Pharmacy flu vaccination needs high standard: ISG

flu vaccination: Prof Alan Hampson from the ISG

Pharmacists who provide flu vaccination services need to be visibly held to the same standards as GPs when providing the service, says a leading flu specialist – and they can further help prevent the spread of flu by combating presenteeism and helping their customers understand the disease, he says.

The Influenza Specialist Group launched its “Flu shot now” national public health campaign yesterday, warning of a potentially severe season and pointing out that the government-funded flu vaccine for at-risk Australians will be made available from April 20, a month later than usual.

“We certainly encourage greater protection of the population, with more people vaccinating if possible,” Dr Alan Hampson, chair of the ISG, told the AJP.

“We’re concerned that the vaccinations need to be seen to be offered under no lesser conditions than they would in a doctor’s surgery: that the vaccine needs to be administered by people who are properly trained and able to offer the appropriate remedial action should somebody suffer a severe vaccine reaction,” he says.

“These are very, very rare, but if they do occur, they can potentially be life-threatening, so we need to know that when they’re offered in pharmacy, they’re offered in a way where they can be handled properly.

“The issue of vaccination in pharmacy and particularly by pharmacists has been somewhat controversial, and I don’t want to express that it’s either a good or bad thing, but we’re anxious to see more people vaccinated and that it’s all done as appropriately as possible.”

He says that it’s important to encourage all Australians to vaccinate, not just those who are in a high-risk group, such as pregnant women; Aboriginal and Torres Strait Islander people aged six months to under five years and 15 years and over; and people with a medical condition that puts them at risk of serious complications of flu.

“These are not the people pharmacists will be vaccinating,” says Dr Hampson. “On the whole, they’ll be vaccinating people who aren’t covered by the free vaccine.

“But there’s good reason to vaccinate them: occasionally younger people will get seriously ill and end up in Intensive Care and may die. And older people and those in the high-risk groups may not have the best immune reaction to the vaccine and may not receive as much immunity, so if younger people are in contact with those in high-risk groups, if they’re protected against influenza it’s going to lessen the chance they’ll pass it on to them.”

He urges pharmacists to ensure they fully understand processes such as reporting adverse reactions to the TGA.

“Things like the 2010 situation with the paediatric vaccine: getting that information out there quickly, getting it back to the TGA and having a response to that was important,” he says. “While we never really anticipate a major problem with the vaccine, when you treat people with medicines and vaccines you do have to be alert to the fact that something could happen. So the feedback system needs to be properly covered.

“Also, there’s an important message for pharmacists to get out: that colds and flu are different.

“They may be encouraged to think about that more if they’re actually administering the influenza vaccine.

“And they need to encourage people not to be doing what some of the pharmaceutical companies insist they do, which is soldier on! That’s not the best thing to do with influenza; probably not with a cold either, but with a serious illness like flu, there can be serious outcomes if people don’t allow themselves to rest and recuperate.

“And Australians are presenteeists. They tend to try and still do the things they normally would, to go to work and social events when they’re not well and when they’re suffering influenza-type symptoms.

“They might even be encouraged to do this by some of the marketing of analgesics and cold and flu medications.

“So I think pharmacists have an important role, whether in vaccinating or in serving people who come to get their analgesics, in reminding people that flu is serious, and in saying, ‘Okay, here’s your analgesics, now go home and go to bed until you’re feeling better and don’t have fever or aches or pains any more. Don’t go to work and share it with anyone else’.”

Dr Hampson also urges pharmacists not to come to work when they are experiencing flu-like symptoms.

“There was a survey done in the US amongst doctors not long ago, showing a very high percentage of them would still come to work with flu-like symptoms,” he says.

“Their reasons were that they didn’t want to let their colleagues down and put extra pressure on them, and that they didn’t want to let their patients down.

“If you don’t want to let your patients down, you don’t encounter your patient while you’re suffering from influenza! People who are sick already with underlying conditions are the ones who are going to succumb if you pass anything onto them.”

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