How are flu vaccinations prepared

Flu shot

Influenza vaccination actually simple, but many questions in detail

Unfortunately, politics and health insurance companies manage to make life difficult for us patients and doctors. For example, the flu vaccination: As we are currently being asked about the flu vaccination by almost every patient, I have summarized the most important questions for you here:

Why not vaccinate as soon as the vaccine is available?
Some doctors start vaccinating as early as September. The vaccination protection is only reliably given approx. 4 months after the vaccination. So if the vaccination was carried out in September and the influenza wave did not come until the end of January, the vaccination protection is no longer guaranteed. Then the vaccination was in vain.

How is the flu epidemic?
That's always a good question! I expect a late and less severe influenza season for five reasons:
1 .: When mouth and nose protection became mandatory, the influenza cases stopped immediately in the spring. If the mouth and nose protection remains in use, there will be significantly fewer cases of influenza in my opinion than in other years.
2 .: Social distancing: With this we not only keep Corona, but also the flu at a distance.
3 .: Less travel: If people continue to travel less, the influenza will not spread as quickly as usual.
4th: Lots of sun in lockdown = lots of vitamin D = good protection against flu. I wrote an article about the protective effect of vitamin D against corona. If you are interested, you can find it here. In practice, we are currently still measuring a large number of pleasantly good vitamin D values. Only when these fall off in winter does the body become more susceptible to infections. By the way: you can maintain good vitamin D levels with vitamin D doses.

Flu shot? …or not?
Another good question. Of course, the influenza wave could “fail” this season for the reasons mentioned. Then, in retrospect, the vaccination would have been superfluous. On the other hand, it is the case that the symptoms of influenza and CoViD-19 disease cannot be distinguished. Remember: A “real” influenza is “not scabies”, but a mostly serious illness that can make hospitalization necessary for young people as well. If someone comes to the hospital with such complaints during CoViD times, they first end up in the isolation ward. And honestly nobody wants to go there. In short: I always buckle up in my car and consider the influenza vaccination to be a kind of “medical seat belt”.

Who will be vaccinated? And how?
We Germans can do bureaucracy! - See vaccinations: There are several ways to correctly classify the same vaccination in a bureaucratic manner. Which group do you belong to?
1.: „Standard vaccination“: All people aged 60 and over can receive the influenza vaccination as a so-called standard vaccination at the expense of the statutory health insurance.
2.: „Indication vaccination": The statutory health insurances pay four population groups the vaccination as a so-called" indication vaccination ". These are:
+ all pregnant women from the 2nd trimester of pregnancy (in the case of a chronic illness also in the first trimester)
+ Children, adolescents and adults with a chronic illness
+ Residents of old people's and nursing homes and
+ People who, as a possible source of infection, could endanger risk groups living in the same household or those you are looking after.
3.: „Occupational indication": People with an increased risk, for example medical staff, employees in facilities with public access, in the care of risk groups and the health insurers have a heart for" people with direct contact with poultry and wild birds ", they can also receive the vaccination as a health insurance benefit. If you have this, we have to record it in the medical file so that you can receive the vaccination as a health insurance benefit.
4.: „Statutory service“: Some health insurances allow their insured persons to have the vaccination even if they do not belong to the groups mentioned above. That changes (of course) every year. This winter they are:
AOK Rhineland / Hamburg, Barmer, Bergische KK, BIG direct healthy, BKK24, BKK Euregio, KKH, DAK, mhplus-bkk, pronova BKK, Siemens BKK, Techniker, Viaktiv KK and actimonda KK.

Do I have to register for vaccination?
Since each of the paths described has its own bureaucratic process (no, not our idea and no, not sensible from our point of view!), You can help us if you check in advance which group you belong to and tell us. This is important to you too, as it depends on how you get the vaccine.

How do I get influenza vaccine?
Here, too, life is made unnecessarily difficult: There are different paths for the different groups:
1 .: People with statutory health insurance who receive the vaccination as a "standard vaccination", "indication vaccination" or "occupational indication" do not need to worry about anything. You come to the practice with the health insurance card and the vaccine has already been obtained.
2 .: Patients who receive a “statutory vaccination” receive a prescription for the vaccine and please get it from the pharmacy. When we write the prescription for you, we will discuss directly when you can be vaccinated.
3 .: Private patients receive a “private prescription”. You may have to clarify in advance whether your health insurance company will cover the costs, as there are an infinite number of different contracts. Most private health insurances include vaccination. A call to your insurance company will give you clarity.
4 .: Statutory insurance companies who do not have any of the above options to get the vaccination as a health insurance benefit, we can issue a private prescription for the vaccine on request.

Why are there different vaccines? Is one better or worse?
Since there are different companies, there are five approved preparations this season. All of them have protection against the four most likely pathogens. Based on what we know so far, we would consider all of them to be equally good.

Will the vaccine be enough?
According to Minister Spahn, that will be the case. The demand from patients in our practice this year is greater than ever.

Why may the vaccine be running out?
According to the media reports about the pneumococcal vaccination, there has been an unbelievable rush for this vaccination nationwide. The deficiency has not yet been compensated for. Patients are still waiting for this vaccination. Vaccines cannot be made “just like that”. Production has a long lead time. Politicians keep writing that it will be enough.

Why not just order more vaccine?
Every year in March all doctors have to predict and order the need for vaccine for the fall for the patients with statutory health insurance. Naturally, this is difficult. The problem: If the vaccine is not used, the doctor will be billed for it. Therefore, many practices approach the order cautiously.
Since I was worried in March whether Corona would be gone in autumn, we ordered 100 more vaccine doses than usual and hope that it will be enough.

Why is it all so complicated?
I have often asked myself that and found no logical reason.

Why don't we vaccinate “foreign” patients?
For the reasons mentioned above, it is difficult enough to get a good supply of flu vaccine for our patients. In addition, in the pandemic, we can only care for a limited number of patients at the same time in the practice to protect against infection.
And: We take time for our patients and are therefore currently unable to provide additional care for new patients.

How can we patients make life easier for us and the practice?
Thank you for the question: There are really a few points that are easy for you and really help us:
+ Tell us directly which group you belong to, that will make it easier for everyone.
+ Bring your insurance card and vaccination certificate with you to the vaccination.
+ Clarify with us when we can vaccinate you: To protect you and the other people in the practice, only a limited number of people can be allowed into the practice.
+ Our team has been doing superhuman efforts since March to provide you with the best possible care despite the pandemic. Masks do not please you or us. We wear them non-stop every day. Many patients are in worry and need, with many “the fuse is short”. Take time for your health and resolve to be friendly to our employees. When in doubt, throw 50 cents more into the parking meter and plan some time for your health.
Many patients have asked me what good things you can do for us: A nice word or a smile is good for us. Even behind your mask, we can see it in your eyes ...

We're also really working to the limit: yesterday, after working in the practice, I treated 198 patients in the test center. We really need your support and kindness in the coming weeks and months!

Addendum 10/17/2020: The DAK has joined the agreement on influenza vaccination as a statutory benefit. On the other hand, contrary to earlier information, the "BIG direkt" did not join the agreement this year, so that its insured persons cannot be vaccinated as part of the statutory benefits.

Dr. Pukies