The Ads Say ‘Get Your Flu Shot Today,’ But It May Be Wiser To Wait

HealthBeat Flu Shots Things to Know

(AP Photo/Darron Cummings, File)

The pharmacy chain pitches started in August: Come in and get your flu shot.

Convenience is touted. So are incentives: CVS offers a 20-percent-off shopping pass for everyone who gets a shot, while Walgreens donates toward international vaccination efforts.

The start of flu season is still weeks — if not months — away. Yet marketing of the vaccine has become an almost year-round effort, beginning when the shots become available in August and hyped as long as the supply lasts, often into April or May.

Not that long ago, most flu-shot campaigns started as the leaves began to turn in October. But the rise of retail medical clinics inside drug stores over the past decade — and state laws allowing pharmacists to give vaccinations — has stretched the flu-shot season.

The stores have figured out how “to deliver medical services in an on-demand way” which appeals to customers, particularly millennials, said Tom Charland, founder and CEO of Merchant Medicine, which tracks the walk-in clinic industry. “It’s a way to get people into the store to buy other things.”

But some experts say the marketing may be overtaking medical wisdom since it’s unclear how long the immunity imparted by the vaccine lasts, particularly in older people.

Federal health officials say it’s better to get the shot whenever you can. An early flu shot is better than no flu shot at all. But the science is mixed when it comes to how long a flu shot promoted and given during the waning days of summer will provide optimal protection, especially because flu season generally peaks in mid-winter or beyond. Experts are divided on how patients should respond to such offers.

“If you’re over 65, don’t get the flu vaccine in September. Or August. It’s a marketing scheme,” said Laura Haynes, an immunologist at the University of Connecticut Center on Aging.

That’s because a combination of factors makes it more difficult for the immune systems of people older than age 65 to respond to the vaccination in the first place. And its protective effects may wear off faster for this age group than it does for young people.

When is the best time to vaccinate? It’s a question even doctors have.

“Should I wait until October or November to vaccinate my elderly or medically frail patients?” That’s one of the queries on the website of the board that advises the Centers for Disease Control and Prevention on immunizations. The answer is that it is safe to make the shots available to all age groups when the vaccine becomes available, although it does include a caution.

The board says antibodies created by the vaccine decline in the months following vaccination “primarily affecting persons age 65 and older,” citing a study done during the 2011-2012 flu season. Still, while “delaying vaccination might permit greater immunity later in the season,” the CDC notes that “deferral could result in missed opportunities to vaccinate.”

How long will the immunity last?

“The data are very mixed,” said. John J. Treanor, a vaccine expert at the University of Rochester medical school. Some studies suggest vaccines lose some protectiveness during the course of a single flu season. Flu activity generally starts in the fall, but peaks in January or February and can run into the spring.

“So some might worry that if [they] got vaccinated very early and flu didn’t show up until very late, it might not work as well,” he said.

But other studies “show you still have protection from the shot you got last year if it’s a year when the strains didn’t change, Treanor said.

In any given flu season, vaccine effectiveness varies. One factor is how well the vaccines match the virus that is actually prevalent. Other factors influencing effectiveness include the age and general health of the recipient. In the overall population, the CDC says studies show vaccines can reduce the risk of flu by about 50 to 60 percent when the vaccines are well matched.

Health officials say it’s especially important to vaccinate children because they often spread the disease, are better able to develop antibodies from the vaccines and, if they don’t get sick, they won’t expose grandma and grandpa. While most people who get the flu recover, it is a serious disease responsible for many deaths each year, particularly among older adults and young children. Influenza’s intensity varies annually, with the CDC saying deaths associated with the flu have ranged from about 3,300 a year to 49,000 during the past 31 seasons.

To develop vaccines, manufacturers and scientists study what’s circulating in the Southern Hemisphere during its winter, which is our summer. Then — based on that evidence — forecast what flu strains might circulate here to make vaccines that are generally delivered in late July.

For the upcoming season, the vaccines will include three or four strains, including two A strains, an H1N1 and an H3N2, as well as one or two B strains, according to the CDC. It recommends that everyone older than 6 months get vaccinated, unless they have health conditions that would prevent it.

The vaccines can’t give a person the flu because the virus is killed before it’s included in the shot. This year, the nasal vaccine is not recommended for use, as studies showed it was not effective during several of the past flu seasons.

But when to go?

“The ideal time is between Halloween and Thanksgiving,” said Haynes at UConn. “If you can’t wait and the only chance is to get it in September, then go ahead and get it. It’s best to get it early rather than not at all.”

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation.

Guess Who Was Born in 1918?

Physical Therapy, Home, Laconia, Meredith, Glford

Central New Hampshire VNA & Hospice will be entering it’s Centennial Year!!!  Please join us for our Centennial Celebration and 2016 Annual Meeting on September 28th at The Inn at Mill Falls Church Landing, Meredith, NH.  Cocktails and hors d’oeurves starting at 5:00pm, Welcoming remarks and A Year in Review at 5:45 then a presentation by Professor Molly Girard Dorsey of the University of New Hampshire, followed by a Buffet Dinner.

RSVP is required.  Please inform Brian Winslow at 603-524-8444 or you may register online by clicking here before September 21st.

Professor Dorsey will help us look back on the last 100 years with her presentation titled, “Major Events in Medicine and their Relationship with Community Healthcare.”  Molly Girard Dorsey is an associate professor of History and core faculty member in Justice Studies at the University of New Hampshire.  She teaches classes on the history of medicine, legal history, and war & society.  She has published a book on chemical warfare in World War I and is working on a project on the integration of civilian professionals, including nurses and doctors, into the modern American military.

The event is sponsored by:

Hospice, Homecare, Physical Therapy, Laconia, Meredith, Center Harbor, Moultonborough Therapy, VNA, Hospice, Healthcare, Laconia, Wolfeboro, Wakfield

How To Fight For Yourself At The Hospital — And Avoid Readmission

Everything initially went well with Barbara Charnes’ surgery to fix a troublesome ankle. But after leaving the hospital, the 83-year-old soon found herself in a bad way.

Dazed by a bad response to anesthesia, the Denver resident stopped eating and drinking. Within days, she was dangerously weak, almost entirely immobile and alarmingly apathetic.

“I didn’t see a way forward; I thought I was going to die, and I was OK with that,” Charnes remembered, thinking back to that awful time in the spring of 2015.

Her distraught husband didn’t know what to do until a long-time friend — a neurologist — insisted that Charnes return to the hospital.

That’s the kind of situation medical centers are trying hard to prevent. When hospitals readmit aging patients more often than average, they can face stiff government penalties.

But too often institutions don’t take the reality of seniors’ lives adequately into account, making it imperative that patients figure out how to advocate for themselves.

“People tell us over and over ‘I wasn’t at all prepared for what happened’ and ‘My needs weren’t anticipated,’” said Mary Naylor, director of the NewCourtland Center for Transitions and Health at the University of Pennsylvania.

It’s a mistake to rely on hospital staff to ensure that things go smoothly; medical centers’ interests (efficiency, opening up needed beds, maximizing payments, avoiding penalties) are not necessarily your interests (recovering as well as possible, remaining independent and easing the burden on caregivers).

Instead, you and a family member, friend or caregiver need to be prepared to ask plenty of questions and push for answers.

Here’s what doctors, health policy experts, geriatric care managers, older adults and caregivers recommend:

Start Planning Now

Planning for a transition home should begin as soon as you’re admitted to the hospital, advised Connie McKenzie, who runs Firstat RN Care Management Services in Fort Lauderdale, Fla. You may be too ill to do this, so have someone you trust ask your physician how long you’re likely to be hospitalized and whether you’ll be sent home or to rehabilitation afterward.

Ask if a physical therapist can evaluate you or your loved one at the hospital. Can you get out of bed by yourself? Walk across the room? Then discuss what difficulties might arise back home. Will you be able to handle your own bathroom needs? Get dressed? Climb stairs? What kind of assistance will you require?

Request a consultation with a nutritionist. What kinds of foods will and won’t you be able to eat? Does your diet need to change over the short term, or longer term?

Consider where you’ll go next. If you or your loved one is going to need rehabilitation, now is the time to start researching facilities. Ask a hospital social worker for advice or, if you can afford it, hire a geriatric care manager (now called aging life care professionals) to walk you through your options.

Before Being Discharged

Don’t wait to learn about the kind of care that will be required at home. Will a wound need to be dressed? A catheter need tending to? What’s the best way to do this? Have a nurse show you, step by step, and then let you practice in front of her — several times, if that’s what it takes.

Ann Williams watched a nurse give her 77-year-old mother a shot of Warfarin two years ago after being hospitalized for a dangerous blood clot. But when it was Williams’ turn to give the injection on her own, she panicked.

“I’m not a medical professional: I’ve only given allergy shots to my cats,” she said. Fortunately, Williams found a good instructional video on the internet and watched it over and over.

Make sure you ask your doctor to sit down and walk you through what will happen next. How soon might you or your loved one recover? What should you expect if things are going well? What should you do if things are going poorly? How will you know if a trip back to the hospital is necessary?

If the doctor or a nurse rushes you, don’t be afraid to say, “Please slow down and repeat that” or “Can you be more specific?” or “Can you explain that using simple language?” said Dr. Suzanne Mitchell, an assistant professor of family medicine at Boston University’s School of Medicine.

Getting Ready To Leave

Being discharged from a hospital can be overwhelming. Make sure you have someone with you to ask questions, take good notes and stand up for your interests — especially if you feel unprepared to leave the hospital in your current state, said Jullie Gray, a care manager with Aging Wisdom in Seattle.

This is the time to go over all the medications you’ll be taking at home, if you haven’t done so already. Bring in a complete list of all the prescriptions and over-the-counter medications you’ve been taking. You’ll want to have your physician or a pharmacist go over the entire list to make sure there aren’t duplicates or possibly dangerous interactions. Some hospitals are filling new prescriptions before patients go home; take advantage of this service if you can. Or get a list of nearby pharmacies that can fill medication orders.

Find out if equipment that’s been promised has been delivered. Will there be a hospital bed, a commode or a shower chair at home when you get there? How will you obtain other supplies that might be needed such as disposable gloves or adult diapers? A useful checklist can be found at Next Step in Care, a program of the United Hospital Fund.

Will home health care nurses be coming to offer a helping hand? If so, has that been scheduled — and when? How often will the nurses come, and for what period of time? What, exactly, will home health caregivers do and what other kinds of assistance will you need to arrange on your own? What will your insurance pay for?

Be sure to get contact information (phone numbers, cell phone numbers, email addresses) for the doctor who took care of you at the hospital, the person who arranged your discharge, a hospital social worker, the medical supply company and the home health agency. If something goes wrong, you’ll want to know who to contact.

Don’t leave without securing a copy of your medical records and asking the hospital to send those records to your primary care doctor.

Back At Home

Seeing your primary care doctor within two weeks should be a priority. “Even if a patient seems to be doing really well, having their doctor lay eyes on them is really important,” said Dr. Kerry Hildreth, an assistant professor of geriatrics at the University of Colorado School of Medicine.

When you call for an appointment, make sure you explain that you’ve just been in the hospital.

Adjust your expectations. Up to one-third of people over 70 and half of those over 80 leave the hospital with more disabilities than when they arrived. Sometimes, seniors suffer from anxiety and depression after a traumatic illness; sometimes, they’ll experience problems with memory and attention. Returning to normal may take time or a new normal may need to be established. A physical or occupational therapist can help, but you may have to ask the hospital or a home health agency to help arrange these visits. Often, they won’t offer.

It took a year for Barbara Charnes to stand up and begin walking after her ankle operation, which was followed by two unexpected hospitalizations and stints in rehabilitation. For all the physical difficulties, the anguish of feeling like she’d never recover her sense of herself as an independent person was most difficult.

“I felt that my life, as I had known it, had ended,” she said, “but gradually I found my way forward.”

We’re eager to hear from readers about questions you’d like answered, problems you’ve been having with your care and advice you need in dealing with the health care system. Visit khn.org/columnists to submit your requests or tips.

KHN’s coverage of late life and geriatric care is supported by The John A. Hartford Foundation.

Centennial Celebration and 2016 Annual Meeting

Insider September 16.inddJoin Central New Hampshire VNA & Hospice for our Centennial Celebration and 2016 Annual Meeting on September 28th at The Inn at Mill Falls Church Landing, Meredith, NH.  Cocktails and hors d’oeurves starting at 5:00pm, Welcoming remarks and A Year in Review at 5:45 then a presentation by Professor Molly Girard Dorsey of the University of New Hampshire, followed by a Buffet Dinner.

RSVP is required.  Please inform Brian Winslow at 603-524-8444 or you may register online by clicking here before September 21st.

Professor Dorsey will help us look back on the last 100 years with her presentation titled, “Major Events in Medicine and their Relationship with Community Healthcare.”  Molly Girard Dorsey is an associate professor of History and core faculty member in Justice Studies at the University of New Hampshire.  She teaches classes on the history of medicine, legal history, and war & society.  She has published a book on chemical warfare in World War I and is working on a project on the integration of civilian professionals, including nurses and doctors, into the modern American military.

The event is sponsored by:

Central New Hampshire VNA & Hospice Attains Highest “We Honor Veterans” status.

Central New Hampshire VNA & Hospice is a “We Honor Veterans” partner with the National Hospice and Palliative Care Organization in collaboration with the Department of Veteran Affairs.  Just recently Central New Hampshire VNA & Hospice has been recognized for attaining the highest “We Honor Veterans” partner status.

Over the past three years, the We Honor Veterans team at Central New Hampshire VNA & Hospice has worked diligently to promote a Veteran-centric culture in our community. By educating ourselves on how to best serve Veterans in our community, we have been able to educate others on the multi-faceted care of the Veteran population. Building strong working relationships with key VA resources to better provide access to benefits provided by the VA administration was a vital piece of this project. Outreach started in small groups within our organization and expanded to community groups and facilities. Spreading the knowledge of how to best serve our Veterans has been an eye opening experience as well as an honor.Meredith, Gilford, Laconia, Center Harbor, Moultonboro, Belmont

We are extremely proud of the Veteran certificate presentations that our Veteran Volunteers and other hospice team members present to acknowledge our Veteran patients who have given selflessly to our military in order to protect our country and its citizens. A certificate, pin and hand knitted red, white and blue throws and a much deserved salute are key components of these heartwarming presentations.

Wolfeboro’s Appeal Attracts Central New Hampshire VNA & Hospice House Tour Owner

Close to town, within easy walking distance to shops and restaurants and within driving distance of their grandchildren, the new owners of this 1850 in town farmhouse have made Wolfeboro their permanent residence. This is just one of four homes on this year’s Central New Hampshire VNA & Hospice House Tour to be held on Wednesday, July 13th from 10 to 4:00.  Tickets for the tour as well as an optional lunch ticket are now available at Black’s Paper and Gift Store at 8 South Main Street in Wolfeboro. The tour tickets are $40.00 and the luncheon tickets are $15.00. This year’s luncheon will be held at O Bistro at The Inn on Main.

Wolfeboro, Home & Garden Tour, Alton, Wakefield

1850 Era In-town Farmhouse Living Area

Over the past three years the owners of this home have transformed it into an exquisite, eclectic home filled with unique paintings and furnishings most of which was purchased while they traveled the globe. They have had a lot of experience renovating several residences over time but an old house was the first for both of them.  Much of the interior of the first floor was gutted. Walls were taken down, new wiring was installed throughout and several small rooms on the first floor were converted into what is now a living area, dining area and modern kitchen. There are beautiful dark wood floors throughout the living and dining area. The kitchen is now a modern bend of black and stainless appliances, white cabinets, modern lighting fixtures and a stunning stainless steel backsplash.

There are several unique pieces of object d’art found throughout the home including artwork by Canadian painter Charles Malinsky, Murano glass from Italy and an impressive dining room table and sideboard designed by Swede Schmidt for Mustache Flats furniture. There is a lovely sitting area at the back of the home which overlooks the back deck and yard beyond. A half staircase leads to what was originally an attached barn now converted into a spacious master bedroom with en suite with garage and storage area underneath. Additional guest bedrooms are located on the second floor of the home.

Dine Around raffle tickets will also be sold this year on Saturdays leading up to the tour. Look for house tour volunteers who will be selling tickets at one of the following locations – Hunter’s Shop n Save, Harvest Market or Blacks Paper and Gift Store.

For twenty-nine years this tour has continued its mission of supporting the financial needs of the Hospice program within Central New Hampshire VNA & Hospice. Over time the hospice program has grown from meeting the needs of a specific family to making the difference in the lives of many. For more information about the services provided by Central New Hampshire VNA & Hospice call 603-524-8444.

Elton John Tribute Band to Rock FOR LAKES REGION COMMUNITY SERVICES

One of America’s primo tribute bands, Yellow Brick Road – a Tribute to Elton John, will dominate the stage at the McEvoy Theater on the New Hampton School campus in a benefit for Lakes Region Community Services at 7:00PM on Saturday, June 18th. This high energy reenactment of everything you have ever seen or heard of Elton John’s legendary staging and music will come alive for you and your friends in this tribute to a living artist.

Meredith, Center Harbor, Moultonborough

The group’s leader, Gerald Brann, IS Elton John in vocal, performance and instrumental brilliance. Every detail of an actual Elton John concert is present: white piano, flamboyant tailor-made costumes, glasses and the huge range of songs. Honed to perfection and officially endorsed by the International Elton John Fan Club, this tribute band performs up and down the Eastern part of the United States, as well as performing in Las Vegas as part of the British Invasion show and with the Augusta Symphony before an audience of nearly one thousand people. Traditionally, tribute bands bring to life beloved music and musicians of the past and this rendering of Elton John’s music is famed as one of the best.

This is the fourth “We Care” concert organized by Temple B’nai Israel of Laconia in which the net ticket proceeds are donated to a local and deserving non-profit.  Event Chairperson Stu Needleman says, “We’ve sold out every show that we have organized due to the talent of our scouting team and its leader, Ken Goodman. On this occasion, the event will be held in a larger venue and as always, the ticket price includes high quality home baked refreshments and beverages. The music of Elton John appeals to everyone and every age group, and Yellow Brick Road will perform hits from Sir Elton’s huge body of work from rock that will move your body to ballads that will touch your heart. We know that the community will support this great cause, while having an amazing and fun evening.”

TBI is delighted to welcome back 2014 “We Care” recipient Lakes Region Community Services (LRCS) as the beneficiary of the net profits from this event. Lakes Region Community Services (www.lrcs.org), a community partner for over 40 years, offers comprehensive support and services to individuals with developmental disabilities and/or acquired brain disorders and their families. LRCS is a state designated Area Agency serving residents of Belknap and Southern Grafton counties, with offices in Laconia and Plymouth. The mission of LRCS is dedicated to the community by promoting independence, dignity and opportunity, and its comprehensive services and wide-ranging programs provide supports from birth throughout the lifespan. LRCS’ Family Resource Center of Central NH (FRC-CNH) is a community based center available to anyone seeking programs, resources, activities or supports designed to strengthen families. The FRC-CNH mission is to strengthen families and their communities by enhancing social connections and offering programs and services with a primary goal of strengthening adult capacities to improve child outcomes.

The McEvoy Theater at New Hampton School is located less than 5 minutes from Exit 23 off of Interstate 93 at 70 Main Street, New Hampton. Its central location will make it convenient for everyone in the Lakes Region and Central NH.

By purchasing a ticket ($27.50), you will enjoy great music, food and drink while supporting a local and deserving agency.  Complimentary delicious snacks and desserts can be enjoyed at 7 PM and the concert, with open seating, begins at 7:45PM.

To purchase tickets and for more information, visit www.tbinh.org. Questions may be directed to info@tbinh.org. For more information about the performer and some music samples: www.tributetoeltonjohn.com.

If you are not a member of the International Elton John Fan Club, you will want to be after your June 18th evening with the Yellow Brick Road-A Tribute to Elton John!