Flu-misty covered memories of the way we were

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Elizabeth Newman
Elizabeth Newman

Within the conspiracy theories around the flu vaccine — and trust me, healthcare reporters have heard them all — there's also one secret lurking within people's refusal to receive the shot. It involves a sharp needle stabbing into one's arm.

The fear of needles is a phobia, in the same way people are claustrophobic, agoraphobic or acrophobic. In one study, 22% of study participants who reported a fear of needles were more likely to avoid healthcare. Many of them had had a bad needle experience, or vasovagal symptoms.

Trust me, I understand. I didn't have a big fear of needles until an inexperienced nurse had a hard time finding a vein a few years ago and I eventually swooned to the floor in what is called a vasovagal response. That's why I've been a huge embracer of FluMist, which I've taken every time it's been offered, probably four times in the past 8 years. But this season I'll be offering up my arm because yesterday the Centers for Disease Control and Prevention said the spray should not be used in the upcoming flu season.

While the recommendation was based on data involving children who had poor effectiveness from the live attenuated influenza vaccine (LAIV), it's a guideline based in science and follows two previous sessions with poor or lower than expected vaccine effectiveness for LAIV. As the CDC noted, there's no known reason for these results.

While the news will most impact pediatricians (the nasal spray flu vaccine accounts for a third of flu vaccines given to children), long-term care directors of nursing or other staff may have already placed vaccine orders for workers. The CDC said it will work with manufacturers through the summer to make sure there is enough supply.

The news is a blow to skilled nursing facilities convincing people to use the painless spray rather than get the shot. The government has been fighting the battle to raise long-term care employee vaccination rates for years, and this certainly won't help.  But last year millions of people were protected against the flu, including those who are most vulnerable: nursing home residents.

If long-term care facilities move toward mandatory vaccines, there will be lots of employees who throw fits about overreach. Yet I suspect the day is coming where someone is able to document how their loved one died of the flu that was transmitted to him/her by an employee.  Let me know how that lawsuit — or more likely, settlement — works out.

So if you're convinced your facility needs to raise its vaccination rate, perhaps the secret lies in tackling people's reluctance to receive a shot.

If an employee confides in you that he/she hates needles, don't default to, “Get over it.” (I'll admit that's my response to a lot of complaints about long-term care, but I'm working on my empathy.) Whether it's long-term care or day-to-day life, people often want to be heard. If you suss out that fear is what is holding an employee back from the shot, you can offer these ideas, which were culled from anti-anxiety strategies:

• Practice tensing in the arms, legs and the trunk, for 10 to 15 seconds, then relaxing for 20 seconds.

• Consider a topical lidocaine cream, which can numb the skin.

• Offer to go with the employee and talk to him/her during the shot.

• Work on taking deep breaths.

• Ask if listening to relaxing music would help.

For those who truly believe the vaccine industry is in bed with the government or refuse to let go of conspiracy theories, there's little that can be done. But we can address misinformation and fear.

Follow Elizabeth Newman @TigerELN.


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Daily Editors' Notes

McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Marty Stempniak.