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What's new with flu in 2021

While COVID-19 has been raging on for more than a year, the U.S. has not seen much of the flu. According to the CDC, flu activity has been at a record low, with deaths, cases and hospitalizations far lower than in previous years. Why is this? According to a recent Johns Hopkins article; this trend is thought to be attributed to higher flu vaccination rates, widespread use of respiratory etiquette (face masks, handwashing, physical distancing); schools/business holding virtual classes/meetings, and lower travel rates.1

However, there is concern that given how few people were exposed to flu strains in the 2020-2021 season, a large portion of the population may be without immunity to the coming year's strains. More than ever, it is extremely important that everyone get their flu shot this year.

Increasing vaccination rates of office staff

Providers and office staff are on the front line of preventing the spread of the flu virus, so it's important they get their shot. One way to remove perceived barriers is to communicate the importance of the flu vaccine:

  • Share the benefits of the flu vaccine
  • Let them know that the flu vaccine does not cause flu
  • Highlight influenza prevalence; use the 2019-2020 season as an example
  • If staff believe influenza is not serious, share hospitalization statistics; highlight symptoms and cost-associated
  • If they believe the influenza vaccine causes illness or side effects, note extensive research on vaccine benefits and address safety

Flu or COVID-19? How to tell

Since we're expecting an increase in flu prevalence this season and with COVID-19 still active in the community, it's important to be prepared to spot the similarities and differences between the two viruses:2

  • They are both respiratory viruses. Both cause very similar symptoms (with the unique pattern of COVID-19 sometimes causing change or loss of taste and/or smell)
  • The mechanism of spread. Both spread primarily through droplets released through sneezing, talking, or coughing, though the surface transfer is also possible
  • High-risk groups are similar and include older adults, pregnant people, and patients with pre-existing medical conditions
  • Complications are similar. Pneumonia, respiratory failure, cardiac injury, and multiple-organ failure can be caused by both

On the other hand flu and COVID-19 can present differently. Some of these include:

  • The onset of symptoms. Flu symptoms typically manifest 1-4 days after infection, whereas COVID-19 varies from 2-14 days after infection; most often symptoms appear within 5 days 
  • For certain age groups and patient populations, COVID-19 has shown to be more contagious than the flu
  • On rare occasions, school-aged children infected with COVID-19 can develop multisystem inflammatory syndrome in children (MISC)
  • In severe cases, those infected with COVID-19 have displayed widespread clotting in various body systems
  • Younger children are more at risk for serious illness from the flu than COVID-19

What types of flu vaccines are on the market?

There are three general types of flu vaccines: intranasal, multi-dose vials and pre-filled syringes. The multi-dose vial presentation contains preservatives by default while intranasal spray and pre-filled syringes are preservative-free.

There are also two general culture media: egg-based and cell/DNA-based. Until recently, poultry egg was the most prevalent and most cost-effective. An example of this is Afluria. For cell or recombinant DNA cultures, some show increased effectiveness. This is because the virus has no opportunity to interact with poultry eggs, which could reduce effectiveness. Examples of these are FluBlok and Flucelvax. Flu vaccines target two general populations, the general population and geriatric patients. The general population is defined as anyone from ages 6 months and up. Afluria, Fluarix/FluLaval, FluBlok, and Fluzone Quad all target the general population.

Flu vaccines that target the geriatric population focus on anyone above 65 years old. They are specially formatted for compromised immune systems and use either higher dose concentration or adjuvants to create a strong immune response.

Check out our flu vaccine portfolio >

Storage best practices for the flu vaccine

Handling flu vaccines in the office is a complicated task. Below are some dos and don'ts that can help you and your staff stay organized.


  • Overcommunicate with your flu vaccine provider as the date for vaccine delivery approaches
    • Our team of flu specialists has a refined system of contacting customers upon vaccine shipment, with a detailed description of arrival times
  • Designate a single individual, or a small group of employees, as designated "vaccine handlers" who will take receipt of vaccine from delivery professionals
  • Keep vaccines in a dedicated refrigerator - preferably, with a thermometer with an external display to visualize current temperature (per CDC)
  • Keep vaccines in the target maintenance temperature range of 36-46°F (per CDC)
  • Provide consistent organization model for vaccine storage (per CDC)
    • Separate bins or shelves for each vaccine
    • Stock according to the expiration date, beginning with batches closest to expiration
    • Keep in original, small boxes to prevent light exposure


  • Allow unspecified staff to sign for vaccine
  • Allow the received vaccine to stay in non-refrigerated areas longer than necessary

Policies & procedures before flu vaccine administration

Screen patients for contraindications and precautions before a vaccine is administered, even if the same vaccine was administered previously. A patient's health status or the recommendations for contraindications and precautions may have changed since the last dose was given.

Healthcare personnel should be prepared to provide comprehensive vaccine information to the patient and the patient's representative, such as the vaccine information statement, or VIS. VIS are produced by the CDC and are information sheets that explain the benefits and risks of a vaccine.

VIS must be given:

  • To anyone receiving a vaccine or to that person's parent or caregiver
  • Every time a dose of vaccine is administered, even if the patient has received that vaccine or VIS before
  • Before administering the vaccine to allow time for questions

Proper preparation is critical for maintaining the integrity of the vaccine during the transfer from the vial to the syringe. They should always use the aseptic technique and follow infection prevention guidelines when preparing vaccines.

Proper vaccine administration guidelines3 should be followed. Each vaccine has a recommended administration route and site. This information is included in the manufacturer's package insert for each vaccine. Deviation from the recommended route may reduce vaccine efficacy or increase local adverse reactions.

After the vaccine is administered, nurses should monitor the patients for side effects such as injection site pain, fever, or fussiness. Health care providers are required by law to record the vaccination administration and education in a patient's medical record. This record can be in electronic or paper form.

Antiviral treatment for the flu

When a resident is experiencing flu-like symptoms, they should be tested to confirm the flu. However, CDC recommends starting the antiviral as soon as possible and not wait for confirmation of the flu. Antivirals are best when started within the first two days of symptoms. If an outbreak is determined all residents in the facility should receive antiviral chemoprophylaxis as soon as a flu outbreak is determined. Antiviral treatments are important, but you should also have enough infection control supplies on hand in case of an outbreak. These supplies, including antiviral medications are available with McKesson Medical-Surgical. For more information about what's available to our customers, contact your account manager.

Treating the flu at correctional facilities

There are several ways to help keep the flu from spreading at correctional facilities, including:

  • Encourage all persons within the facility to cover their cough or sneeze with a tissue
  • Throw all tissues in the trash after use
  • Maintain good hand hygiene by washing with soap and water, or using an alcohol-based hand sanitizer, especially after coughing or sneezing
  • Avoid touching eyes, nose and mouth without cleaning hands

It's important to make the means for appropriate hand cleansing readily available within the facility, including intake areas where inmates are booked and processed, visitor entries and exits, visitation rooms, common areas, and staff-restricted areas, in addition to lavatories and food preparation and dining areas. The means for hand cleansing are ideally running water, soap, and hand drying machines or paper towels and wastebaskets; alternatively, except in lavatories and food preparation areas, alcohol-based hand sanitizers may be used.

Clean all common areas within the facility routinely and immediately, when visibly soiled, with the cleaning agents normally used in these areas. Eating utensils should be washed either in a dishwasher or by hand with water and soap. Cups and utensils should not be shared until after washing.

Respiratory hygiene/cough etiquette should be implemented beginning at the first point of contact with a potentially infected person to prevent the transmission of all respiratory tract infections in correctional settings.

About McKesson FluWise®

We're here to help answer your flu questions with McKesson FluWise®. With McKesson FluWise® you get a comprehensive, year-round program that gives you access to a large variety of professional flu products, promotional offers and support with our dedicated Flu Connection team. Our monthly e-newsletters are full of important market updates, trends and best practices for flu season. Plus you can access the McKesson Clinical ConnectionTM webinar series with key topics like flu prevention, hand hygiene and infection prevention. Learn more >




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Be advised that information contained herein is intended to serve as a useful reference for informational purposes only and is not complete clinical information. This information is intended for use only by competent healthcare professionals exercising judgment in providing care. McKesson cannot be held responsible for the continued currency of or for any errors or omissions in the information.