Doctors Respond: Where Should Patients Receive their Flu shots?
By Dr. Linda Girgis

This week we are getting an opportunity for a unique perspective from physician and author Dr. Linda Girgis.  Using our microsurvey technology InCrowd surveyed some of our primary care and pediatric physicians to get their perspective on flu vaccine trends.   We’ve asked Dr. Girgis to review our research data and be our guest blogger on this topic.  We will have a second piece from the pharmacist perspective in January to continue this timely conversation during flu season.  Please enjoy her thoughtful and knowledgeable point of view on this topic.

Influenza season is here in many areas, but there is still time to get vaccinated. In our current environment, getting a flu vaccine is easier than ever before as they are now offered in most doctors’ offices, pharmacies and even grocery stores. Many employers offer free flu shots to their employees, especially if they work in the healthcare system.

In a survey conducted by InCrowd, primary care physicians were surveyed regarding their administration of flu vaccine. Of the 108 physicians who completed the survey, almost 100% of them administer the vaccine and/or prescribe anti-viral medications to treat influenza.

Healthcare workers know that there was a mismatch in the influenza vaccine in the 2015/2016 flu season. CDC estimated the effectiveness of last year’s vaccine to be around 60%. Much effort went into making this year’s vaccine more effective and likely to cover the circulating strains that were observed in the past few years. One change to the vaccine this year is that the nasal live vaccine will no longer be available due to its poor efficacy. But, as one Pediatrician from Illinois with 13 years in practice commented, “we won’t know until it hits”.

Of the doctors completing this survey, 64% believe that this will be an average year for the disease while 24% predict that it will be worse than usual. Approximately 11% believe this flu season will be mild and the remaining percent believe it will be severe this year. This prediction is somewhat important to know when recommending this vaccine to patients. All high risk patients should receive the vaccine regardless of how severe it is predicted the season will be. It is generally a good idea for everyone else to be vaccinated as well, especially if we are predicting a worse than average or severe season. Vaccines do not protect just individuals but provide herd immunity as well.

While most doctors recommend the flu vaccine to patients, this survey examines where patients go to receive the flu shot.

In order to get the highest number of patients vaccinated, it is important to know why so many do not want the flu shot this year.

Respondents commented that patients falsely believe the shot will “give them the flu”.  Another 30%, doctors responded, do not feel they need a flu vaccine because they never get sick or never get infected with the flu.  Other deterrents cited, but at very low rates, included: cost of vaccine, proximity to the site administering the vaccine, and belief in a government or corporate conspiracy.

The CDC reported from their own studies that approximately 20% of adults receive their flu shots at a pharmacy or grocery store rather than at a doctor’s office. Approximately 50% of doctors who responded to this survey felt the greatest benefit of receiving the shot at alternate sites was the ease of access offered there and just over 20% cited not needing an appointment as being a benefit. Only 7% felt that there was no clear benefit. One doctor commented that it is often easier for patients while they are at the pharmacy for other reasons than to schedule an appointment with a doctor just for the vaccine.

Doctors were also surveyed as to what disadvantages were to receiving flu shots at these outside sources. The fact that there was no flu shot recorded in a patient’s chart was reported by 30% of doctors surveyed. One doctor reported that it takes extra time to track down the shot record and update it in the patient’s chart. About 20% of doctors surveyed felt that it disrupted the care of the patients. One doctor thinks it may keep the patient from discussing other preventative health issues with the doctor. Just over 15% felt that there in fact are no drawbacks. One respondent commented that they don’t care where the patient gets the shot as long as they receive it. On the other side, another physician feels these other places are stealing business. One physician also raised concerns that the shot given may not be the appropriate one at the pharmacy and the patient may not be properly apprised of side effects.

While we all know how important the influenza vaccine is for patients, we need to improve the process in many regards and help raise the number of people being vaccinated. The above survey results give us a clear path where to focus to improve that rate.

InCrowd will examine pharmacists’ insights on flu vaccination and treatment in their blog in the coming week.

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