Healthcare Associate Influenza Vaccination Policy Frequently Asked Questions

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1 Healthcare Associate Influenza Vaccination Policy Frequently Asked Questions FLU VACCINE PROGRAM Q1: What are the dates for the flu vaccine? A: Vaccination for all Associates and physicians for Columbia St. Mary s and Madison Medical will start Monday, October 6 through Friday, November 7, Q2: What are the changes if any this year? A: There will be two exemptions this year, medical and religious. Details regarding how to apply for these exemptions can be found on the CSM Associate Health & Wellness website under the Influenza tab. Completed forms should be submitted to the CSM Associate Health & Wellness Department by Friday, October 24, Associates will be notified by Friday, October 31, 2014 if their exemption has been approved. For Associates who do not have access to the website, the CSM Associate Health & Wellness Department will fax or the form to the Associate. Q3: What will happen if I refuse to be vaccinated? A: If you choose not to be vaccinated, you will be expected to wear a mask from Friday, November 7, 2014 through Tuesday, March 31, Q4: Are there changes to the mask policy? A: Mask must be worn as follows: Mask for all ambulatory, clinical and inpatient areas including ED and Urgent Care; Mask for all other areas within three (3) feet of direct patient care, such as Registration; and _ Please do not draw on and/or put stickers on the mask. You will be required to re-mask, if you do so.

2 VACCINE SAFETY AND EFFECTIVENESS Q5: Is the vaccine really safe for me to receive? A: The same process to produce and test the vaccine has been used for decades, and is repeated year after year. There is a small risk associated with any vaccination. We need to consider the risk/benefit and determine if the minimal risk outweighs the risk of doing nothing and potentially causing personal illness and possibly life-threatening illness to our patients. The degree of risk is similar to that of TB testing and the rubella vaccination already required for many healthcare providers. Other Systems that have implemented similar policies have not seen an increase in negative vaccine-related incidents. Q6: Is the vaccine really effective for this year s influenza strains? A: Seasonal flu vaccines are designed to protect against infection and illness caused by the flu viruses research indicates will be most common this season. (Note: for the flu season, some seasonal flu vaccines will be formulated to protect against four flu viruses. These vaccines are called quadrivalent flu vaccines.) Flu vaccines will NOT protect against infection and illness caused by other viruses that can also cause flu-like symptoms. There are many other viruses besides flu viruses that can result in flu-like illness (also known as influenzalike illness or ILI ) that spread during the flu season. This season s flu vaccine is expected to have a similar safety profile as past seasonal flu vaccines. Over the years, hundreds of millions of Americans have safely received seasonal flu vaccines. The most common side effects are soreness, redness, tenderness or swelling where the flu shot was given and nasal congestion after the flu vaccine nasal spray. Q7: Can t the influenza vaccine actually give me the flu? A: Neither the injectable (inactivated) vaccine nor the live attenuated (nasal spray) vaccine can cause influenza. The injectable influenza vaccine contains only killed viruses and cannot cause influenza disease, while the nasal spray vaccine contains live attenuated (weakened) viruses that at worst can only produce mild symptoms similar to a cold. Any vaccination can be associated with short-term fever of less than 101 degrees and aches at the injection site lasting less than 24 hours. These nuisance-type symptoms are likely caused by your body s response to a foreign presence. Any experience of the flu is coincidence and most likely the result of whatever is circulating during the season when you are vaccinated because the vaccine takes about two weeks to become effective. QUALIFYING FOR AN EXEMPTION Q8: What medical conditions will be accepted for a medical exemption? A: Per the policy, documentation of: Serious adverse reaction to previous influenza vaccine Significant allergy to eggs (anaphylactic or systemic reaction). Note: patients with less severe egg allergies CAN receive the vaccine since the amount of egg protein is minimal in modern vaccines.

3 History of Guillain-Barré Syndrome All Associates who are unable to receive the vaccine will be required to wear a mask in ambulatory, clinical and inpatient areas including ED and Urgent Care, as well as other areas within three (3) feet of direct care, such as Registration. Q9: Are there any other exemptions that will be accepted? A: You can complete a Religious exemption. Signing this form will result in your wearing a mask from Friday, November 7, 2014 through Tuesday, March 31, All Associates who are unable to receive the vaccine will be required to wear a mask if you were in ambulatory, clinical and inpatient areas including ED and Urgent Care, as well as other areas within three (3) feet of direct patient care, such as Registration. EXEMPTION PROCESS Q10: When do I need to get the exemption forms into CSM Associate Health & Wellness? A: Exemption forms must be sent to CSM Associate Health & Wellness by Friday, October 24, Associates will be notified by Friday, October 31, 2014, if their exemption is approved. Q11: What if I do not have a doctor who can complete my medical exemption request form? A: The form requires an appropriate signature to certify the information submitted. Q12: Can an employee health nurse from CSM Associate Health & Wellness sign the medical exemption form? A: No, this form must be signed by a medical professional who provides your routine medical care. Q13: What if I miss the Friday, October 24, 2014 deadline to apply for an exemption? A: Unless you have developed a new condition since the Friday, October 24, 2014 deadline, forms will not be accepted after Friday, October 24, Q14: Will my manager know about my request for an exemption? A: Managers will have access to information that indicates who from their team has been vaccinated, who has submitted a request for an exemption, and the status of each exemption request. The manager will not have access to the medical nature of the request, which is protected by HIPAA. Q15: What if my request is denied? A: You will have until Friday, November 7, 2014 to receive the vaccination. Q16: Is there an appeal process? A: Unless there is new information that had not previously been reviewed, there is no appeal process.

4 VACCINATION DEADLINE Q17: By what date must I be vaccinated? A: You have until Friday, November 7, 2014 to receive the vaccination. Q18: What are the dates and times of associate flu vaccine clinics? A: Click here for a listing of flu clinic dates and times, which are located under the Influenza tab on the CSM Associate Health & Wellness content on the CSM Intranet. Q19: What if I receive a flu vaccine somewhere else? A: Vaccinations given through CSM Associate Health & Wellness will automatically be tracked. If you receive the vaccination elsewhere, proper documentation (consent form), including vaccine lot number and the signature of the person administering the vaccine, must be submitted to CSM Associate Health & Wellness Department by Friday, November 7, Q20: What if I am on a leave of absence and will not return until after Friday, November 7, 2014? A: Associates who are on a leave of absence during the vaccination period will be required to receive an influenza vaccination before they will be allowed to return to work or submit a form applying for an exemption. The vaccine may be received from the CSM Associate Health & Wellness Department, prior to the return to work or documentation of having received the vaccine elsewhere must be submitted to the CSM Associate Health & Wellness Department, prior to the Associate s return to work. Q21: What if there is a shortage of vaccine? A: In the event of a shortage of vaccines, Associates will receive additional instruction as to the distribution of the vaccine to ensure our most vulnerable patients are protected. Q22: If I refuse to be vaccinated, will I be terminated? A: If you choose not to be vaccinated by Friday, November 7, 2014, you will need to wear a mask from Friday, November 7, 2014 through Tuesday, March 31, Q23: What will happen if I refuse to wear a mask? A: If you choose not to wear a mask, CSM will consider you to be voluntarily terminating your employment relationship with Columbia St. Mary s. Q24: Will CSM keep data regarding Associate absenteeism during the flu season? A: No, Columbia St. Mary s has a no-fault attendance policy, so we do not track the reason for individual absences. WHO IS INCLUDED Q25: Are physicians included in this policy? A: Yes, physicians and all healthcare professionals who have clinical privileges with Columbia St.

5 Mary s are covered by this policy. Q26: Who else is covered by this policy? A: In addition to physicians and all healthcare professionals, Associates who work in buildings where they could come into contact with patients are covered by this policy. Also, all vendors, students, contractors and volunteers are covered by this policy. Q27: What about new hires? A: This policy will be integrated into the new hire process just like any other pre-employment requirement. VACCINATION PROGRAM MASKING Q28: Does everyone at CSM have to wear a mask? A: No, just people who have NOT been vaccinated against flu and have an approved exemption. Q29: We don't keep masks on hand in my department or work area. Where do I get one? A: Leaders will be responsible for ordering droplet masks (i.e., surgical masks) for their locations. Additional information will be made available to leaders regarding the proper ordering procedures. Note: These are not N95 masks. Q30: What if a patient asks me why I'm wearing a mask? A: We expect our Associates to be truthful with our patients if asked about our compliance requirement. Our requirement is intended to prevent transmission of the flu from unvaccinated Associates to patients. A mask is a form of personal protection, like wearing gloves. It protects the Associate and patient. Here's a response example: "I am wearing a mask for your safety. Q31: Could our patients become alarmed by associates wearing masks around them? A: This is an opportunity to raise awareness and educate our patients about our compliance requirement and our ongoing commitment to patient safety during the flu season. This measure is about putting patients first, and is intended to protect patients and Associates from infection. Q32: Will I be required to wear a mask at all times? A: You are required to wear a mask during the entire work day as follows: - Mask for all ambulatory, clinical and inpatient areas including ED and Urgent Care; - Mask for all other areas within three (3) feet of direct patient care, such as Registration; and - Please do not draw on and/or put stickers on the mask. You will be required to remask, if you do so. Q33: If there is skin breakdown from wearing the mask, will CSM pay for treatment? A: Associates will need to file a claim with Sedgwick, our Worker s Compensation administrator, for consideration. If the claim is denied, then there would not be any payment for treatment.

6 FOR MORE INFORMATION: Q34: Where can I go for more information about the influenza vaccine? A: CSM Associate Health & Wellness Department, the CSM Associate Health & Wellness website, and the CDC website. Q35: Who do I contact if I have questions about the policy? A: Clarissa Azcueta-Cox, Vice President Quality and Clinical Integration; and Beverly Hermann, Interim Director Infection Prevention, Associate Health & Wellness

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