International Association of Fire Chiefs

Emergency Medical Services: Flu Vaccine Options—Boost Your Department Participation

The Centers for Disease Control and Prevention (CDC) and the Occupational Safety & Health Administration require all employers of healthcare providers offer free flu shots to their staff. It's well documented that seasonal flu shots promote wellness and decrease absenteeism.

As many of you already know, many medical facilities have mandated flu vaccination as a condition of employment. This is viewed as a patient-safety issue. Some allow employees to sign a declination form but require those who do so to wear a surgical mask for their entire shift. This proactive approach is now finding its way to fire/EMS providers. Medical facilities are asking for lists of unvaccinated EMS providers and requiring them to wear a surgical mask on entry to the facility.

Reasons for declining flu vaccination vary:

  • I don't like needles.
  • I don't want to put a virus into my body, living or dead.
  • I have an allergy to eggs.
  • I get the flu when I take a flu shot.

These concerns are now moot with the new flu vaccines available this season. Unfortunately, the news hasn't gotten out in time for many departments to select the vaccine most suited to their members concerns, but here's information on each of the new vaccines. This year, there are six different ways to be protected:

  • We have the standard trivalent vaccine that contains two type-A strains and one type-B strain that the World Health Organization and the CDC predicted would be the main cause of influenza this flu season.
  • There's a quadrivalent vaccine that has two type-A strains and two type-B strains. The additional type-B strain is one that often infects children and this vaccine will be offered mainly to children.
  • Fluzone High-Dose is for seniors age 65 and older. This vaccine contains four times the amount of antigen than a normal flu shot, creating a more robust immune response, which equals better protection.
  • Fluzone Intradermal is for persons who don't like needles. This vaccine is given with a tiny micro-needle and injects just under the skin.
  • Flucelax is a vaccine that isn't egg derived, so individuals with egg allergies can safely be vaccinated. Additionally, this vaccine has no mercury or antibiotic preservative.
  • FluBlok is a wave-of-the-future vaccine. It's DNA-based (not derived from eggs), doesn't contain virus, living or dead, and is available for persons up to 49 years of age. It contains flu viral DNA that, when injected into a person, generates protection from influenza using the individual's own immune response. In the future, all vaccines will probably use this type of technology. An added benefit is a much more rapid production cycle since the vaccine isn't grown in eggs, which also means that it doesn't contain trace amounts of antibiotics (used to prevent bacterial contamination during manufacturing) or thimerosal (ethylmercury) added as a preservative.

You may be wondering what happened to FluMist. It's still available, but is only recommended for persons aged 2 to 49. For people in this age range who want nothing to do with shots, this nasal spray vaccine remains an option.

Flu shots for healthcare personnel should have begun in mid-September. In December, department leaders should assess participation and survey why those who didn't participate to determine why. This will be valuable information for next years' planning.

Remember, declination forms are required for all members who refuse vaccination, in accordance with NFPA 1581, CDC and OSHA. Declination forms help to demonstrate that the employer met their responsibility to offer the vaccine. A declination doesn't remove any employee rights.

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