The most wonderful time of the year (flu shots!)

[UkrainianTracksuit]

Hey,

I know this was discussed in depth (I think, at some point, or I am hallucinating) here last year or some time prior. As usual, nothing goes smoothly when you have the insides of an old person but the exterior and the birth certificate don't match.

This year, the province is offering high dose flu vaccines in pharmacies and publicly funded if you are over age 65. My infectious disease doc told me that I need the high dose vaccine and she sent memo off to my GP. However, I have a new GP and disputes this memo because I am under 65 so i don't need it as well as the fact that I may have an "unfavorable" immune response. That's the first I heard and my ID doctor deals specifically with tx, so I am kind of lost. Any of you hear anything similar?

I put this in the general Dialysis category as perhaps someone else under 65 has encountered this situation on dialysis as well? I don't care that I have to pay for it because I am not a senior citizen, but just do I keep impressing on the GP to do it? It has to be done at the GP office because there is no way I can convince the pharmacy (this year) to do one. Do the flu shot clinics even acknowledge medical notes if I brought one? Just throwing that thought out there too...

[MooseMom]

I get my flu shot either at the GP or at my local Walgreens (American chain of pharmacies, as you probably know).  Both sites have in my records that I am a transplant patient, so I'm given the high dose shot even though I am not 65 or over.  They both defer to my transplant team, so I admit to being surprised and confused that your GP would think s/he would know better than your ID doc.  That's really odd; it doesn't make medical sense.  Are you once again having to deal with a "know it all" doctor?

[kristina]

Hello UT and I do hope, you get your flu-jab a.s.a.p.
My GP allowed me to get my flu-vaccination because my kidney-transplant makes me a vulnerable person who is - because of all my heavy kidney-transplant-anti-rejection-medication etc. regarded to be not as "robust" as other people might be to get over an influenza.

Please ask your Transplant doctor or your GP etc. how to get your flu-jab a.s.a.p. and hopefully they understand that you certainly need it since your kidney-transplant. Perhaps it also might be a good idea to get a little note from any of your doctors if you wish to get it elsewhere? Or perhaps you can get your flu-jab at their clinic?

Is your husband recovering well?

I send you both my good-luck-wishes from Kristina.

[UkrainianTracksuit]

Hey again, I'll try to answer both of your kind replies.

This is the first week the shots are available here. I booked a flu shot for my husband easily and at the same time I asked if I could receive the high dose option at the same pharmacy. Nope. Just for senior citizens. Need to go to my GP office. So, GP is the only option.

I reached out to my GP again and they won't be in office until next week now.  Stupid long-weekend holiday in which Thanksgiving is cancelled anyway! So, I have to call back and then wait...again. MY GP is very young so sometimes I think that she likes to take control of situations. However, at the same time, I really do believe that despite the big flu shot campaign across the province, they are "rationing" them for 65 and over. Target groups for the high dose include vulnerable populations in long term care, hospitals and retirement homes, and then seniors due to COVID. If it is anything like the prior years here, they've run out of supply early. Last year, early on, they had to get another batch sent down. (For background info: https://www.cp24.com/news/ontario-has-ordered-5-1m-flu-vaccine-doses-ahead-of-second-wave-of-covid-19-that-may-come-at-us-harder-than-the-last-one-ford-1.5114628)

I will browbeat her over it so I am not concerned, but I am just annoyed that it means having to make an appointment and that means pushing my flu jab back even further. Anyway, since tx, I have been lucky not to catch anything, but when I was on dialysis, it was an annual (sometimes twice in a season) event to be hospitalized for influenza.

Kristina, my husband is doing much better, thanks to a lot of rest and finally a narcotic pain medication. He thinks that he will go back to work on Wednesday although he is still icing his back regularly and taking medications. We shall see. Naturally, with a back, one cannot rush such things or there never is truly a recovery but nagging pain.

[Simon Dog]

My transplant clinic insists on the high dose for me (age 62), but I was not due to see them for a couple of months.  Booked it with my GPs office - only extra step was the functionary who gave flu shots had to get approval from my GP.

It has to be done at the GP office because there is no way I can convince the pharmacy (this year) to do one. Do the flu shot clinics even acknowledge medical notes if I brought one? Just throwing that thought out there too...

Go to a pharmacy where they do not know you; pay cash and lie about your age.

[MooseMom]

Well, in this country, all I've been hearing since God was a boy is that when it comes to covid, tx patients are in the super duper high risk category along with the other populations you mentioned.  I suppose elderly people who live in long term care homes are at the top of that unenviable pyramid, mainly because the residents live close together.  So, while I understand wanting to "ration" the heavy duty flu vaccine for the elderly living in such places, I am not sure that it is medically sound to conclude that someone who is 65 and healthy is more vulnerable than someone younger who is immunosuppressed.

I've had the flu only once in my life, and I was so sick that week of illness has been seared into my immunosuppressed brain.  I am so sorry to hear that this is an illness that you've had to deal with on an annual basis back when you were on dialysis.  You know, I'd throw that little morsel of info into any conversation you have with your young GP, that you've been hospitalized with flu in the past and understand full well how deadly this disease can be.  If I were her and heard this, I'd lose sleep at night knowing I'd refused the super duper shot to you.

I can see how you'd be annoyed.  I'm annoyed after reading your posts.  Urgh.

[UkrainianTracksuit]

Go to a pharmacy where they do not know you; pay cash and lie about your age.

Yeah, there's like three decades between where I am and age 65 so that wouldn't fly. Even face masks don't hide much features and they don't match a senior citizen at all. Age also shows up on the consent form. DOB is also on the OHIP cards.

MM, I agree with you overall. It's complete frustration, to be honest. Now I know I just have one route and that's through my GP. We did get my shingles vaccine done after all and that's a "typical senior" thing too. It was frustrating before to get in to the office but with this "skeleton crew" pandemic operation it's worse. And have I complained about Thanksgiving yet? 

Flu shot will get done, I ensure it. Just kind of fed up with the whole "the government is making flu shots more accessible this year" by offering high dose in pharmacies ---but only in a certain demographic. Oh well, can't change it.

In the mean time, I'll go read WTF my doctor meant by unfavorable immune response.

[Simon Dog]

I suppose elderly people who live in long term care homes are at the top of that unenviable pyramid, mainly because the residents live close together.

The Holyoke, MA soldiers home lost 71 elderly patients to the virus in one facility.

My understanding is that high-doses is a quad dose.  I wonder if 4 conventional shots would be the same.

[UkrainianTracksuit]

 

Woes of the husband flu shot now too.

We were out the door this morning bright and early. Got to the pharmacy with a sign dated today that they were all out of flu shots. I said let's get the **** outta here as now my frustration is pretty high, but no, he wanted to go in and ask for clarification.  My husband likes to ask 50 bazillion questions, even if a line forms behind him. They couldn't give a definitive answer exactly when the next shipment would arrive but definitely by the end of next week. So is it a free for all again? And this is just the standard dose!

Upon which, all that info must be submitted again. I thought it was an issue just for out forgotten dumpster area but it's happening in the big city too. https://toronto.citynews.ca/2020/10/07/some-gta-pharmacies-report-running-out-of-flu-shots/

[Michael Murphy]

I am a cardiac and renal patient if any one wants to change or alter my renal prescriptions I call my nephrologist and let the doctors duke it out, same thing with my cardiac prescriptions.  I have good specialist doctors and I am not going to allow a intern or resident mess with my drugs.

[UkrainianTracksuit]

I am just beyond fed up at this point.

Last week, I rang my GP's office to be told to call on Tuesday. So, I called today only to be told they are out until the end of the month. That means no access to the high dose flu shot until the end of the month, at the earliest. I really, really want a new family doctor at this point but that means I get to sit on a list and wait.

I checked with public health. They are completely booked until the end of the month and once again "no high dose until age 65."

My husband finally got his today. It was on a whim that I told him to call to see if any arrived. They had a few dozen left so we rushed there. He was the first in line and then the trail of others steadily followed. Thank goodness we got there when we did.

I asked the pharmacist once again about high dose. She told me that they were all out in the first few days. As well, age restrictions. So, I said, if it is a quad-dose, why don't I just take up 4 of them? (Keep in mind, I was fed up and sarcastic and expected a big no, but I am ready to physically assault someone.) She said that was unfair to others.

My question then: what is the latest you have waited for your shot? At this rate, it definitely looks like I will be going into November.

At this rate, I am so angry that I just might forgo the whole damn thing because I just feel once November comes, more of a crap show.

[Simon Dog]

I am a cardiac and renal patient if any one wants to change or alter my renal prescriptions I call my nephrologist and let the doctors duke it out, same thing with my cardiac prescriptions.  I have good specialist doctors and I am not going to allow a intern or resident mess with my drugs.

When i was in the hospital for an unrelated mater well before my xplant i had to repeatedly fight off residents trying to prescribe transfusions to boost my HGB.  The big cahuna hemo guy (RIP) helped protect me when he was around, but it seems every time he was gone I'ld hear something like "you're getting a unit of while blood with dialysis".   I finally got tired of explaining why (amazin=g some Mds did not know!!!) and just said "I do not consent to transfusions".

[enginist]

You organ recipients may want to be vaccinated twice. 

https://pubmed.ncbi.nlm.nih.gov/28362949/

https://pubmed.ncbi.nlm.nih.gov/23103195/

[Riki]

I got mine on Wednesday at dialysis.  They are free here, and Public Health has said that anyone over the age of 6 months should get it.  The province ordered 77,000 more doses than they normally do, because they figured there would be more of a demand this year.

When it comes to the high dose shot, I've no idea if that's what we got or not.  I think i may ask on Monday, just for curiosity's sake

[UkrainianTracksuit]

So, it's official: no high dose flu shot for me. There are none in this town and no one knows when they'll come in.

My doctor is out of them and doesn't expect to get any more in. Missed my boat when they had them.

Public health told me that I could get one as long as they are in stock but once out, nope. And their next appointment is in December, so, ha, I doubt they'd have any. Their next best option was to send me to a "socially distanced" flu shot event at a big venue, where it is unknown again, where these mystical high doses are.

Pharmacies are out of the regular doses. As well, no bumping of lines when they do come in and everything is booked up.

At this rate, I could have been vaccinated with Sputnik V for covid. And at least when I actually paid for my health care in private clinics, I got what I wanted.

And OH! I just got off the phone with YET ANOTHER PHARMACY who told me that it is the discretion of the pharmacist whether they would give the high dose to me if they had it in stock. To which, I said, they would overrule the prescription by an infectious disease specialist? And she said yes.

[kristina]

Hello UT,
I am very sorry about this "sad saga" you have to go through and I keep my fingers crossed that some good luck comes along very soon for you.

Could it be a good idea to contact your transplant-team for help in this matter? After all, if anything happens to your new kidney just because it has been made too difficult for you to protect yourself and your new kidney well enough with a good flu-jab etc., I am sure your transplant-team could get alarmed and try and help you find a positive way forward??

Best wishes from Kristina.    Take good care.

[MooseMom]

I am really having a hard time wrapping my head around the idea that a pharmacist could overrule the judgment of an infectious disease specialist and/or a transplant consultant.  That's absurd.

What are you going to do?  Do you have any "good" choices at all?

[UkrainianTracksuit]

kristina: Thank you for your kind thoughts however my tx team is 500+ km away. They don’t really have a hand in the inner-workings of what happens locally. They did what they could — note and explanation.

MooseMom: ME TOO! This blows my mind! It is beyond absurd!

As she stated, “it explicitly states for 65 years and over.” “I understand your situation but...” At this point, I did lose my temper.

So what the hell? My specialist knows I’m not 65 and still wrote the note.

As well, there are a handful of academic journal articles that discuss high dose and solid organ transplant as a good thing, not defined by age.

So, let’s just be blunt and call it what it is: rationing. The government is rationing.

Ooooh, like when they get audited, how dare they have vaccinated an under 65 with precious, precious vaccine.

As for options, I can get a regular vaccine later next month. That’s it.

I actually said after today, I would move back to Russia. That’s how frustrated I am.

[Simon Dog]

Talk about rationing.... Tom Parker (apparently some sort of celebrity in England) had a Glioblastoma and was put on the waiting list for an MRI scan and got one 6 weeks later.  Here in the US, you get one the same day if urgent, but if not, you might have to wait a couple of days for insurance approval.   I needed one for a hip problem and it took 3 days between the screening X-Ray and approval for the scan that then happened immediately.   As to "high dose" - I could drive 20 miles to my transplant clinic or a bit under 5 to my primary care MD for the shot - much easier than trying to communicate MD approval to the local pharmacist.   Haven't seen anything in the news about a shortage here. 

[UkrainianTracksuit]

Talk about rationing.... Tom Parker (apparently some sort of celebrity in England) had a Glioblastoma and was put on the waiting list for an MRI scan and got one 6 weeks later.  Here in the US, you get one the same day if urgent, but if not, you might have to wait a couple of days for insurance approval.   I needed one for a hip problem and it took 3 days between the screening X-Ray and approval for the scan that then happened immediately.   As to "high dose" - I could drive 20 miles to my transplant clinic or a bit under 5 to my primary care MD for the shot - much easier than trying to communicate MD approval to the local pharmacist.   Haven't seen anything in the news about a shortage here.

Please explain how this reply is helpful in any context?

In your quest for sarcastic and sense of superiority reactions to many of my posts, this is getting old.

[kristina]

kristina: Thank you for your kind thoughts however my tx team is 500+ km away. They don’t really have a hand in the inner-workings of what happens locally. They did what they could — note and explanation.

MooseMom: ME TOO! This blows my mind! It is beyond absurd!

As she stated, “it explicitly states for 65 years and over.” “I understand your situation but...” At this point, I did lose my temper.

So what the hell? My specialist knows I’m not 65 and still wrote the note.

As well, there are a handful of academic journal articles that discuss high dose and solid organ transplant as a good thing, not defined by age.

So, let’s just be blunt and call it what it is: rationing. The government is rationing.

Ooooh, like when they get audited, how dare they have vaccinated an under 65 with precious, precious vaccine.

As for options, I can get a regular vaccine later next month. That’s it.

I actually said after today, I would move back to Russia. That’s how frustrated I am.

Hello UT, your story sounds totally absurd and reminds me of some of the "Robots in Human Clothes" I had the misfortune to come across as well these days...
... Unfortunately it seems "they" have found their way into the medical world and that is very unfortunate for people like us. "They" only seem to know their rules and regulations with which they feel "at home" and which they have studied "by heart" (if there is any ...) and when I had the misfortune to come across them, there was nothing I could do to make them logically follow my thought-process and understand, because of the illogical rule-book they know so well ... and I must admit, I nearly lost "it" as well ... "Robots" with such a "rule-obeying-stand" are unfortunately without any detectable human feelings and are often not able to understand where the likes of us come from and I really can't imagine where "they" actually come from ...

I feel very sorry for your unfortunate experience and send you my best wishes for better luck from Kristina.