Influenza Immunization During the COVID Pandemic

This year, we must improve our vaccination program and IPC (Infection Prevention and Control) for influenza prevention.  In recognition of this necessity, CALTCM provided a free webinar on this subject on September 21, the slide handout and recording are available on CALTCM's COVID-19 Webinar Series webpage.  In that webinar, Dr. Lily Horng, CDPH Public Health Medical Officer, noted that the CDC recommends that persons with COVID should not receive the influenza vaccination until they are out of quarantine (10 days from diagnosis and 24 hrs afebrile), so as to reduce the transmission risk to HCP and other residents.  This statement can be found in the August 21 CDC Influenza Vaccination Guidance for Professionals.  If available, our seniors should receive the enhanced vaccines, which have been shown to be more effective and durable.  Immunization should start now so that our seniors and HCP are immunized prior to onset of influenza.  You should know that San Francisco has already had cases of influenza A.  The above CDC web site has a link to current influenza activity.  My county is considering an order for mandatory vaccination of all HCP unless there is an identified contraindication.  We now know that the masking rules at work do not prevent employees who have refused a flu shot from acquiring COVID outside of the facility and then spreading it within our facilities.  On a recent AMDA podcast, Dr. Barbara Resnick shared great ways to encourage your residents, families and HCP to receive flu shots.  She and AMDA were parts of work groups which created four helpful one-page fact sheets that will enhance your flu immunization program.  Please go to this free AMDA ON-THE-GO podcast where you can hear this superb educator and also download these helpful fact sheets.  

Finally, some have raised questions about the safety of giving influenza vaccinations to persons with possible COVID symptoms.  The CDC guidance states immunization is safe in mild COVID and that the main reason for forgoing vaccination as noted above, is to reduce the risk of COVID transmission.  That said, some experts are recommending checking a temperature prior to administering the vaccine and forgoing immunization if febrile.  A febrile illness in our setting should also trigger an investigation for possible PUI and possible COVID testing.  My public health department, and I suspect your local health department, will give further guidance on this subject in the near future. 

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