Wednesday, November 11, 2015

Should I Get the Flu Shot at Work or at My Doctor’s Office?

It’s flu season again, and now is the time to get vaccinated if you haven’t already done so. The flu shot is the most effective way to reduce your risk of getting influenza, according to the Centers for Disease Control and Prevention (CDC). Many people take advantage of employer-offered vaccinations, making work the second most common place Americans get the vaccine after a doctor’s office. But questions and misconceptions persist about getting the flu shot in the workplace.
Fueling any concerns people may have about getting vaccinated at work is the recent news that a nursereused a syringe multiple times while administering the vaccine at a New Jersey pharmaceutical company. Safe injection guidelines, like the CDC’s, require that healthcare workers use one needle and syringe per patient, and then discard both.
“This unfortunate incident reminds us that vaccinations require meticulous and thoughtful care and preparation,” says Mark Schleiss, MD, a professor of pediatrics and director of the division of infectious diseases and immunology at the University of Minnesota Medical School. Dr. Schleiss points out that, in this case, the nurse was a licensed practical nurse (LPN) contracted from a nursing agency, not a registered nurse. If she did not receive appropriate training, the agency could be held accountable.
Schleiss believes the risk of a needleborne infection is “extraordinarily low” for anyone who got the shot from the reused syringe. “I would be very surprised if there was even a single case of transmission of a bloodborne agent that occurred as a result of this mishap,” he says. Still, those employees affected were being tested for HIV and hepatitis.
Things to Ask and Watch For
If you’re considering at-work vaccination, feel free to ask who is administering the vaccine, and about their qualifications, says Marci Drees, MD, a hospital epidemiologist and medical director of infection prevention at Christiana Care Health System in Wilmington, Delaware.
“The person who is giving the vaccine should be certified to do so and should be comfortable giving injections,” Dr. Drees says.
Anyone getting vaccinated should expect to sign a consent form. “An employee should always be asked about allergies and other contraindications for the shot or any current illness,” Drees says. You should also receive one of the CDC’s Vaccine Information Statements (VIS) with information about the flu vaccine ahead of time.
Schleiss advises people to ask which vaccine is being given. Getting the flu shot at a doctor’s office might offer you more options. Trivalent vaccines protect against three strains of the flu, for instance, while quadrivalent vaccines protect against four strains. There is also a nasal vaccine for needle-phobic patients, and “a recently licensed ‘enhanced potency’ flu vaccine that is an option for those 65 and older,” he says.
Pregnancy and the Flu Shot
One misconception about the flu vaccine is that it’s unsafe for pregnant women, and that expectant mothers should stay home when it’s being given at work. Not true, says Drees, but there are some things to keep in mind.
“Pregnant women should not get the live, intranasal flu vaccine — all live vaccines are to be avoided in pregnancy — but they do not need to avoid being around people who have received the intranasal or the standard flu shot,” Drees says. “The intranasal flu vaccine is modified so that the virus can only grow in the cooler temperatures of the nose, not in the warmer temperature of the lung, so it can’t cause influenza, pneumonia, or other serious disease.”
Many employers don’t offer the live vaccine anyway. “If a woman’s workplace only offers the traditional flu shot, there is no concern whatsoever,” Schleiss says.
Drees stresses how important it is that pregnant women get vaccinated. “Pregnant women absolutely should get the flu shot themselves as they are at risk of serious complications from the flu, and to protect their newborn, who cannot be vaccinated until age 6 months,” she says. “Flu vaccination during pregnancy has been proven to improve the outcomes both in women and in their babies, and can be given in any trimester.”
Another misconception is that employers may offer the flu vaccine too early in the season, and that its protection will wear off. “There’s no reason to think that waiting is a more effective strategy,” Schleiss says. “If you wait and wait and wait until flu is rampant in your community, by that point you’ve probably got flu, and you’re a risk to others.”

The bottom line: Drees and Schleiss agree that there’s no reason not to consider at-work vaccination. “I have not heard anything negative about workplace administration compared to any other location,” Drees says. “Most people consider it a benefit and a convenience.”

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