Nursing Practice

Frequently Asked Questions: Mandatory Flu Vaccination in New York

Vaccine Effects and Side Effects | Prevention and Control | For more information

Does the regulation require me to get both the regular flu shot and the HIN1 vaccine?

The regulation specifically requires the seasonal flu vaccine, but will also cover the H1N1 vaccine when it is available. Even if they receive both vaccines, nurses and other healthcare workers must maintain strict infection prevention measures as well.

How many injections will I need?

The seasonal flu vaccine is available now. As of Sept. 15, the H1N1 vaccine had been licensed and was expected to be available by mid-October. According to the most recent information from the Centers for Disease Control and Prevention, the H1N1 vaccine will be given in one injection.

Can the seasonal vaccine and the H1N1 vaccine be given at the same time?

When both vaccines are available, they may be administered on the same day.

What will happen if I choose not to get the flu vaccine?

According to the regulation, healthcare facilities will be fined if they cannot demonstrate that all workers who come in contact with patients have been vaccinated. In effect, flu immunizations are a condition of employment and employees can be terminated if they refuse to comply.

I am opposed to immunizations for religious reasons. What can I do?

Employees cannot be exempted from the vaccination requirement for anything but medical contraindications as certified by a physician or nurse practitioner.

Why are nurses and other workers being forced to get flu shots?

The DOH maintains that this regulation will reduce the likelihood that patients will contract the flu from infected healthcare personnel. Healthcare workers are more likely to be exposed to the flu than the general population. In addition, a vaccinated healthcare workforce could mean lower absenteeism due to sick days.

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Vaccine Effects and Side Effects

Does being immunized guarantee that I won’t get the flu?

No. Although the vaccine is usually effective, it will not be effective if it is poorly matched to the strain of flu that is circulating through the population. The vaccine constantly mutates, so people must be vaccinated every year. That’s why it’s possible for you to get the flu even if you’re vaccinated.

What are the contraindications of the vaccine?

The vaccine is contraindicated for individuals who have had a severe allergic reaction to previous influenza vaccines, eggs, or thimerosol. It also is not recommended for people who have previously had GBS. Persons with moderate-to-severe acute febrile illness usually should not be vaccinated until their symptoms have abated. Consult with your physician or nurse practitioner if you are concerned about whether you should receive the flu vaccine.

How is medical contraindication reported to the state?

The New York State Department of Health has created a form for physicians, nurse practitioners, physician assistants, nurse midwives, and certified midwives to use to certify that a person should be exempt from the vaccine mandate.

Are there side effects from the influenza vaccine?

Almost all people who receive influenza vaccine have no serious side effects. Normal reactions to the trivalent inactivated influenza vaccine (TIV) flu shot, which generally occur within two days, can include soreness, redness, irritation, or swelling at the injection site; low-grade fever; and muscle aches.

In children, side effects from attenuated influenza vaccine (LAIV) nasal spray can include runny nose, wheezing, headache, vomiting, muscle aches, and fever. In adults, side effects from LAIV can include runny nose, headache, sore throat, and cough.

What are serious adverse reactions to the vaccine?

More serious adverse reactions include high fever; weakness; behavioral changes; and difficulty breathing, hoarseness or wheezing, hives, paleness, weakness, a rapid heartbeat, or dizziness. If you experience a serious adverse reaction:

What does filing a VAERS form do?

Reporting serious reactions, even if you’re not sure whether the vaccine caused them, adds to the databases available to researchers, the Centers for Disease Control and Prevention, and the Food and Drug Administration. This provides information about:

Can I get the flu from the flu vaccine?

No. The flu shot does not contain a live virus and cannot cause infection. The nasal spray contains a live virus that is attenuated (weakened) and cannot cause the flu.

What if I’m pregnant or planning to become pregnant?

It is recommended that pregnant women receive the TIV flu shot without preservatives rather than the LAIV nasal spray. Consult your physician or nurse practitioner if you are concerned about the effects of the vaccine on you or your unborn child. Vaccination is recommended for a pregnant woman because she is at higher risk for complications if she gets influenza.

Who else should not be given the LAIV (FluMist®) nasal spray?

I am breastfeeding and I’m concerned about the effect of the vaccine on my baby.

Breastfeeding is not a contraindication for the flu vaccine.

As a nurse, how should I protect myself when giving LAIV?

Universal precautions should always be followed when giving immunizations and medications. People may experience sneeze or cough when receiving LAIV, so use precautions to prevent accidental or excessive exposure to the vaccine.

Can I be compensated if I’m injured by a flu vaccination?

As of July 1, 2005, people who think that they have been injured by the flu shot can file a claim for compensation through the National Vaccine Injury Compensation Program (VICP). This is a federal program operated by the Health Resources and Services Administration (HRSA). VICP helps pay for the care of individuals who have had serious reactions to a vaccine covered by the VICP. A petition must be filed with VICP to start a claim for compensation. For more information call 800.338.2382, or visit HRSA online.

Prevention and Control

Is the H1N1 flu different from the seasonal flu?

Seasonal flu is a contagious respiratory illness that is most widespread during the winter and early spring. It is estimated that an average of 36,000 people die each year from flu complications, most of them 65 years or older. The novel H1N1 virus is a new strain that is being seen more frequently in children and young adults between the ages of 6 months and 24 years. The original outbreak of H1N1 in the spring of 2009 was relatively mild; it could cause more severe illness during the 2009-2010 flu season.

Symptoms of seasonal flu include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. H1N1 flu has the same symptoms, but may also include vomiting and diarrhea.

How can I protect myself from getting H1N1 flu?

As with the seasonal flu, wash your hands frequently, use sanitizing gel, and stay healthy by eating well, exercising and getting plenty of rest to help boost your immunity. Avoid touching your eyes, nose or mouth to minimize the entry of viruses and bacteria into your body.

If you are working in a healthcare setting with patients with suspected or confirmed influenza, you should use a fit-tested N95 respirator that will prevent you from breathing in aerosolized virus particles.

How long does the virus survive on surfaces?

The influenza virus can remain alive and virulent 2 to 8 hours after being deposited on surfaces such as patient charts, counter tops, or grocery cart handles.

What should I do if I think I have the flu?

First of all, stay home. If you have a fever, take antipyretics to keep your fever down, drink ample amounts of fluids, and get plenty of rest. It is not necessary to go to the emergency department unless you have difficulty breathing or shortness of breath, chest pain, confusion, severe or persistent vomiting, sudden dizziness, or your symptoms improve but then return with fever or worse cough.

How long will I be infectious?

You can infect others one day prior to onset of symptoms and 5 to 7 days after the first symptoms appeared. It is recommended that you stay home from work or school one week after your first symptoms appeared or 24 hours after symptoms are completely gone.

Do antiviral medications work against H1N1 flu?

Two prescription medications are used to treat the flu: oseltamivir (Tamiflu®) and zanamivir (Relenza®). If the novel H1N1 flu becomes widespread, antiviral drugs may be in short supply. In that case, the drugs may be given first to people who have been hospitalized or are at high risk of severe illness from flu. The drugs work best if given within two days of onset, but may be given later if illness is severe or for those at a high risk for complications.

Antiviral drugs are not recommended as a preventive measure, due to the high probability that patients will develop resistance to antiviral medications.

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