Receiving the influenza vaccine has always been important for patients with kidney disease, but the COVID-19 pandemic makes influenza vaccinations even more crucial now. Listen to this podcast, in which Mandy Tilton, DNP, MSN, MBA, RN, CNN, chief nursing officer for DaVita Kidney Care interviews Jeffrey Giullian, MD MBA, FASN, chief medical officer for DaVita on why influenza vaccination is so crucial and whom he recommends be vaccinated during the pandemic. Dr. Giullian and Mandy also dispel some myths about the flu vaccine, state which form of the vaccine is most effective, discuss the benefits and safety concerns of getting vaccinated during spikes of COVID-19 prevalence in patients’ communities and provide guidance for clinicians in speaking with patients about influenza vaccination.

Podcast Transcript:

Mandy Tilton, DNP, MSN, RN (00:44): Hello and welcome to the DaVita Medical Insight Podcast. My name is Mandy Tilton and I have the honor of being the chief nursing officer for DaVita Kidney Care. I'm excited today to be joined on the phone with Dr. Jeffrey Guillian, who is our chief medical officer for DaVita, and today we will discuss the importance of influenza vaccination during the COVID-19 pandemic. Thank you for joining us, Dr. G.

Dr. Jeffrey Guillian (01:12): Hey Mandy, I'm glad to be able to speak with you on such an important and timely topic.

Mandy Tilton, DNP, MSN, RN (01:18): Timely it is. Receiving the influenza vaccine has always been important, but why does the COVID-19 pandemic make it even more crucial now?

Dr. Jeffrey Guillian (01:29): Well, Mandy, as I'm sure you can imagine, the flu season is going to be particularly complicated this year given the similarities in symptoms between influenza virus and COVID. And more than any other year, it's really important that all patients and teammates get vaccinated for the flu. Last season, unfortunately, less than half of all Americans got a flu vaccine and at least 410,000 people were hospitalized.

Dr. Jeffrey Guillian (01:54): And remember, that although we don't yet have a vaccine for COVID, we do have a vaccine for the flu. And by getting the flu vaccine, you are also helping to protect the people around you. And this is something known as herd immunity. If the majority of the population is vaccinated against the flu, it then reduces the entire community's risk, particularly for vulnerable patients. And preventing the flu supports good stewardship of resources. Even if your illness doesn't require a hospitalization, it helps avoid visits to the doctor, where you might go if you want to confirm that you actually do have the flu.

Mandy Tilton, DNP, MSN, RN (02:31): And knowing all of this, who do you think should be recommended to obtain influenza vaccination during the COVID-19 pandemic?

Dr. Jeffrey Guillian (02:41): Well, annual flu vaccine is recommended for everyone six months of age or older, so that's certainly all of us listening, except for rare exception, because it is an effective way to decrease the flu illness, decrease hospitalizations, and certainly to decrease deaths. During the COVID-19 pandemic, reducing the overall burden of respiratory illness is an important way to protect vulnerable populations at risk for severe illnesses, and it protects the health care system, and it protects critical infrastructure.

Dr. Jeffrey Guillian (03:12): And I want to highlight one vulnerable population, and that's obviously our patients, those with kidney disease. This group of individuals is at high risk for both severe COVID and severe flu. Clinicians should use every opportunity during the influenza vaccination season to administer influenza vaccines to every eligible person. And time is of the essence. It takes around two weeks after the vaccination to achieve immunity, so don't wait until your friend or your neighbor tells you that they've got the flu. Get vaccinated now.

Dr. Jeffrey Guillian (03:45): And that brings up an important point. I have certainly heard some people say they are planning on getting the flu vaccine this year because they're already wearing a mask. Now, Mandy, what is your suggested guidance for clinicians who are approached with this thought, by either their patients or their colleagues?

Mandy Tilton, DNP, MSN, RN (04:01): Well, that is an important thing to cover. A mask is great and it is a really important barrier for infections, but it's certainly not perfect for stopping the spread of flu. I would encourage us to think about it this way. When we get into cars, we put on seatbelt. I'm guessing most of us all do that even though our car may have safety features like airbags, but we want to keep ourselves as safe as possible. And while the airbags are great and helpful, combined with the seatbelt, they're even better. The same is really true when we think about fighting the flu. Masks are great. In this case, they're your airbags. The vaccine, however, is your seatbelt.

Mandy Tilton, DNP, MSN, RN (04:47): And while we're on the subject of dispelling this, can you help us answer a question that many of us are hearing from patients and others? And that question is, can I get the flu from the flu shot?

Dr. Jeffrey Guillian (05:02): No, you cannot. You absolutely cannot get influenza from the flu shot. You can get a sore arm, and trust me, I just got my flu shot and my arm was sore. And you can get some achiness, which is proof that your immune system is waking up and becoming activated, but you cannot get the influenza virus itself. Real influenza is a life-threatening viral infection.

Dr. Jeffrey Guillian (05:25): Help me, Mandy, if individuals do want to get the flu vaccine, what is your suggested guidance on receiving the nasal flu preparation in its place?

Mandy Tilton, DNP, MSN, RN (05:36): The injectable form of the vaccine has proven to be more effective, but even the nasal option is more effective against influenza than receiving no vaccine at all. It's important to remember though, that the nasal spray is not for everyone, particularly those with a compromised immune system. If you or a patient are interested in the nasal spray vaccine, please do first discuss this with your physician.

Mandy Tilton, DNP, MSN, RN (06:06): Dr. G, can you help provide some insight on whether the influenza vaccine will protect individuals against COVID-19?

Dr. Jeffrey Guillian (06:16): Well, sure, Mandy. I think it's important to remember that getting an influenza vaccine will not protect against COVID-19 directly; however, influenza vaccination has many other important benefits. Influenza vaccines have been shown to reduce the risk of getting the influenza virus and the illness, and hence hospitalizations and deaths. And getting an influenza vaccine this fall will be more important than ever, not only to reduce your risk from the flu, but also to help conserve potentially scarce healthcare resources as we discussed earlier. Many intensive care units are already full with people with COVID.

Dr. Jeffrey Guillian (06:52): Now, Mandy, how would you suggest clinicians respond to patients who wonder if it's safe to get an influenza vaccine if COVID-19 is spreading in their community?

Mandy Tilton, DNP, MSN, RN (07:01): Well, as clinicians, we can remind patients to practice everyday preventative actions and follow CDC recommendations for things like running essential errands. We can tell patients to ask their doctors, pharmacists, or health departments whether they are following the CDC's vaccination pandemic guidance. And any vaccination location following CDC's guidance should be a safe place for them to obtain their influenza vaccination.

Mandy Tilton, DNP, MSN, RN (07:36): I think we've covered a lot, but do you have any additional guidance for clinicians as they speak with patients about the influenza vaccine?

Dr. Jeffrey Guillian (07:45): Absolutely. Please remember, people call lots of bad colds the flu, and this is unfortunate and it's not accurate. The real influenza A and B viruses can be life-threatening and make you feel much, much worse than a bad cold. The flu vaccine doesn't stop you from getting a cold, even a bad one, it does, however significantly reduce the risk that you or your patients or your loved ones will get the actual flu, and that, that might just save a life.

Mandy Tilton, DNP, MSN, RN (08:18): Well, Dr. G, thank you for joining me and discussing the importance of influenza vaccination during this ongoing COVID-19 pandemic.

Dr. Jeffrey Guillian (08:28): Well, thanks for having me, Mandy. I appreciate you having this opportunity.

Mandy Tilton, DNP, MSN, RN (08:32): And listeners, thank you all for tuning in and be sure to check out other DaVita Medical Insights episodes for more kidney care educational podcasts. You can also find additional kidney care thoughts, leadership and industry news by following @DaVitaDoc on Twitter.