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The fact that there is a flu vaccine shortage in the nation doesn’t change Mary Oden’s view of the upcoming flu season. As the infection control operations director for Duke University Hospital, she knows that her message will be mostly the same as it was last year.

Wash your hands, and cover your mouth.

“Personal hand hygiene is going to be important this year because there may be fewer people around with the flu vaccination,” says Oden, who has survived 11 years of flu season at Duke. “But we’ve never had 100 percent vaccination rate among our employees, so it has always made sense to wash your hands a lot, to use tissues when you have to sneeze or cough, to keep your distance from people who have flu symptoms.” All these good habits can lessen the chances of you getting (or giving) the flu, which is spread by droplets sent out by coughing and sneezing.

Protecting Patients

While the flu is a major nuisance for many people, it can be much more serious for some patients. For this reason, Duke will direct its supply of vaccine to patients who are at high risk for complications from the flu or employees who care for high-risk patients.

A team of health care providers has been working to determine the most appropriate use for Duke’s limited supply. Duke will use approximately 85 percent of its vaccine for patients. The remaining vaccine will be offered to employees working in units that provide direct patient care for high-risk patients. Vaccinations for these groups will begin in early November.

Duke is continuing to work with local and regional providers and institutions as well as governmental officials to explore all options for securing more vaccine. “But regardless of how much vaccine we ultimately receive, we will be guided in the distribution of vaccine by our commitment to protect the health and safety of the patients in our health system,” says Victor J. Dzau, MD, chancellor for health affairs and president and CEO of Duke University Health System.

Duke has been encouraging health care workers with direct patient care responsibilities to take advantage of vaccine being offered through sources other than Duke, such as Blue Cross Blue Shield, local health departments, and vaccine clinics being held at local retail centers. Some of these places have vaccine because they ordered from Aventis, not Chiron. These two companies are the only two suppliers to the U.S. of flu vaccine, and on Oct. 5, Chiron’s supply was found to be contaminated and therefore is not allowed to be used.

On October 15, the North Carolina Division of Public Health determined that the guidelines put out by the Centers for Disease Control (CDC) about who should receive vaccinations have the force and effect of law. That means giving flu vaccine to non high-risk patients will be considered a misdemeanor in North Carolina.

According to CDC guidelines, these people are eligible to receive the vaccine in North Carolina:

• People 65 years of age and older
• Children ages 6 months to 23 months
• Adults and children 2 years of age and older with chronic lung or heart disorders including heart disease and asthma
• Pregnant women
• Adults and children 2 years of age and older with chronic metabolic diseases (including diabetes), kidney diseases, blood disorders (such as sickle cell anemia), or weakened immune systems, including persons with HIV/AIDS
• Children and teenagers, 6 months to 18 years of age, who take aspirin daily
• Residents of nursing homes and other chronic-care facilities
• Household members and out-of-home caregivers of infants under the age of 6 months (Children under the age of 6 months cannot be vaccinated.)
• Health care workers who provide direct, hands-on care to patients

Healthy people 2 to 64 years of age are asked to postpone or skip getting a flu shot this year so that available vaccine can go to protect those at greater risk for flu complications.