[MCOH-EH] [External] RE: Medical Center Occupational Health: At Home Flu Vaccine

[David S. Cockrum]

Thanks Laura. I guess I should have clarified – we do accept FluMist similar to how you do. In Employee Health for local employees, remote employees must have it observed and attested by a clinical professional. Either way, employees have to get it themselves through home order and bring it in. My goal is to make it available through the organization as an option to the shot for those who want it – with appropriate restrictions, of course.

From: MCOH-EH <mcoh-eh-bounces+david.s.cockrum=hitchcock.org at mylist.net> On Behalf Of RADKE, LAURA via MCOH-EH
Sent: Thursday, July 23, 2026 11:58 AM
To: MCOH-EH <mcoh-eh at mylist.net>
Cc: RADKE, LAURA <laura.radke at froedtert.com>
Subject: Re: [MCOH-EH] [External] RE: Medical Center Occupational Health: At Home Flu Vaccine **EXTERNAL**

We do have FluMist available for our employees. It is only available for administration in employee health and employees complete a screening tool which is sent to me for approval prior to dosing. We do not accept self-administered FluMist. 

We do have FluMist available for our employees.  It is only available for administration in employee health and employees complete a screening tool which is sent to me for approval prior to dosing.  We do not accept self-administered FluMist.  All doses must be given in employee health by one of our staff members for them to count for employees local to our system.

For remote workers, if approved by me, they can receive it at a retail pharmacy or from their physician and submit documentation  – we do not accept self administration documentation from remote workers, either.  We are currently working on possible removal of the influenza mandate from fully remote workers who do not enter our facilities or provide patient care.  I have an SBAR out to HR and OGC related to this, as legal has raised significant concerns about denying both medical and religious exemptions for remote workers based on “undue hardship” to the organization.

Laura L Radke, MD
Adjunct Assistant Professor of Medicine
Senior Medical Director, F&MCW Occupational Health Services
Phone: 262-253-8197 | Fax: 262-253-5152 Cell Phone: 414-530-0723
E-mail: laura.radke at froedtert.com<mailto:laura.radke at froedtert.com>
Froedtert & the Medical College of Wisconsin Workforce Health / North Hills Health Center
Building B First Floor
W129 N7055 Northfield Dr.
Menomonee Falls, WI 53051

From: MCOH-EH <mcoh-eh-bounces at mylist.net<mailto:mcoh-eh-bounces at mylist.net>> On Behalf Of Behrman, Amy via MCOH-EH
Sent: Thursday, July 23, 2026 9:01 AM
To: David S. Cockrum <David.S.Cockrum at hitchcock.org<mailto:David.S.Cockrum at hitchcock.org>>; MCOH-EH <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Cc: Behrman, Amy <behrman at pennmedicine.upenn.edu<mailto:behrman at pennmedicine.upenn.edu>>
Subject: Re: [MCOH-EH] [External] RE: Medical Center Occupational Health: At Home Flu Vaccine

Hi David and MCOH colleagues, I'm happy to share more details in hopes some may be useful: Similar to your institution, we have an employer requirement for annual influenza vaccination that includes remote employees. I don't think that will change this year. Onsite, we provide influenza vaccines t



Hi David and MCOH colleagues,

I'm happy to share more details in hopes some may be useful:


  *   Similar to your institution, we have an employer requirement for annual influenza vaccination that includes remote employees. I don't think that will change this year.

  *   Onsite, we provide influenza vaccines that are approved by the pharmacy antimicrobial committee and actually available for pharmacy purchase.  I attend those meetings and have been successful in advocating for a range of products to meet employee needs and preferences.  That generally includes a default conventional vaccine for most, high-dose for eligible employees who want it, and Flublok for eligible employees who want it.

  *   We'd like to be able to offer FluMist onsite for eligible needle-phobes, but have not been able to obtain from pharmacy for several (many) years.  It's been very difficult for employees to find it in local external pharmacies either.  Per the communication with AZ, I'm hopeful that'll change this year, both onsite and externally.

  *   We accept dated external documentation of any licensed influenza vaccine, including FluMist.

  *   Per our Infection Control chief, FluMist has to be documented by a licensed individual who either administers it or witnesses self-administration.  I don't think that will change this year.

  *   Per our Infection Control chief as of 2025, staff who receive FluMist can work without restriction except for the Intensive Care Nursery and Bone Marrow/Stem Cell Transplant.  That could evolve to be more conservative this year.

As an aside related to FluMist restrictions, we have many staff who simply opt to mask much of the time.  I have no data, just observation, but it seems to be increasing, even in months like this when we have incredibly low numbers of respiratory pathogens circulating locally*

Amy

*leaving aside Pennsylvania's measles surge unfortunately



________________________________
From: David S. Cockrum <David.S.Cockrum at hitchcock.org<mailto:David.S.Cockrum at hitchcock.org>>
Sent: Thursday, July 23, 2026 7:17 AM
To: MCOH-EH <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Cc: Behrman, Amy <behrman at pennmedicine.upenn.edu<mailto:behrman at pennmedicine.upenn.edu>>
Subject: [External] RE: Medical Center Occupational Health: At Home Flu Vaccine


Amy (and I’m “replying all” on purpose as I suspect others will be interested in this discussion)-



I am trying to bring FluMist on board as an option in our flu vaccine campaign – the vaccine remains a mandate here, even for fully remote employees. I’ve lost that battle every year for 3 years. My Hospital Epi/ID, while not opposed, wants to have a formal conversation about efficacy and safety and how the FluMist would impact us operationally. I am generally aware of this information, but I am struggling to pull together the best published data to support the efficacy and safety data to support. I know there are some limiting factors (LIMFACs, from my military days) – age restrictions, complicating medical conditions, pregnancy, etc – and I saw Rachel’s comment on the 7 day masking requirement, with which I concur.



Operationally, the arguments are relatively simple. Administration is so much quicker, cleaner, and easier, and really much cheaper since we wouldn’t have to pay for nursing time for administration clinics.



I guess where I’m going with this is: did you have to do any convincing to get your institution to agree to purchase/provide FluMist, and if so, what did you use? Are you able to share your “ammunition”? Following the discussion with ID, I have to meet the pharmacy antimicrobial committee to get that group on board. Love the bureaucracy!



Thanks for any ideas or suggestions!



David



From: "Amy Behrman, M.D. MD, FACOEM via American College of Occupational and" Environmental Medicine <Mail at ConnectedCommunity.org<mailto:Mail at ConnectedCommunity.org>>
Sent: Wednesday, July 22, 2026 5:24 PM
To: David S. Cockrum <David.S.Cockrum at hitchcock.org<mailto:David.S.Cockrum at hitchcock.org>>
Subject: RE: Medical Center Occupational Health: At Home Flu Vaccine **EXTERNAL**



Hi Everyone, I touched base with Astra Zeneca. They will have FluMist in all 50 states, and Flumist-At-Home in 48 (omitting Alaska and. . . -posted to the "Medical Center Occupational Health" community Catch up on activity from your Component,

Hi Everyone, I touched base with Astra Zeneca. They will have FluMist in all 50 states, and Flumist-At-Home in 48 (omitting Alaska and... -posted to the "Medical Center Occupational Health" community

Catch up on activity from your Component, Section, and Governance groups.

________________________________


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Jul 22, 2026 4:24 PM


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Hi Everyone,



I touched base with Astra Zeneca.  They will have FluMist in all 50 states, and Flumist-At-Home in 48 (omitting Alaska and Hawaii for transportation/temperature control concerns).   We hope to have it as an onsite influenza vaccine option at Penn.   Amy



Amy J Behrman, MD, FACP, FACOEM

Chief, Occupational Medicine

Professor, Perelman School of Medicine

University of Pennsylvania

3400 Spruce Street

Philadelphia, PA  19104








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-------------------------------------------
Original Message:
Sent: 7/21/2026 4:42:00 PM
From: Melanie Swift, MD, MPH, FACOEM
Subject: RE: At Home Flu Vaccine

Last year, we added it to the list of available options in our online flu vaccine self-report tool, where employees would normally report externally administered vaccines. The self-report tool has a document upload feature.

If your institution requires documentation, you can instruct employees to use the online pharmacy portal AstraZeneca provides to log in and verify their FluMist self-administration. Then they can obtain their vaccination record in that portal. Their portal will also send the record to their state's immunization information system (IIS).

Last year, it wasn't available in 14 states, including MN, but we have many employees living in other states where it was available. Has anyone heard if it will be available in all states this year?


------------------------------
Melanie Swift MD, MPH, FACOEM
Professor of Medicine
Mayo Clinic
Rochester MN
615-579-0943
------------------------------
-------------------------------------------
Original Message:
Sent: 07-21-2026 01:45 PM
From: Jennifer Lund, DO, MPH, FACOEM
Subject: At Home Flu Vaccine

Hello,

In preparation for flu season, I was wondering how other medical centers are handling the at home flu vaccine. Are you accepting it? What documentation are you requesting?

Thank you!


------------------------------
Jennifer Lund DO, MPH, FACOEM
Inova Health System
Alexandria VA
------------------------------










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