Joanne Lewis [00:00:08] Welcome to influenza immunization for your patients with diabetes. My name is Joanne Lewis and I am the Director of Health Care Provider Education and Engagement with Diabetes Canada. This webinar is presented by Ashen Chetty and Dr. Nadira Husein, coauthors of the chapter on influenza and other vaccinations in the 2018 Diabetes Canada Clinical Practice Guidelines. We are pleased to have them here to speak about the importance of ensuring your patients with diabetes are aware of their increased risk of complications related to contracting influenza.
Ashen Chetty [00:00:46] Agneda for the presentation is what is influenza? What are the complications related to influenza? Why are people with diabetes at high risk for influenza related to complications? Tips to help your patients make an informed choice about influenza immunization.
Nadira Husein [00:01:06] Canadian vaccination recommendations by the NACI for the 2019- 2020 seasonal influenza vaccine. Recommendations from the 2018 Diabetes Canada clinical practice guidelines for influenza immunization in people with diabetes and an interactive case study.
Ashen Chetty [00:01:27] Influenza is not the same as a common cold. They are caused by different viruses. Symptoms of influenza include fever, headaches, muscle aches, pain that can present a severe. Weakness and extreme fatigue. Stuffy and runny nose. Chest discomfort and coughing can also be severe. Sneezing and sore throat are also present. In comparison, cold symptoms are usually milder than the flu symptoms. These symptoms include mild headache, aches and pains, some weakness, stuffy/runny nose, mild chest discomfort, sneezing and sore throat.
Ashen Chetty [00:02:15] Now think about your practice. Can you think of someone whose quality of life has been impacted by contracting influenza? Each year in Canada influenza causes an estimated twelve thousand two hundred hospital stays, approximately three thousand five hundred deaths. Complications of influenza include pneumonia and respiratory failure, worsening of chronic health conditions, which result in hospital stays and/or deaths. How influenza could impact a person with diabetes. The influenza virus can cause worsening of chronic medical problems and other multi system complications which may include encephalitis, myocarditis, myositis, and in rare cases, generalized sepsis with organ failure. Annual influenza immunization is recommended for people with diabetes. Diabetes increases the risk of morbidity from influenza. Influenza immunisation decreases hospitalisation rates by 40 percent in high risk groups. Vaccine hesitancy. Lack of awareness about the vaccine or influenza. And the severity of complications. Conflicting information on vaccines from online searches and media. Mistrust in the necessity of vaccines. Perceived risk of taking action and getting vaccinated. Lack of trust in effectiveness of vaccine and needle phobia. Tips for communicating with your patients about the influenza vaccination. First, encourage questions to determine patients beliefs or concerns about getting a vaccine. Listen to determine the source of the vaccine hesitancy. Ask permission to provide information about the vaccine to address their concern. Use clear language. People tend to understand frequency expressions like "1 in 3" and better visuals better than percentages to explain the benefits of vaccination.
Nadira Husein [00:04:36] Who is the NACI, the National Advisory Committee on Immunization provides the Public Health Agency of Canada with public health advice related to immunizations. Canadian vaccination recommendations 2019-2020. Influenza vaccine should be offered annually for those six months of age and older without contraindications to the vaccine. Focus should be placed especially on those at highest risk of influenza related complications. Anyone who is pregnant. Adults and children with chronic health conditions, including diabetes. Residents of nursing homes and other chronic care facilities. Adults 65 years of age and older. All children six to fifty nine months of age. Indigenous People. Diabetes Canada. 2018 Clinical Practice Guidelines, Chapter 19: Influenza Vaccinations. The recommendations for people with diabetes to be vaccinated are the same for the rest of the population. It is recommended that people with diabetes receive an annual influenza immunization. When to offer the vaccine. Vaccination before the onset of the influenza season as preferred. Seasonal influenza activity may start as early as November in the Northern Hemisphere. Vaccine may still be administered up until the end of the season. What strain is expected this year? Influenza is a respiratory infection caused primarily by influenza A and B viruses from Flu Watch Summary September 2019, influenza A continues to be the most common influenza virus circulating in Canada. Choice of influenza vaccines for adults. Healthy adults, 18 to 59 years of age, IIV3 or IIV4 should be used. Adults with chronic health conditions, IIV3 or IIV4 should be used. Adults 60 to 64 years of age, IIV3 or IIV4 should be used. Adults 65 years of age and older, IIV3 high dose should be used over IIV3 standard dose, IIV3 adjuvanted, and IIV4 standard dose may also be used. Canadian Community Health Survey 2015 to 2016. The most common reason given by Canadians for not getting a flu shot was that they did not think it was necessary. The next most common reason was that they were unsure of or did not believe in the benefits of the flu vaccination. What would you say to a patient who told you, "Last year I got the flu shot and I think it made me sick." Think about your answer to that question. Peter is a 66 year old male. Type 2 diabetes well controlled with A1C of six point seven percent. Other conditions include asthma. He walks outside daily, except on very hot or cold days due to breathing difficulties. Peter hasn't had an influenza vaccine for many years and states that exercise keeps him fit. He rarely gets sick, so he doesn't need a flu shot. Take a minute to write down what you would say to Peter. If Peter agrees to an influenza vaccine, which type would you recommend? A: IIV3 standard dose. B: IIV4 standard dose. C: IIV3 high dose. D: IIV3 or IIV4. E: Any of the above. As Peter is over 65, the recommendation would be C: IIV3 high dose.
Joanne Lewis [00:08:26] This concludes our webinar on influenza immunization for your patients with diabetes. If you have any questions, please email us at webinars@diabetes.ca. This webinar was made possible by a grant by Sanofi Pasteur. On behalf of Diabetes Canada, I would like to thank both our speakers and our sponsor and thank you, our audience for joining us.