Flu Season – Are you ready?

2019 Flu Season is almost upon us! At our practice, patients have already begun to ask when the flu shots will arrive. The latest update from Queensland Health and our private flu vaccine suppliers is mid April 2019. In the meantime, it is important to start to begin preparation. So without further ado here is a how to prepare for (dreaded) flu season!

Get a Flu Vaccine Consent Form

Flu Vaccine Consent forms are an essential modern day requirement. Below is a copy of the 2019 Quadrivalent flu vaccine template that I sourced from this website.

When I stumble across any other good templates I will be sure to upload them!

Agree how long the patients should remain in the vicinity of your practice post flu vaccine

I.e. 15 minutes or 20 minutes!

Make sure you take note of how long your consent form says for the patient to remain in the vicinity in case of an allergic response and that reflects the your practice’s position on this issue. I have read on some websites, it is best patients wait for 20 minutes and I notice this consent form says 15 minutes. So I would recommend you have a discussion with your doctors and nurses to see what they feel is best and make sure you reflect this in your consent form.

The risk of a severe allergic reaction to vaccination (anaphylaxis), to inactivated influenza vaccine is very low, estimated at 1.35 per million doses (10, 13). Immunisation guidelines recommend an observation period of 15 minutes (Australia) or 20 minutes (New Zealand) post-vaccination. The first symptoms of anaphylaxis may occur 20 minutes or longer after vaccination. However, because anaphylaxis is a very rare event it is not considered routine practice for vaccinated individuals to be observed beyond these specified times.

https://www.allergy.org.au/hp/papers/vaccination-of-the-egg-allergic-individual

I am not a doctor, but I think it is always best to err on the side of caution and ask patients to wait for 20 minutes. Unless they have a known analyfilaxis egg allergy…

Obtain Consumer Medicine Information (CMI) & Product Information (PI)

The CMI is referred to in the Consent Form above, so it is essential to have a couple of (laminated) copies floating around. I would also bookmark these on the nurses’ computer so they can do a quick search (the time saving wonder of Control F)!

Here is the link to 2019 CMI and PI flu vaccines.

Establish a Flu Vaccine Shortcut

Business for Doctors recently released a newsletter with a suggested flu vaccine shortcut which I thought was an excellent idea! Here a Quadrivalent flu vaccine shortcut which you can review with your clinical staff, adjust to suit your news and then insert into your practice software!

Quadrivalent Flu Vaccine Shortcut

Patient presents for [government funded/ privately funded] annual flu vaccine – 
Government funded criteria met – [>65 years/ATSI/medical condition which increases the risk of influenza/pregnancy ]
Patient has read the consent form, has no questions and signed the form. A copy can be found scanned into patient’s record.

Previous flu vaccine [yes/no]
previous adverse events [yes/no] 

Well today 
No history of Gillian-Barr Syndrome 
No contraindications for vaccine 

The vaccine: 
Quad variant vaccine that covers

  • A (H1N1): an A/Michigan/45/2015 (H1N1)pdm09 like virus
  • A (H3N2): an A/Switzerland/8060/2017 (H3N2) like virus
  • B: a B/Colorado/06/2017 like virus (not included in the TIVs)
  • B: a B/Phuket/3073/2013 like virus.

Explained possible adverse effects of vaccine 
Pain, redness and swelling – to the injections site. Common and will resolve in a few days. If not improving or concerned to return to the clinic for review 
Fevers, cold like symptoms – should pass in a few days 
Anaphylaxis – usually occurs within [15/20] minutes of the vaccine been given.  Advised patient required to wait in waiting room at practice for [15/20] minutes after having the vaccine. 

Review Medicare Benefits Schedule for the latest on Flu Vaccines

Below is an extract from the MBS which is quite useful but wordy. Put simply:

EXAMPLE ONE: Patient paying for private flu vaccine plus presents for not related consult

GP can claim 23,36, 44, 2713 etc (whatever is most appropriate for consult)

It is OK for the practice to charge for the Flu Vaccine separately

If the patient just wanted a private flu vaccine it is an item 3

EXAMPLE TWO: Patient wants Government funded flu vaccine plus presents for not related consult

GP can claim 23,36, 44, 2713 etc (whatever is most appropriate for consult)

If the patient just wanted a private flu vaccine it is an item 3

Mass immunisations are strictly prohibited under the Health Insurance Act!

What does this mean for Appointments? I would suggest the following approach for booking flu shots

  • Book a flu vaccine in at the same time as the patient’s regular appointment; and
  • Occasionally add fit a patient who just wants a ‘flu shot’ only. Just be careful you aren’t doing too many ‘flu only’ at once.

I have heard some practices have 2-3 hours of flu only appointments. I am not sure this entirely complies with the Medicare guidelines but happy to be told otherwise. I think it really depends on how many per hour you would be vaccinating.

Also some practices bill a 10997 for a patient to receive a flu shot if it is listed as an action/task in their care plan. Then they also bill a consult for the other non related topics discussed that day with the patient.


Extract from Medicare benefits and vaccinations

Example 1
A patient presents to a GP to receive the influenza vaccination. The patient is not in the cohort of patients which is covered for the influenza vaccine under the NIP.


After taking a short patient history, the GP administers the vaccine to the patient. The GP has met the requirements of a level A consultation and claims item 3. The GP can bulk bill the patient for the cost of the MBS service and can charge a separate amount for the cost of the vaccine, which is not covered under the NIP.


If a patient presented to a GP to receive a vaccine and to enquire about a medical condition, the GP may claim the appropriate item (such as item 23).


Example 2
A patient presents to a GP to receive the influenza vaccination. The patient is in the cohort of patients which is covered for the influenza vaccine under the NIP.
After taking a short patient history, the GP administers the vaccine to the patient. The GP has met the requirements of a level A consultation and claims item 3. The GP can bulk bill the patient but does not need to charge a separate amount for the cost of the vaccine, which is covered under the NIP.
If a patient presented to a GP to receive a vaccine and to enquire about a medical condition, the GP may claim the appropriate item (such as item 23).

http://www9.health.gov.au/mbs/fullDisplay.cfm?type=note&q=GN.12.32&qt=noteID&criteria=gn%2E12%2E32

Memorise those eligible for Government Funded Flu Vaccine

In 2019, the following Groups can receive a free Flu vaccine:

  • all Aboriginal and Torres Strait Islander people aged 6 months and over
  • pregnant women (during any stage of pregnancy)
  • all people aged 65 years and over
  • people aged six months and over with medical conditions which increase the risk of influenza disease complications.

I would recommend all your nurses, doctors and receptionist memorise this list and have a couple of copies on walls for easy reference.

Enable the Flu Vaccine Appointment option in your online booking software

Once you receive your flu vaccines you can enable this option on your online booking system. Make sure the time allocated reflects what has been agreed at your practice amongst your clinical team (often this is 15 minutes). Also you can use your online software to do an SMS or email broadcast when you have received your flu shots. Appoinuit have a good (free) email broadcast tool for subscribers called Appointuit Engage.

Hotdoc have a good article about How to Inform Your Patients About a Flu Clinic (Without Pestering Them).

Ensure you have enough staff

Have a practice meeting, agree on who will distribute the flu consent form (probably the receptionist), who will collect the patient (likely the nurse or doctor), where will they take them (likely to the nurses’ room if it is just for a flu vaccine). Make sure you have enough staff rostered so that things run smoothly!

Hope this helps. If you have any comments or questions please let me know in the section below.

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