NHS Greater Glasgow and Clyde

1. Flu Vaccination Through Peer Immunisation: What immunising staff need to know? Public Health Protection Unit NHS Greater Glasgow and Clyde

2. Why is flu important in health care setting? • It is a highly infectious viral illness • Someone with flu can infect others at least 24 hours before symptoms develop • Severe complications of flu include pneumonia, encephalitis and meningitis • Most serious illness in neonates, pregnant women, older people and those with underlying chronic medical conditions - the people most likely to be in contact with health care staff

3. How serious is flu in some patients? • In Scotland, in the flu season 2010/11, 177 patients were seriously ill in an ITU and 63 died • Overall flu related death rates among those in the risk groups are approximately 11 times higher than those not in the risk groups • During the 2009/10 flu pandemic, 12 pregnant women died in the UK and the risk in them dying was 7 fold higher than a non pregnant women of same age

4. How is flu spread? • Flu is highly contagious. It is passed on when people breathe in droplets containing the flu virus that have been coughed and sneezed into the air • You can also catch flu by touching objects and surfaces contaminated by the virus • From the time a person is first infected by the virus, it can take between one to three days before any symptoms develop

5. How can staff protect themselves? • Through vaccination: this is required annually as the virus is constantly changing and every year the vaccine is matched against the circulating strain • Through good infection control practice: good infection control practice is important for reducing health care associated infection but this may have limited impact for flu as staff can be infectious before symptoms develop

6. Which staff are eligible for the flu vaccine ? • All staff directly employed by NHSGGC are eligible e.g. • Portering services • Domestic staff • Laboratory staff • Medical staff • Nursing staff

7. Administration of the flu vaccine • A single intramuscular injection of 0.5 ml into the deltoid area of the arm (pre-filled syringe contains one dose only) • If the person receiving the vaccine has a known bleeding disorder the vaccine should be given as a deep subcutaneous route • Skin cleansing is not necessary • If spirit swabs are used the skin should be allowed to dry before the vaccine is administered .

8. Administration of the flu vaccine

9. Is The Vaccine Safe ? • All vaccines are rigorously tested and the same vaccine production techniques have been used for many decades. • The first flu vaccine was developed in 1945 and vaccination has been recommended in the UK since the late 1960s i.e. for the last 50 years. The seasonal flu vaccine is therefore well established and very safe. • The Medicines and Healthcare products Regulatory Agency (MHRA) is the agency responsible for ensuring that medicines and medical devices are safe. The MHRA follow up all reported and suspected adverse events following flu vaccination. • Millions and millions of doses of flu vaccine have been used over decades in North America, Europe and Australia with no serious safety concerns.

10. Possible side effects after receiving the flu vaccine • Pain, swelling and redness at injection site for 24 to 48 hours • Low grade fever, malaise, headache and muscle aches for 24 to 48 hours • Very rarely anaphylactic reaction but unlikely if had flu vaccine previously

11. Contraindications to receiving the vaccine • There are very few contraindications to flu vaccine • Check the Patient Group Direction for contraindications (PGD) • If they had the flu vaccine before, there is unlikely to be any contraindications • If a contraindication is identified please seek advice from Public Health Protection Unit (PHPU) 0141-201-4917

12. Can flu vaccine give me the flu? • No • The flu vaccine is made from incomplete parts of the dead flu virus which can not reproduce in your body • The vaccine contains 3 strains (H1N1, H3N2 and a type B) of the flu viruses that are most likely to be circulating this winter • Flu vaccine made this way can not give you the flu as this is not biologically possible • The vaccine can take 10 to 14 days to produce antibodies, so you could still catch flu before it starts to work • Only 10 to 15% of all flu like illnesses during winter months are due to the flu virus. Other respiratory viruses that also circulate in the winter months account for the remainder of the flu like illnesses. Flu vaccine will not prevent these infections

13. How is the vaccine packaged? • It comes in a pre-filled syringe in single dose

14. What is PeerImmunisation? • The Staff Flu Peer Immunisation Programme simply allows clinical staff to immunise their colleagues • This enable them to get vaccinated on site of their work without having to attend a mass vaccination or occupational health clinics • Staff working in the evenings, night shift and at weekends can also get vaccinated on site while at work

15. Peer Immunisation – Opt in Process • PGD: Patient Group Direction - legal document allowing the immuniser to administer the seasonal flu vaccine. Must be signed by immuniser and clinical lead for the area. • The Influenza PGD can be downloaded from the flu website in the Peer Immunisation Section

16. Peer Immunisation – Opt in Process

17. Peer Immunisation – Clinic Process

19. Screening for fitness and suitability of receiving the vaccine • Scan screening form • Advise colleague to print off the screening/consent form prior to receiving the vaccine

22. Recording of the flu vaccine • Ensure that the form has been completed by your colleague prior to administering the vaccine • Use the sticky label on the prefilled syringe which has the batch number and expiry date and place on the screening form, • Date the form and sign your signature

23. Where do the forms get returned to? • On completion of the vaccine being given • Please return to : Carol McCafferty Project AdministratorPublic Health Protection UnitRoom 7.02, 1st Floor, West HouseGartnavel Royal Hospital

24. Any Questions ? • Contact PHPU • 0141 201 4917 • PHPU@ggc.scot.nhs.uk