Pharmacy Flu Vaccination Will Require Many Special Precautions This Year

The annual influenza vaccination season at pharmacies had become fairly routine in most places, but that is changing in 2020. Find out what alterations to pharmacy procedures are recommended and why public health officials consider immunization against the flu so critical this year.

ATLANTA – The annual influenza vaccination season in pharmacists will look very different in 2020, thanks to the COVID-19 pandemic.

The national Centers for Disease Control and Prevention emphasizes that routine vaccination is essential to prevent illnesses that lead to unnecessary medical visits, hospitalizations and further strain the healthcare system. “For the upcoming influenza season, influenza vaccination will be paramount to reduce the impact of respiratory illnesses in the population and resulting burdens on the healthcare system during the COVID-19 pandemic,” public health officials advise.

On its website, the CDC recently outlined some of the changes, including that anyone with suspected or confirmed COVID-19, regardless of symptoms, should not be vaccinated until criteria have been met for them to discontinue isolation. “While mild illness is not a contraindication to vaccination, vaccination visits for these individuals should be postponed to avoid exposing healthcare personnel and other patients to the virus that causes COVID-19,” the guidance points out. “When scheduling or confirming appointments for vaccination, patients should be instructed to notify the provider’s office in advance if they currently have or develop any symptoms of COVID-19.”

Many of the CDC protocols are to help pharmacy staff avoid asymptomatic transmission of the virus that causes COVID-19. Those involve infection prevention practices in encounters with all patients, including physical distancing, respiratory and hand hygiene, surface decontamination, and source control.

During vaccine visits, public health officials recommend the following to minimize chances for exposure:

  • Screening for symptoms of COVID-19 and contact with persons with possible COVID-19 prior to and upon arrival at the facility and isolate symptomatic patients as soon as possible.
  • Limiting and monitoring points of entry to the facility and install barriers, such as clear plastic sneeze guards, to limit physical contact with patients at triage.
  • Implementing policies for the use of a cloth face covering in anyone older than 2 years old, if appropriate for their health condition.
  • Ensuring adherence to respiratory hygiene, cough etiquette, and hand hygiene.
  • Making sure that all staff adhere to the following infection prevention and control procedures.
  • Following standard precautions to clean the environment between patients.

In addition, pharmacists and others interacting during the vaccine encounter must wear a medical facemask at all times and should consider use of eye protection based on level of community transmission. In effect, the CDC said that eye protection should be used in areas with moderate to substantial community transmission but that the extra precaution is optional in areas where there is minimal to no transmission.

Pharmacists are advised to wear gloves when administering intranasal or oral vaccines because of the increased likelihood of coming into contact with a patient’s mucous membranes and body fluids. The CDC includes a reminder that gloves should be changed between patients, in addition to performing hand hygiene.

Because administration of the vaccines is not considered an aerosol-generating procedure, the use of an N95 or higher-level respirator is not recommended, according to the guidance.

When intramuscular or subcutaneous vaccine are administered, any gloves should be changed between patients in addition to performing hand hygiene.

Pharmacies also are urged to reduce crowding in any waiting areas by asking patients to remain outside, such as staying in their vehicles, until they are called into the drugstore for their vaccination.

Physical distancing measures, with separation of at least six feet between patients and visitors, should be maintained during all aspects of the visit, including check-in, checkout, screening procedures, and postvaccination monitoring, according to the guidance, which suggests strategies such as physical barriers, signs, ropes, and floor markings. The Advisory Committee on Immunization Practices recommends that providers consider observing patients for 15 minutes after vaccination to decrease the risk for injury should they faint, so selecting a space large enough is important, according to the advice.

The CDC also encourages electronic communications as much as possible, such as filling out necessary paperwork online in advance, to minimize time in the office as well as potentially infectious reuse of materials such as clipboards and pens).

Pharmacies might also consider arranging a separate vaccination area or separate hours for persons at increased risk for severe illness from COVID-19, such as older adults and persons with underlying medical conditions, the CDC suggests.

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