Fight the Flu For Free!

Transcription

1 l Fight the Flu For Free! FREE INFLUENZA VACCINATIONS FOR STUDENTS AT YOUR SCHOOL Why does my child need the flu vaccine? It's a SAFE and effective way to prevent the flu Children miss fewer days of school due to illness Parents need to take off less work to be home with a sick child Children won't spread the flu to other family members at home Help stop flu related health complications Should my child get a shot or the nasal spray vaccine (FluMist )? Most children can get FluMist Ca nasal spray vaccine) Children with asthma, diabetes, or other health conditions will need a flu shot. It is extra important that children with these conditions get protected from the flu. What do I have to do? Fill out and sign the consent form for the flu vaccine (see back of this page) Read the attached Vaccine Information Statements (VIS) and keep them Detach and return only the completed consent form to your school nurse Nurses from Franciscan Children's Immunization Program will give the flu vaccine during school hours. A parent does not need to be present Your child will receive a shot record after receiving the vaccine-check backpacks! Questions? Call (253) t CMHOLIC HEMTH 1Nll1All\"fS Franciscan Health System Franciscan Women's Care

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3 t"l\.hh)uc fh:l\tlti t INITIATIVE~ Franciscan Health System Franciscan Women's Care i ~ ~... ~ Parent/Guardian Consent Form.' Influenza Immunization Consent Form Return completed form to school. PARENT/GUARDIAN: The following questions will help us to know which type of flu vaccine to give your child. Most children can receive nasal spray (Flu Mist). Some children who have asthma, diabetes or other medical conditions should get a flu shot. All flu vaccines will be provit/ed free of charge. PLEASE call us if you have any question or concerns at (253) CHILD Last Name First Name Middle Initial Select One: Male Female Mailing Address City State Zip Code Telephone Number Parent/Guardian can be Grade & Teacher's Name Birth Date Age reached at: PLEASE CIRCLE THE ANSWER TO THESE QUESTIONS Does your child have a severe allergy to eggs or Yes No Does your child have chronic wheezing or other Yes No any influenza vaccine (such as hives or trouble breathing problems (such as asthma)? breathing? Has your child received a MMR, chickenpox or a Yes No Does your child have any long-term health Yes No nasal spray Flu-Mist vaccine in the past month? problem or condition (such as heart disease, Date: diabetes, kidney disease, blood disease, Downs Syndrome, birth defect, etc.) or ever had Guillain-Barre' syndrome? If your child is under 9 years old, did he or she Yes No Does your child have a weakened immune Yes No have TWO (2) flu vaccinations since July 1, system because of HIV I AIDS, cancer treatment, {Children under age 9 who have not had 2doses high-dose steroids or another disease or since 7 /1/10 need a second dose of flu vaccine 1 medication? month after the first) Does your child take aspirin for a health Yes No condition? PLEASE TELL US ABOUT YOUR CHILD'S MEDICAL COVERAGE My child does not have health insurance My child is underinsured (has health insurance that does not pay for vaccinations) My child has state supported insurance (Medicaid, Coupons, Healthy Options, Molina, Basic Health Plan) My child has private insurance My child is American Indian or Alaska Native PARENT/GUARDIAN SIGNATURE I have received and read/had explained to me the Influenza Vaccine Information Statement {VIS). I am the parent or legal guardian of the above child, and I give my permission for my child to receive the flu vaccine at school. I understand the benefits and risks of the influenza vaccine. I understand that I do not need to be present for my child to receive the flu vaccine and that my child may receive either nasal spray or a shot, depending on medical need. I understand that my child's Immunization Information will be entered Into an electronic database that can be shared with other medical providers and school staff. I authorize my child's Public School District to provide this form to Franciscan Children's Immunization Program for the purpose of authorizing administration of Influenza vaccine. x Parent/Guardian Signature FOR OFFICE USE ONL V LAIV-Dose 0.2 ml Intranasal VIS Date:07 /02/12 Mfgr: Medlmmune Lot# Exp. TIV-Dose 0.5 ml IM Site: RA LA VIS Date: 07/02/12 Mfgr: Sanofi Fluzone Lot# Exp: Nurse Signature and Title: Date: School Name: Date Franciscan Children' s Immunization Program _ - (253) '

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5 Influenza Vaccine Live, Intranasal What You Need to Know ( i~l w_h_y_g_e_t_v_ac_c_i_na_t_e_d_? ) Influenza ("flu") is a contagious disease. It is caused by the influenza virus, which can be spread by coughing, sneezing, or nasal secretions. Anyone can get influenza, but rates of infection are highest among children. For most people, symptoms last only a few days. They include: fever/chills cough sore throat headache VACCINE INFORMATION STATEMENT muscle aches fatigue runny or stuffy nose Other illnesses can have the same symptoms and are often mistaken for influenza. Young children, people 65 and older, pregnant women, and people with certain health conditions - such as heart, lung or kidney disease, or a weakened immune system -can get much sicker. Flu can cause high fever and pneumonia, and make existing medical conditions worse. It can cause diarrhea and seizures in children. Each year thousands of people die from influenza and even more require hospitalization. By getting flu vaccine you can protect yourself from influenza and may also avoid sp1 eading influenza to others. 2 Live, attenuated influenza vaccine - LAIV (nasal spray) There are two types of influenza vaccine: 1. Live, attenuated influenza vaccine (LAJV) contains live but attenuated (weakened) influenza virus. Jt is sprayed into the nostrils. 2. Inactivated (killed) influenza vaccine, the "flu shot," is given by i~jection with a needle. This vaccine is described in a separate Vaccine Information Slalement. Influenza viruses are always changing, so annual vaccination is recommended. Each year scientists try to match the viruses in the vaccine to those most likely to cause flu that year. Flu vaccine will not prevent disease from other viruses, including flu viruses not contained in the vaccine. It takes up to 2 weeks for protection to develop after the vaccination. Protection lasts about a year. LAIV does not contain thimerosal or other preservatives Many Vaccine Information Statements are available in Spanish and other languages. See Hojas de Jnfomrncian Sohre Vacunas estfili disponibles en Espanol yen muchos otros idiomns. Visite ( 3_j~w_h_o_c_a_n_r_e_c_e_iv_e_L_A_l_V_?~ J LAIV is recommended for healthy people 2 through 49 years of age, who are not pregnant and do not have certain health conditions (see #4, below). 4 Some people should not receive LAIV LAIV is not recommended for everyone. The following people should get the inactivated vaccine (flu shot) instead: Adults 50 years of age and older or children from 6 through 23 months of age. (Children younger than 6 months should not get either influenza vaccine.) Children younger than 5 years with asthma or one or more episodes of wheezing within the past year. Pregnant women. People who have long-term health problems with: - heart disease - kidney or liver disease - lung disease - metabolic disease, such as diabetes - asthma - anemia, and other blood disorders Anyone with certain muscle or nerve disorders (such as seizure disorders or cerebral palsy) that can lead to breathing or swallowing problems. Anyone with a weakened immune system. Anyone in close contact with someone whose immune system is so weak they require care in a protected environment (such as a bone marrow transplant unit). Close contacts qf'other people with a weakened immune sys/em (such as those with HIV) may receive LAIV. Healthcare personnel in neonatal intensive care unit\' or oncology clinics may receive LAfl-'. Children or adolescents on long-tenn aspirin treatment. Tell your doctor if you have any severe (life-threatening) allergies, including a severe allergy to eggs. A severe allergy to any vaccine component may be a reason not to get the vaccine. Allergic reactions to influenza vaccine are rare. Tell your doctor if you ever had a severe reaction after a dose of influenza vaccine. Tell your doctor if you ever had Guillain-Barre Syndrome (a severe paralytic illness, also called OBS). Your doctor will help you decide whether the vaccine is recommended for you. U.S. Department or Ha.Ith f1d Hl.imi1n 5ervic i (\>n\{'i S fo< 01~~i!S(' Con1m! ood P.,r-v~nnon

6 Tell your doctor if you have gotten any other vaccines in the past 4 weeks. Anyone with a nasal condition serious enough to make breathing difficult, such as a very stuff)' nose, should get the flu shot instead. People who are moderately or severely ill should usually wait until they recover before getting flu vaccine. If you are ill, talk to yolll' doctor about whether to reschedule the vaccination. People with a mild illness can usually get the vaccine. 5 When should I receive influenza vaccine? Get the vaccine as soon as it is available. This should provide protection if the flu season comes early. You can get the vaccine as long as illness is occurring in your community. Influenza can occur any time, but most influenza occurs from October through May. In recent seasons, most infections have occurred in January and February. Getting vaccinated in December, or even later, will still be beneficial in most years. Adults and older children need one dose of influenza vaccine each year. But some children younger than 9 years of age need two doses to be protected. Ask your doctor. Influenza vaccine may be given at the same time as other vaccines. ( 6 I What are the risks from LAIV? ) A vaccine, like any medicine, could possibly cause serious problems, such as severe allergic reactions. The risk of a vaccine causing serious hann, or death, is extremely small. Live influenza vaccine viruses very rarely spread from person to person. Even if they do, they are not likely to cause illness. LAIV is made from weakened virus and does not cause influenza. The vaccine can cause mild symptoms in people who get it (see below). Mild problems: Some children and adolescents 2-17 years of age have reported: runny nose, nasal congestion or cough fever headache and muscle aches wheezing abdominal pain or occasional vomiting or diarrhea Some adults years of age have reported: runny nose or nasal congestion sore tlu oat cough, chills, tiredness/weakness headache Severe problems: Life-threatening alle1-gic reactions from vaccines are very rare. If they do occur, it is usually within a few minutes to a few hours after the vaccination. lf rare reactions occur with any product, they may not be identified until thousands, or millions, of peop.le have used it. Millions of doses of LAIV have been distributed since it was licensed, and the vaccine has not been associated with any serious problems. The safety of vaccines is always being monitored. For more information, visit: and Activities/ Activities_ Index.html 7 What if there is a severe reaction? What should I look for? Any unusual condition, such as a high fever or behavior changes. Signs of a severe allergic reaction can include difficulty breathing, hoarseness or wheezing, hives, paleness, weakness, a fast heart beat or dizziness. What should I do? Call a doctor, or get the person to a doctor right away. Tell the doctor what happened, the date and time it happened, and when the vaccination was given. Ask your doctor to report the reaction by filing a Vaccine Adverse Event Reporting System (VAERS) fom1. Or you can file this report through the VAERS website at or by calling VAERS does not provide medical advice. 8 The National Vaccine Injury Compensation Program The National Vaccine Injury Compensation Program (VICP) was created in Persons who believe they may have been injured by a vaccine can learn about the program and about filing a claim by calling , or visiting the VICP website at ( 9 I How can I learn more? J Ask your doctor. They can give you the vaccine package insert or suggest other sources of infonnation. Call your local or state health department. Contact the Centers for Disease Control and Prevention (CDC): - Call (1-800-CDC-INFO) or - Visit CDC's website at Vaccine Information Statement (Interim) Influenza Vaccine (Live, Attenuated) 7/2/ U.S.C. 300aa-26 Office Use i

7 Influenza Vaccine Inactivated What You Need to Know ( 1 I Why get vaccinated? Influenza ("flu") is a contagious disease. It is caused by the influenza virus, which can be spread by coughing, sneezing, or nasal secretions. Anyone can get influenza, but rates of infection are highest among children. For most people, symptoms last only a few days. They include: fevel'/chitts sore throat muscle aches fatigue cough headache runny or stuffy nose Other illnesses can have the same symptoms and are often mistaken for influenza. Young children, people 65 and older, pregnant women, and people with certain health conditions - such as heart, lung or kidney disease, or a weakened immune systemcan get much sicker. Flu can cause high fever and pneumonia, and make existing medical conditions worse. It can cause dia1thea and seizures in children. Each year thousands of people die from influenza and even more require hospitalization. By getting flu vaccine you can protect yourself from influenza and may also avoid spreading influenza to others. ( 2 J Inactivated influenza vaccine ) There are two types of influenza vaccine: 1. Inactivated (killed) vaccine, the "flu shot," is given by il\iection with a needle. 2. Live, attenuated (weakened) influenza vaccine is sprayed into the nostrils. This vaccine is described in a separate Vaccine Information Statement. A "high-dose" inactivated influenza vaccine ls available for people 65 years of age and older. Ask your doctor for more information. Influenza viruses are always changing, so annual vaccination is recommended. Each year scientists try to match the viruses in the vaccine to those most likely to cause flu that year. Flu vaccine will not prevent disease from other viruses, including flu vimses not contained in the vaccine. It takes up to 2 weeks for protection to develop after the shot. Protection lasts about a year. VACCINE INFORMATION STATEMENT J Many Vaccine Tnfonnation Statements are available in Spanish and other languages. See Hojas de Infom1aci:in Sohre Vacunas estan disponibles en Espallol y en nmchos otros idiomas. Visite Some inactivated influenza vaccine contains a preservative called thimerosal. Thimerosal-free influenza vaccine is available. Ask your doctor for more information. 3 Who should get inactivated influenza vaccine and when? WHO All people 6 months of age and older should get flu vaccine. Vaccination is especially important for people at higher risk of severe influenza and their close contacts, including healthcare personnel and close contacts of children younger than 6 months. WHEN Get the vaccine as soon as it is available. This should provide protection if the flu season comes early. You can get the vaccine as long as illness is occurring in your community. Influenza can occur at any time, but most influenza occurs from October through May. In recent seasons, most infections have occurred in January and Febrnary. Getting vaccinated in December. or even later, will still be beneficial in most years. Adults and older children need one dose of influenza vaccine each year. But some children younger than 9 years of age need two doses to be protected. Ask your doctor. Influenza vaccine may be given at the same time as other vaccines, including pneumococcal vaccine. Some people should not get 4 inactivated influenza vaccine or should wait. Tell your doctor if you have any severe (Jifethreatening) allergies, including a severe allergy to eggs. A severe allergy to any vaccine component may be a reason not to get the vaccine. Allergic reactions to influenza vaccine are rare. U.S. Dep.1nmentof HMllh nd Humon S..Vlcti Clrf\le-r~ fof Oi5oe11se Comr ' uld Pre-yrention

8 Tell your doctor if you ever had a severe reaction after a dose of influenza vaccine. Tell your doctor if you ever had Guillain-Barre Syndrome (a severe paralytic illness, also called GBS). Your doctoi' will help you decide whether the vaccine is recommended for you. People who are moderately or severely ill should usually wait until they recover before getting flu vaccine. If you are ill, talk to your doctor about whether to reschedule the vaccination. People with a mild illness can usually get the vaccine. 5 What are the risks from inactivated influenza vaccine? A vaccine, like any medicine, could possibly cause serious problems, such as severe allergic reactions. The risk of a vaccine causing serious harm, or death, is extremely small. Serious problems from inactivated influenza vaccine are very rare. The viruses in inactivated influenza vaccine have been killed, so you cannot get influenza from the vaccine. Mild problems: soreness, redness, or swelling where the shot was given hoarseness; sore, red or itchy eyes; cough fever aches headache itching fatigue If these problems occur, they usually begin soon after the shot and last 1-2 days. Moderate problems: Young children who get inactivated flu vaccine and pneumococcal vaccine (PCV13) at the same time appear to be at increased risk for seizures caused by fever. Ask your doctor for more infonnation. Tell your doctor if a child who is getting flu vaccine has ever had a seizure. Severe problems: Life-threatening allergic reactions from vaccines are very rare. If they do occur, it is usually within a few minutes to a few hours after the shot. In 197 6, a type of inactivated influenza (swine flu) vaccine was associated with Guillain-Barre Syndrome (GBS). Since then, flu vaccines have not been clearly linked to GBS. However, if there is a risk ofgbs from current flu vaccines, it would be no more than I or 2 cases per million people vaccinated. This is much lower than the risk of severe influenza, which can be prevented by vaccination. The safety of vaccines is always being monitored. For more information, visit: and fety/ Activities/ Activities_ In dex.htm I 6 One brand of inactivated flu vaccine, called Afluria, should not be given to children 8 years of age or younger, except in special circumstances. A related vaccine was associated with fevers and fever-related seizures in young children in Australia. Your doctor can give you more information. What if there is a severe reaction? What should I look for? Any unusual condition, such as a high fever or unusual behavior. Signs of a serious allergic reaction can include difficulty breathing, hoarseness or wheezing, hives, paleness, weakness, a fast heart beat or dizziness. What should I do? Call a doctor, or get the person to a doctor right away. Tell your doctor what happened, the date and time it happened, and when the vaccination was given. Ask your doctor, nurse, or health department to repo1t the reaction by filing a Vaccine Adverse Event Reporting System (VAERS) form. Or you can file this report through the VAERS web site at or by calling VAERS does not provide medical advice. 7 The National Vaccine Injury Compensation Program The National Vaccine Injury Compensation Program (VICP) was created in People who believe they may have been injured by a vaccine can learn about the program and about filing a claim by calling or visiting the VICP website at (... s. j _H_o_w_c_a_n_l_l_e_a_rn_m_o_r_e_? J Ask your doctor They can give you the vaccine package insert or suggest other sources of information. Call your local or state health department. Contact the Centers for Disease Control and Prevention (CDC): - Call (1-800-CDC-INFO) or - Visit CDC's website at Vaccine Information Statement (Interim) Influenza Vaccine (Inactivated) 7/2/ U.S.C. 300aa-26 Office Use m ~

9 Keep your kids safe - every fall or winter! COPY THIS FOR YOUR PATIENTS get them vaccinated Is influenza more serious for kids? Influenza vaccine may save your child's life. \Vhatisinfluenza? \Vhat types of vaccine are available for children? How else can I protect my child? \Vhat are signs of influenza? Infants and young children are at a greater risk for getting seriously ill from influenza. That's why health experts recommend that all children 6 months and older and all adults get vaccinated against influenza each fall or winter. Most people with influenza are sick for about a week, and then they feel better. But, some people, especially young children, pregnant women, older people, and people with chronic health problems can get very sick. Some even die. A yearly vaccination against influenza is the best way to protect your child from this serious disease. It is recommended for everyone 6 months and older. Influenza, or "flu," is an infection of the nose, throat, and lungs. It can easily spread from person to person. Influenza shots can be given to children 6 months and older. A nasal-spray vaccine can be given to healthy children 2 years and older. Children younger than 5 years who have had wheezing in the past year-or any child with chronic health problems-should get the injectable vaccine (a shot), not the nasal-spray vaccine. Children younger than 9 years old who are getting influenza vaccine for the first time need two doses. Every year, get an influenza vaccination yourself. Urge your child's close contacts to get vaccinated, too. This is extremely important if your child is younger than 5 or if he or she has a chronic health problem such as asthma or diabetes. Because children under 6 months can't be vaccinated, they rely on those around them to get vaccinated. Wash your hands often and cover your coughs and sneezes. It's best to use a tissue and quickly throw it away. If you don't have a tissue, you should cough or sneeze into your upper sleeve, not your hands. This will prevent the spread of germs. Tell your children to - Stay away from people who are sick, - Wash their hands often, - Keep their hands away from their face, and - Cover coughs and sneezes to protect others. Influenza comes on suddenly. Most people with influenza feel extremely fatigued and have a high fever, headache, dry cough, sore throat, runny or stuffy nose, and sore muscles. The cough can last two or more weeks. Some people, especially children, may also have stomach problems and diarrhea. page i of 2 Technical content reviewed by the Centers for Disease Control and Prevention, October 2011 IMMUNIZATION ACTION COALITION 1573 Selby Avenue St. Paul, Minnesota Item #P4070 (10/11)

10 KEEP YOUR KIDS SAFE: GET THEM VACCINATED EVERY FALL OR WINTERI- PAGE 2 How is influenza spread? How long can a sick person spread influenza to others? What should I use to clean hands? What can I do if my child gets sick? What warning signs should I be on the look-out for during my child's illness? Can my child go to school/ day care with influenza? When can my child go back to school or day care after having influenza? People who have influenza usually cough, sneeze, and have a runny nose. The droplets in a cough, sneeze, or runny nose contain the influenza virus. Other people can get influenza by breathing in the virus or by getting it in their nose or mouth. It is also spread by touching a surface that an infected person has touched, such as doorknobs, tabletops, or keyboards. People can spread influenza from one day before getting sick to up to five or more days after getting sick. Wash your children's hands with soap and water. Wash them for as long as it takes to sing the "Happy Birthday" song twice. If soap and water are not handy and hands are not visibly soiled, use wipes or gels with alcohol in them. Gels should be rubbed into hands until hands are dry. Make sure your child gets plenty of rest and drinks lots of fluids. Talk with your child's doctor before giving your child over-the-counter medicine. If you suspect that your child may have influenza, never give him or her aspirin or medicine that has aspirin in it. It could cause serious problems. If your child has any of the following emergency warning signs, seek urgent medical attention by taking them to an emergency room or calling 9-1-1: Fast breathing or trouble breathing Bluish skin color Not waking up or not interacting Being so irritable that the child does not want to be held Not drinking enough fluids Not urinating or not producing tears when crying Severe or persistent vomiting Influenza-like symptoms improve but then return with fever and worse cough No. If your child has influenza, he or she should stay home to rest. This helps avoid spreading it to other children. Children with influenza should be isolated in the home, away from other people. They should also stay home until they are symptom-free for 24 hours (that is, until they have no fever without the use of fever-control medicines and they feel well for 24 hours.) Remind your child to protect others by covering his or her mouth when coughing or sneezing. You may want to send your child to school with tissues or wipes with gels that have alcohol in them if the school allows gels. page 2 of2 Produced in cooperation with the New York State Department of Health IMMUNIZATION ACTION COALITION 1573 Selby Avenue St. Paul, Minnesota ltern #P4070 (10/11)