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Last Updated: October 6, 2020
System Wide Influenza Campaign Questions & Answers
For the 2020-2021 influenza campaign, it is critically important that every encounter is an opportunity to provide the influenza vaccine to patients and to support staff and families. Below are some guidance to great questions asked in a Town Hall on the need for a System Wide Response, hosted by a provincial working group.
This year is your opportunity to try innovative ways to provide the influenza vaccine in your area. Determine local processes that meet safety, regulatory and reporting requirements (on 4flu.ca). Learn from other areas who already have processes to support influenza immunization to their patients/clients. The provincial working group is available to advocate for this system-wide response, remove provincial and client access barriers, and support consistent communication.
To develop your local plan to support immunization, please refer to the checklist and General Resources sections on www.4flu.ca NOTE: the information included in this document may not be applicable for every health care provider in every setting. Screening
1. Are we to continue to use the paper immunization screening forms that we have used in previous years?
Local areas should work through what process is going to best work for them. Some areas may still require the paper process; however, some may be utilizing Panorama Direct Entry.
Providers
2. Where can I find out which community pharmacies will be providing influenza immunizations in locations around the province? Please click on the Saskatchewan Pharmacy List. Please note this list may be subject to change.
Where and Who Can Immunize 3. What is the process that I should follow if a non-resident presents for or requests an influenza immunization?
(Out-of-province, out-of-country)
Out-of-province and out of country residents are eligible to receive publicly funded flu vaccine during the flu immunization campaign from public health. This includes two doses for children younger than 9 years old if required.
As in past years, pharmacists are to refer out-of-province or out-of-country individuals to public health for immunization. Other providers such as physicians may offer influenza vaccinations to out of province/out of country residents; however, clients are encouraged to ask if there are additional charges for vaccine administration, as these fees are not reimbursed by the province
4. Can a Nurse Practitioner authorize/support/approve a medical directive for an affiliate or non-SHA facility?
It is within the scope of practice of a Nurse Practitioner to write a medical directive.
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Orders, Protocols, Directives 5. Saskatoon and Regina Urban - Continuing Care has an order set in place that includes influenza vaccine in
addition to other medications. Will Long Term Care (LTC) homes be required to use the new order set this year?
LTC homes will not be required to use the provincial order sets this year if they have their own – order sets are signed by the MRP or NP so provincial consistency is less of a concern. The expectation is that the content should be similar and that the information is consistent with that available at Health Care Providers: General Resources. Many LTC homes have already followed their routine process for influenza orders via admission orders or their annual process. This often includes additional orders including that of Tamiflu. If orders are in place already, utilizing the new order set will not be required.
6. Visitor/family - If a nurse has the appropriate training for vaccine provision - can they provide the vaccine to
family members, staff or residents without a practitioner order? Immunizers are authorized by their position and through either a medical directive for a population or a patient-specific order. Immunizers working with order sets have only an order for the patient, not the family/visitors. Immunizers working under medical directive may immunize families/visitors if a discussion is had in advance with local leadership and public health to ensure that this is appropriate for their setting and that documentation of administered vaccine occurs. For example: a child presenting for their childhood immunizations will be immunized by a public health nurse who is authorized under medical directive. Being that the public health nurse also immunizes all members of the public if the current clinic decides to include families in whom they offer influenza vaccines to, it would be appropriate to immunize the parent. It is also possible that a provider covered under medical directive to immunize in community mass clinic settings is also asked to immunize visitors in a facility. This would be seen an extension of a mass clinic opportunity and as long as documentation occurs for reporting purposes (as in a mass clinic setting), then this too would be considered appropriate.
7. Is it acceptable to immunize those that are sick or unwell – current patients admitted to acute care? Historically in community settings, we would be ok if people presented same day for a flu shot and had a low fever. However, with Covid-19 screening, we encourage people in community to wait until they are asymptomatic, as we do not want unwell people coming out into mass clinic sites and spreading the virus.
In an acute setting, illness is not typically a reason to delay. The SIM summarizes this below:
For more information, please reference Saskatchewan Immunization Manual. Chapter 6: Contraindications and Routine Precautions.
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8. What is the appropriate PPE and infection control measures when providing immunizations? Please reference PPE Guidelines for Outpatient & Primary Health Settings that includes SHA operated flu clinics in an SHA facility. NOTE: Gloves are not required for the administration of vaccine providing all hand hygiene guidelines are followed.
For PPE guidelines for SHA mass flu clinics please reference Mass Immunization Clinic Operational Flow document.
9. Are SHA medical directives applicable to Affiliate LTC homes since they are not SHA staff? No, they are not.
Flu Clinic Specific 10. Should we be planning to offer Pneumovax 23™ vaccine for eligible patients/clients?
Pneumovax™ 23 vaccine is not included in the practitioner order set. However, if the provider has the training and ability to assess client eligibility and provide the vaccine, that would be important to consider.
For example, Pneumovax is part of the order set in Regina LTC facility together with Influenza vaccine, as well as administration of epinephrine for anaphylaxis management.
11. What are some appropriate post-vaccination monitoring strategies? (I.e. in vehicles - to promote compliance with COVID 19 public health orders related to physical distancing, etc.)
A 15-minute observation period is required for everyone. Often that has occurred in a post immunization waiting area. During COVID it has been noted that some parents are choosing to wait in their cars with their immunized children to observe them there knowing that they could seek help/assistance if their child were to start to react.
Individual clients should complete the post immunization 15 minutes within a designated waiting area with a plan that ensures safety and observation.
Supplies and Vaccine 12. Will COVID Assessment centers stock and administer influenza vaccine?
Influenza vaccine is to be considered with every healthcare encounter. Therefore, it is for each local department to address if stocking as well as administering the vaccine will work in their setting.
13. Is there a plan to secure additional vaccine doses if required?
The Ministry of Health will closely monitor the provincial influenza vaccine supply and if needed, may be able to order additional doses.
14. What if I do not have a vaccine fridge in my area? Patient immunization doses provided by pharmacy for acute care patients are delivered to the medication fridge in patient care areas as close to the time of administration as possible. Vaccine may be stored in either a vaccine, purpose-built refrigerator (ideally) or a domestic stand-alone refrigerator with an external monitored thermometer. Domestic refrigerators have a wide variation in temperature (outside of 2o – 80C; ‘strive-for-50C’) but water bottles and storage recommendations (see attached NACI guidelines) can reduce this variability. Reference the National Vaccine Storage Guidelines here.
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15. Is vaccine going to be available in multi-dose vials or in pre-drawn syringes? How do we order vaccines and supplies? Vaccine will be available in both formats. Multi-dose vials will be the principle format used in most immunization settings.
16. I am a family physician and/or a nurse practitioner and want to offer vaccines to my patients, how would I get the vaccines? Contact the public health office in your network, your ED of PHC or your ADL Lead. For your reference Network Map
Name Health Network
Email Phone
Brett Enns ED, Primary Health Care North East
North East [email protected] 306-765-6477
Dori Gaudet Interim ED, Primary Health Care North East
North East [email protected] 306-765-6368
Dr. Christine Ryan, Area Department Lead, North East
North East [email protected] 306-314-9928
Jennifer Ahenakew ED, Primary Health Care North West
North West [email protected] 306-235-5833
Vikki Smart ED, Primary Health Care North West
North West [email protected] 306-440-4252
Braden Bouchard, Area Department Lead, North West
North West [email protected]
306-446-6000
Dr. Reid McGonigle. Area Department Lead North West
North West [email protected] 306-833-8080
Sheila Anderson ED, Primary Health Care Regina
Regina [email protected] 306-766-7371
Suzanne Mahaffey ED, Primary Health Care Saskatoon
Saskatoon [email protected] 306-655-7797
Dr. Leanne Helfrich, Area Department Lead, Saskatoon
Saskatoon [email protected] 306- 655-0326
Jacquie Holzmann ED, Primary Health Care South East
South East [email protected] 306-786-0112
Jacqui Kennett-Peppler ED, Primary Health Care South East
South East [email protected] 306-697-4003
Dr. Dag Lawale, Interim Department Lead for Emergency Medicine and Family Medicine
South East [email protected]
306-782-2401
Brenda Schwan ED, Primary Health Care South West
South West [email protected] 306-778-5105
Jeannie Munro ED, Primary Health Care South West
South West [email protected] 306-867-9700 ext. 3297
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Documentation and Reporting 17. What is the process for communication of vaccination status to First Nation healthcare partners on reserve?
First Nations and Inuit Health Branch, Saskatchewan Region (FNIHB-SK) and the Northern Inter-Tribal Health Authority (NITHA) are responsible for providing immunizations to First Nations individuals living in First Nations communities. Currently, 50 First Nations communities (FNIHB-SK and NITHA) use the Panorama immunization module for recording immunizations. The SHA and those First Nations communities that use Panorama enter influenza immunizations administered to children under the age of 18; for these individuals, the influenza immunizations will be visible in Panorama and the eHealth Viewer. For those not being entered into Panorama, providing a wallet card to the client may assist in the client maintaining a record of their influenza immunization.
Employee Health 18. Will staff that exhibit post-vaccination symptoms (headache, myalgia) be required to isolate due to crossover
with COVID symptoms? (absences from work)
All HCW’s will be required to follow the FIT for work screening process when reporting for work. If they are displaying any symptoms as identified on the tool they will be required to follow the process based on the results of the screening.
19. What strategies will be employed to increase uptake of influenza vaccination for health care workers?-
HCW’s will be encouraged to receive their flu shot how it best suits their needs – through Employee Health, a PHC clinic, Pharmacy or any other provider. We continue to expand influenza vaccination and promotion responsibilities to include many more members of the health care team with an increased focus on utilizing peer immunizers. Employee Health teams will continue to work with operations ongoing during this time to consider other ideas and strategies for staff.
20. Can our Trained RN give the staff immunizations on an as needed basis during this time?
As per the Medical Directive – Administration of Influenza Immunization without a Patient-specific Order and the Clinical Procedure – Influenza Immunization 2020-21 Without a Patient-specific order, immunizers must complete the online Public Health Influenza Education session including completion of an anaphylaxis exam to be able to administer influenza vaccine to staff. It is important to remember that providers MUST be authorized under the Medical Directive before they immunize co-workers. Some areas have established peer immunizer programs and others are working to develop a plan for this year. Please contact your local Employee Health or Public Health office for more information on peer immunizers in your area.
21. Can employees receiving the vaccine outside of Occupational Health clinics be asked to call their vaccine date
into the OH Hotline/ Department for data entry? The Employee Health Team is currently looking at alternative ways for HCW to report their influenza immunization. Please watch for more information.
22. What is the process to support CPR and peer immunizer training for all potential care providers working in
residential care through OH&S in collaboration with continuing care? Please reach out to your local education and training contact, Public Health or Employee Health office to provide specific details for your area on CPR re-certifications and peer immunizer training.
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Access to Documents, Information 23. Where can I access the WebEx recording, checklist, toolkit, town hall slide deck?
Please click on the following 4flu.ca link and scroll down to the bottom of the page. All documentation are posted under General Resources.
24. Where can I access the cold chain policy, immunization policy, clinical protocols, practitioner order sets, and medical directive? Please click on the following 4flu.ca link and scroll down to the bottom of the page. All documentation are posted under General Resources.
Logistics - Local Considerations
25. What steps have been taken to inform unions of plans to leverage providers who have not typically provided immunizations? All unions have been informed that the influenza campaign will look different this year due to the COVID-19 pandemic. More specifically the unions were advised that; “We need a system wide response to the 20/21 Influenza Immunization Campaign. Vaccine should be provided at every health care encounter by providers that are qualified, trained and supported.”
