between the beginning of October and the middle of November, but, again, flu doesn't necessarily always follow the rules.
    "We are not provided with wisdom, we must discover it for ourselves, after a journey through the wilderness which no one else can take for us, an effort which no one can spare us, for our wisdom is the point of view from which we come at last to regard the world." --M. Proust

  18. #18
    Join Date
    Feb 2007
    Location
    Watching carolina Go To HELL!
    Quote Originally Posted by rsvman View Post
    They are the same shots.
    Our local family physician's office is offering drive through flu shot clinics starting this Saturday. They also state this:

    Flu Vaccine: This season our physicians have elected to administer Flublok which is: 1) a higher dose vaccine – three times the strength of the regular dose 2) quadrivalent – covers four strains instead of just three and 3) Recommended for patients eighteen years and older.

    Are all shots the same or are some better than others? Inquiring minds want to know!

    We'll be getting ours in the next couple of weeks, not sure when yet.
    Ozzie, your paradigm of optimism!

    Go To Hell carolina, Go To Hell!
    9F 9F 9F
    https://ecogreen.greentechaffiliate.com

  19. #19
    Join Date
    Feb 2007
    Location
    Westport, CT
    Quote Originally Posted by rsvman View Post
    No simple answer to this one, unfortunately.

    Generally speaking, although vaccine immunity does wane some over time (certainly antibody titers wane some over time), the durability of flu-shot based immunity is better than most people think it is. And on the front end, it takes a good 3-ish weeks to really build up a good immune response.

    The timing of the influenza epidemic isn't as predictable as we would like it to be, although it most frequently peaks in February in the North America. Sometimes activity is pretty heavy even in late October, and on rare occasions flu activity persists until the late spring. Add into the equation the question as to whether the SARS-CoV-2 pandemic will alter the timing of the flu epidemic (nobody really knows, although I suspect it won't).

    From a public health standpoint, the most important thing is to get as many people vaccinated as possible, and that is accomplished by widening the window of vaccination as wide as it will possibly go; that's why we advocate for flu vaccine from the time it is available (usually in late August or early September) all the way through nearly the end of the flu season. Optimal timing of the vaccine for any one individual is an entirely separate issue; from the public health perspective, aiming for optimal timing for everybody would inevitably lead to a worse outcome for the collective, both because it narrows the window for vaccination and because it would over-stress the delivery and administration infrastructure.

    So...the "correct" answer to your question is "get it whenever it is available." Ideally, though, one would get the vaccine about one month prior to the onset of heavy flu activity in one's area; that would maximize the chance of being protected throughout the entire season. Most years, that would mean getting the vaccine sometime between the beginning of October and the middle of November, but, again, flu doesn't necessarily always follow the rules.
    This is SO helpful.
    Thanks so much!
    I'll give you a 99214 for that!

  20. #20
    Join Date
    Feb 2007
    Location
    Chesapeake, VA.
    Quote Originally Posted by OZZIE4DUKE View Post
    Our local family physician's office is offering drive through flu shot clinics starting this Saturday. They also state this:

    Flu Vaccine: This season our physicians have elected to administer Flublok which is: 1) a higher dose vaccine – three times the strength of the regular dose 2) quadrivalent – covers four strains instead of just three and 3) Recommended for patients eighteen years and older.

    Are all shots the same or are some better than others? Inquiring minds want to know!

    We'll be getting ours in the next couple of weeks, not sure when yet.
    About five years ago there were actually at least six different vaccines avaiiable.

    The shot that has a lot more antigen in it is designed for seniors. There used to also be a shot that had a lot less antigen in it but it was adjuvaneed differently and injected intradermally instead of intramuccularly. Not sure if that one is still available.

    Quadrivalent became the rage a number of years ago. Previously, flu vaccines only contained antigens fir three strains: two A strains and one B strain. Usually what actually circulates is two A strains and two B strains, although one of the B strains usually predominates over the other. But sometimes the prediction for which B strain will predominate is off. Enter the quadrivalent vaccine, which contains antigens for both A strains and both B strains.

    My personal favorite was the low-dose intradermal vaccine, but i wasn't able to get it last season and I suspect it will be unavailable this season, too, unfortunately.

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