As in past years, this year’s Kick the Flu Summit was a big hit! The Summit was held at the Scripps Schaetzel Center for Health Education in La Jolla from 8:30 a.m. to Noon and was attended by about 270 people, which breaks the attendance record for last year. Attendees included health and human services professionals from a host of public and private agencies and organizations, in and around the county.
Attendees were treated to informative and interesting presentations by some of the most authoritative local experts on influenza, both seasonal and pandemic H1N1. There was also a display area where public and private organizations had tables featuring information and materials on influenza and related matters, such as vaccine, administration and supplies. As in the past, networking and sharing of knowledge and experience between attendees and presenters was a big part of the Summit.
Sponsors of the event included several partner organizations of the San Diego Immunization Coalition (SDIC) including the County of San Diego Immunization Branch, San Diego Black Nurses Association, National Association of Hispanic Nurses (San Diego Chapter), YMCA Childcare Resources, Episcopal Community Services, Pacifica Medical, Sharp Chula Vista Medical Center, Walgreen’s Pharmacy Services, North County Health Services, Community Health Improvement Partners and County of San Diego Child Health and Disability Program.
Below are some resources and other documents from the Summit (most are downloadable PDF files):
Summit Agenda
Speaker Biographies
Speaker PowerPoint Presentations:
Community Programs’ Plans and Challenges Panel PowerPoint Presentations:
Questions and Answers From the Summit
(Please note: Questions have been edited for clarity)
- Shouldn’t nursing moms get preservative free flu vaccination?
- How come seasonal flu vaccine is already available in some places but not in the community clinics?
- Why are 2 doses of vaccine necessary for your children?
- Can we get “free” flu vaccines from the County? If yes, how do we get them? How long does it take to get results of H1N1 test? How, when do we get H1N1 vaccines? Is it free? How do patients from Tijuana get the vaccine?
- Would there be a VIS (Vaccine Information Sheet) form for the novel H1N1 vaccine?
- How do we determine when to administer Tamiflu in the absence of testing? New guidance published by CDC yesterday. Treat high-risk people based on suspicion of flu.
- Is it safe for pregnant women for children <2 years old to come in close contact with someone who recently received the live (nasal) flu vaccine?
- Will the Immunization Branch have materials we can use out in the community? E.g. flyers, posters, window clings, etc.? If so, how do we order those?
- Is there a fee for vaccine? If so, how much?
- Can H1N1 be applied with regular flu vaccine?
- You stated during your presentation “if you are in health care - we need to stay home NOT 24 hours but 7 days after illness?”
- Will there be separate instructions communicated to hospitals and medical groups to order the H1N1 vaccine in large quantities for their patient population and health care personnel?
- Is obesity (BMI > 30) considered a risk factor for complications of influenza and if so, why is not listed as a “high risk group”?
- When during pregnancy should H1N1 and seasonal flu vaccine be given? What trimester? What website can providers go to for billing administration?
- Can seasonal and H1N1 “LAIV” be given simultaneously?
- Can MMR or varicella be given simultaneously with the H1N1 influenza vaccine?
- What are some links for clear, easy, concise info (such as Facebook) on H1N1 prevention and vaccines?
- What is the length of protection conferred by the influenza vaccine (How long/months is it good for?)
- What testing will County Epidemiology be able to support if there is an outbreak of H1N1? What if we are a surveillance clinic? Should we purchase rapid flu tests? Should we be considering Quest instead?
- How fast is PCR lab turnaround for priority and non-priority - lab turnaround. How long may it get?
- In surveillance of the death due to H1N1 - how many of the patients dying of H1N1 had underlying chronic medical problems?
- What percentage of people with ILI has been tested for type of flu? Many people have had ILI with no doctor visits.
- Will we get compensated for the H1N1 vaccine administration and office visit?
- Can a medical assistant give flu shots in a residential setting without a doctor on site?
- Can novel H1N1 A influenza vaccine be given concurrently with seasonal TIV?
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Q: Shouldn’t nursing moms get preservative free flu vaccination?
A: It isn’t necessary. However, the nursing mother can receive it upon request if available at that clinic.
Q: How come seasonal flu vaccine is already available in some places but not in the community clinics?
A: Any vaccine available at present was probably purchased with private funds. Publicly-funded vaccine (such as for the VFC Program) has not yet been distributed.
Q: Why are 2 doses of vaccine necessary for your children?
A: Children under 9 years of age should receive 2 doses if they have never been vaccinated or if they received their first and only dose last season, otherwise only 1 dose is required. This is because many young children have not been exposed to previous influenza viruses and require two doses of vaccine in order to induce an adequate immune response.)
Q: Can we get “free” flu vaccines from the County? If yes, how do we get them? How long does it take to get results of H1N1 test? How, when do we get H1N1 vaccines? Is it free? How do patients from Tijuana get the vaccine?
A: At public health centers there is a $10 fee for the immunization visit, but the fee may be waived if you are unable to pay. The seasonal influenza vaccine will be available at locations throughout San Diego County including public health centers, community clinics, private providers, large pharmacies, etc.
The length of time necessary to receive pandemic H1N1 influenza test results may vary. Whoever is providing the test should be able to give a more specific answer.
The H1N1 influenza vaccine is expected to be available at locations throughout San Diego County including public health centers, community clinics, pharmacies and private providers. The H1N1 influenza vaccine will be offered free of charge at public health centers: the cost of the vaccine administered at community clinics or by private providers is still being determined.
We have no information about the availability of influenza vaccine in Tijuana. Here in San Diego, depending on influenza vaccine availability and eligibility, most people can request vaccine at most influenza vaccine clinic locations.
Q: Would there be a VIS (Vaccine Information Sheet) form for the novel H1N1 vaccine?
A: Yes, there is currently a VIS for the pandemic H1N1 influenza vaccine. It is located on the CDC website at
http://www.cdc.gov/h1n1flu/vaccination/slv/pdf/vis-h1n1-prelicensure.pdf.
Q: How do we determine when to administer Tamiflu in the absence of testing?
A: New guidance published by CDC yesterday. Treat high-risk people based on suspicion of flu.
Tamiflu is approved for both the treatment and prevention of influenza. Health care providers should use their best judgment given the circumstances and extent of exposure when deciding whether prophylaxis and/or treatment is warranted.
Depending on the characteristics of an outbreak, public health officials may provide additional recommendations for prioritization and identification of appropriate recipients. Because testing may require a few days and might have variable accuracy, and the antiviral drugs are most effective when used early in the course of illness, health care providers may choose to begin treatment based on determination of a suspected or probable case. Published CDC recommendations and case definitions should be consulted as appropriate.
Q: Is it safe for pregnant women for children <2 years old to come in close contact with someone who recently received the live (nasal) flu vaccine?
A: Pregnant women should not receive the live nasal spray influenza vaccine but family and household members and other close contacts of pregnant women (including healthcare personnel) who are 2 through 49 years old, healthy* and not pregnant may receive live nasal spray vaccine.
Q: Will the Immunization Branch have materials we can use out in the community? E.g. flyers, posters, window clings, etc.? If so, how do we order those?
A: Check the SDIB Online Catalog for seasonal flu materials. Also, the CDC influenza website (www.cdc.gov/flu) has printable versions of both seasonal influenza and pandemic H1N1 influenza materials.
Q: Is there a fee for vaccine? If so, how much?
A: The H1N1 vaccine will be offered free of charge at public health centers: the cost of the vaccine administered at community clinics or by private providers will be $21.64.
Q: Can H1N1 be applied with regular flu vaccine?
A: The seasonal influenza vaccine and H1N1 vaccine may be administered on the same day.
Q: You stated during your presentation “if you are in health care – we need to stay home NOT 24 hours but 7 days after illness?”
A: In the current flu conditions, students and staff with symptoms of flu should stay home for at least 24 hours after they no longer have fever or do not feel feverish, without using fever-reducing drugs.
If the flu conditions become more severe, CDC recommends that a sick person stay home for 7 days. A person who is still sick after 7 days should stay home until 24 hours after the symptoms have gone away. In addition, this longer period should be used in health care settings and in any place where a high number of high-risk people may be exposed, such as childcare facilities for children less than 5 years of age.
Sick people should stay at home, except for visits to the doctor, and should avoid contact with others. Keeping people with a fever at home may reduce the number of people who get infected. Because high temperatures are linked with higher amounts of virus, people with a fever may be more contagious.
Q:
Will there be separate instructions communicated to hospitals and medical groups to order the H1N1 vaccine in large quantities for their patient population and health care personnel?
A: Visit www.calpanflu.org for comprehensive information about H1N1 vaccine.
Q:
Is obesity (BMI > 30) considered a risk factor for complications of influenza and if so, why is not listed as a “high risk group”?
A: Obesity is not one of the medical conditions that have previously been recognized to place people at greater risk of serious seasonal flu-related complications; however, obesity has been noted as an underlying medical condition in some hospitalized pandemic H1N1 influenza patients. Although the importance of obesity as a contributing factor to pandemic H1N1 influenza complications is currently unknown, many obese persons have other known underlying diseases that put them at risk for flu complications.
Q: When during pregnancy should H1N1 and seasonal flu vaccine be given? What trimester? What website can providers go to for billing administration?
A: There are no restrictions on what trimester to immunize pregnant women. Check the CDC pregnancy website for more information:
http://www.cdc.gov/vaccines/pubs/preg-guide.htm#5
Q:
Can seasonal and H1N1 “LAIV” be given simultaneously?
A: Because there is no data about administering seasonal LAIV and H1N1 LAIV simultaneously CDC does not recommend that they be given on the same day. If an individual only wishes to be immunized with the LAIV vaccines they should wait 28 days between doses.
Q:
Can MMR or varicella be given simultaneously with the H1N1 influenza vaccine?
A: Inactivated vaccines do not interfere with the immune response to other inactivated vaccines or to live vaccines. Inactivated or live vaccines can be administered simultaneously with LAIV. However, after administration of a live vaccine, at least 4 weeks should pass before another live vaccine is administered.
Q: What are some links for clear, easy, concise info (such as Facebook) on H1N1 prevention and vaccines?
A: The www.flu.gov and www.cdc.gov/flu websites are both on Facebook and Twitter.
Q:
What is the length of protection conferred by the influenza vaccine (How long/months is it good for?)
A: Current studies show that the immunity from the seasonal flu vaccine will last the entire season.
Q: What testing will County Epidemiology be able to support if there is an outbreak of H1N1? What if we are a surveillance clinic? Should we purchase rapid flu tests? Should we be considering Quest instead?
A: Reports of clusters of H1N1 illness in congregate settings will be assess as appropriate. When necessary, specimens for lab testing will be obtained and forwarded to the public health lab. Existing outpatient clinic sites that are partnering with the County are encouraged to follow the current protocol for specimen collection and submission. Additionally, the medical care community may considered using reference labs to support their clinical diagnostic abilities as they desire. Regarding the purchase of rapid flu test kits, most large healthcare settings already use some form of rapid test to aid in their diagnostic abilities. However, novel h1N1 influenza is established within the community and is likely the cause of illness for patients that meet influenza-like-illness (ILI) case definitions.
Q:
How fast is PCR lab turnaround for priority and non-priority - lab turnaround. How long may it get?
A: Not all specimens that the public health lab receives will be tested. Currently, all specimens that are received are being prioritized with a higher focus on deaths and hospitalized ICU patients. For those specimens that are tested, depending upon when in the day received and how many higher priority specimens are being tested, the test results may take up to several days.
Q:
In surveillance of the death due to H1N1 - how many of the patients dying of H1N1 had underlying chronic medical problems?
A: The CDC has reported that nearly 70% of the deaths from H1N1 have been among people with underlying health conditions. In San Diego County, approximately 90% of the deaths have had underlying health conditions.
Q: What percentage of people with ILI has been tested for type of flu? Many people have had ILI with no doctor visits.
A: The true incidence and prevalence of the H1N1 illness is unknown. It is true that many people who have been infected with the novel H1N1 Influenza A virus did not seek medical attention and still fewer people have been laboratory tested for the illness. Because influenza illness is not reportable by state law like some other communicable disease are, we many never know the true incidence of this disease. In San Diego County we are tracking a few indicators that will help us understand when influenza activity in general is increasing and also for us to determine the level of deaths and hospitalizations due to novel H1N1.
Q: Will we get compensated for the H1N1 vaccine administration and office visit?
A: Visit www.calpanflu.org/pdfs/H1N1FAQ.pdf and view page 4 about reimbursement.
Q:
Can a medical assistant give flu shots in a residential setting without a doctor on site?
A: Only with a standing order from a medical doctor.
Q:
Can novel H1N1 A influenza vaccine be given concurrently with seasonal TIV?
A: The seasonal influenza vaccine and pandemic H1N1 influenza vaccine may be administered on the same day.
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Below are some general resources related to Seasonal Influenza as well as Pandemic H1N1:
EVENT PHOTOS
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