Flu vaccine: it doesn’t pay to wait

Edition: November 2012 - Vol 20 Number 11
Article#: 4117
Author: Repertoire

Flu vaccines may not be foolproof. But, when combined with commonsense steps to prevent the spread of germs, the injection goes a long way in preventing illness and sometimes saving lives. As such, physicians and pharmacists continue to depend on a steady supply of vaccine for their patients. And, even as the customer base continues to shift as more hospitals acquire physician practices and patients take advantage of pharmacy and retail clinics, experts believe physician practices – for now – still account for the bulk of vaccine sales for distributor sales reps.

The percentage of Americans receiving flu vaccinations at retail or other nonmedical settings, such as workplace or school-based clinics – particularly among adults under 65 – is growing, according to Patricia Baran, vice president, ambulatory care, Cardinal Health. At the same time, there continues to be some shift in vaccine sales to the hospital market, as more IDNs scoop up physician practices. Still, “physician offices continue to remain the most prominent site for immunizations,” she says. Whereas hospitals represented 7.2 percent of sales during the 2010-2011 flu season, physician practices accounted for 39.8 percent of sales, she notes, citing the HIDA 2010-2011 Influenza Vaccine Production & Distribution Market Brief.

Indeed, based on the report, distributor sales reps certainly should not discount the growing importance of retail clinics. This market increased an estimated 10-13 percent during the 2009-2010 flu season, and approximately 18.4 percent during the 2010-2011 flu season, thanks in large part to the under-65 crowd. In addition, the Department of Health and Human Services (HHS) appears to regard retail health clinics as a potential venue for reaching underserved populations. In December 2010, HHS and Walgreens partnered on a four-month program to provide 350,000 free flu vaccines in retail sites at Walgreens, the Duane Reade pharmacy chain in New York, and other locations, according to the report.

Understanding the provider

Distributor sales reps continue to play an important role with their customers – whether physician practice, hospital or retail clinic – and as such, must understand their varied needs, not only for influenza vaccine but for needles and syringes, soaps and sanitizers and rapid influenza diagnostic tests as well. In addition, they should help their customers understand the different types of flu vaccine available, depending on age indication, reimbursement differences, and presentation (e.g., multi-dose vial, prefilled syringe, high dose, nasal spray, etc.), says Baran.

“Reps need to understand the healthcare provider’s patient mix, such as Medicare/Medicaid for reimbursement purposes, as well as the high-risk population for seasonal influenza (e.g. children, pregnant women, adults 65+, etc.) to help them determine the appropriate flu vaccine,” she continues. In addition, depending on flu vaccine supply and demand, “some customers are concerned about purchasing too much flu vaccine and getting stuck with unused product,” she points out. “Sales reps should help them anticipate the number of doses [they] will actually need and work with them on shipments to correspond with the timing of flu vaccine clinics.” And, by helping customers market influenza vaccine to their patients, reps provide added value, she notes.

2012-2013 Season

The Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO), together with the Food and Drug Administration (FDA), have designed and approved a new vaccine to protect against three viral strains most likely to cause the flu in the upcoming year. The three strains include:

• A/California/7/2009 (H1N1)-like virus (same strain as 2011-2012 season).

• A/Victoria/361/2011 (H3N2)-like virus.

• B/Wisconsin/1/2010-like virus.

The vaccine is expected to be manufactured by six companies, including GlaxoSmithKline, Sanofi and Novartis.

The CDC recommends that everyone six months and older be vaccinated for influenza, noting that between 5 and 20 percent of Americans get the flu each year, leading to 200,000 hospitalizations and between 3,000 and 49,000 deaths. Those at highest risk for contracting flu-related complications, such as pneumonia, include:

• People who have certain medical conditions, such as asthma, diabetes and chronic lung disease.

• Pregnant women.

• People 65 years and older.

And, it’s not just the patients who should be vaccinated. When healthcare workers are vaccinated for flu, they protect themselves as well as others around them. According to the CDC, vaccinating healthcare workers helps reduce the following:

• Transmission of influenza.

• Staff illness and absenteeism.

• Influenza-related illness and death, especially among people at high risk.

• Nosocomial influenza cases.

• Influenza related illness and death in nursing homes and long-term-care facilities.

In spite of the good that generally comes out of vaccinating healthcare staff against influenza, only 63.5 percent were vaccinated during the 2010-2011 flu season, according to the CDC – yet another reason why distributor sales reps should remind their customers of the importance of marketing the value of flu vaccines not only to their patients, but to their staff as well.

National Influenza Vaccination Week

For those who drag their feet about getting their flu vaccine, think holiday season. In fact, the CDC has marked Dec. 2-8, 2012, National Influenza Vaccination Week. Since it was established in 2005, National Influenza Vaccination Week is an opportunity to highlight the importance of continuing flu vaccination through the year’s end and into the new year.

Historically, the CDC has found that flu vaccination coverage drops after the end of November. But, it’s not uncommon for flu season to peak in January or February, and extend into May. As long as flu viruses spread and cause illness, vaccination should continue and can provide protection. Even unvaccinated people who already have contracted flu can benefit from the vaccine – particularly since it protects against three flu viruses, and more than one flu virus circulates each season, according to the organization.

Annual vaccination against influenza is imperative, says the CDC. From one season to the next, flu viruses change. And, immune protection from a vaccine declines over time. Given that it takes about two weeks for the vaccine to provide full protection, it simply doesn’t pay for physician customers – or their patients and staff – to wait.


Myths about flu

Flu vaccines do not – and cannot – cause the flu, say experts. In fact, aside from a bit of soreness at the injection site, the vaccine rarely causes serious problems. Yet, each year, many people put off or avoid being vaccinated for fear it will not be effective or, worse, make them sick. Recently, CBS ran an online article highlighting 12 myths about flu vaccine.

Myth: Flu shots can cause the flu

Flu vaccines contain only inactivated flu viruses. As such, they are unable to cause infection. In studies comparing flu shot recipients to people who get salt-water placebo shots, the only difference between the two groups is that the flu shot recipients experience redness at the injection site and arm soreness. They are not reportedly more likely to experience body aches, fever, cough, runny nose, or sore throat.

Myth: Late flu shots don’t help

Some people believe it makes no sense to get a flu shot after November. But, because flu season varies from year to year, experts say it can be helpful to get a vaccine as long as flu viruses are circulating. Though seasonal influenza usually peaks in January or February, some people get the flu as late as May.

Myth: Flu shots protect for years

Flu vaccine must be updated yearly as well. Flu viruses change from year to year, and last year’s vaccine won’t necessarily protect against this year’s viruses.

Myth: Flu shots make other precautions unnecessary

Even with a flu shot, government researchers say it’s a good idea to take everyday steps to prevent the spread of germs and viruses, including those that cause influenza. Simple precautions include covering one’s mouth and nose when coughing or sneezing; staying away from people who are sick; washing one’s hands often, either with soap and water or an alcohol-based hand sanitizer.

Myth: It pays to wait

Some people believe they need a flu shot only if the people around them come down with the flu. Because it takes about two weeks for the flu vaccine to provide full protection, however, by waiting until others get sick, it likely will be too late to protect against flu.

Myth: Babies should get flu shots

Although children under six months of age are at risk for influenza, they are too young to get a flu shot. The best way to protect them against flu is to make sure other members of the household get vaccinated, along with their caregivers.

Myth: Flu shots aren’t very effective

True, the flu vaccine doesn’t work all the time. Still, studies show that it can reduce the chances of getting the flu by up to 90 percent. The vaccine is a bit less effective in old people and young children, but getting vaccinated can help them avoid serious complications of flu even if it doesn’t prevent the illness itself.

Myth: Everyone should get a flu shot

Flu shots are now recommended for everyone over the age of six months – except for people who have a severe allergy to chicken eggs or other substances in the vaccine or who have sustained a serious reaction to

previous flu shots.

Myth: Flu shots cause autism

Some flu vaccines contain thimerosal, a mercury-containing preservative that has been blamed for health problems, including autism. But studies have shown that low doses of thimerosal are harmless, causing nothing more than redness and swelling at the injection site. Many studies have shown no link between thimerosal exposure and autism.

Myth: One flu shot isn’t enough

This year, only one flu vaccine is needed, and most people need to get vaccinated only once. Children between the ages of six months and eight years who have never gotten a seasonal flu vaccine should get two doses of vaccine spaced at least four weeks apart.

Myth: Antiviral drugs make flu shots unnecessary

Antiviral pills, liquids and inhaled powders are available to treat flu symptoms. But, these prescription-only products – Tamiflu and Relenza – are considered a second line of defense against the flu. And, they tend to work only if they are taken within the first day or two of coming down with influenza.

Myth: Flu shots are the only option

For needle-phobic patients, a nasal spray flu vaccine is available and can be safely used by healthy people between the ages of two and 49 years, as long as they are not pregnant.

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