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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.
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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.
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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.
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We accept dated external documentation of any licensed influenza vaccine, including FluMist.
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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.
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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*
From: David S. Cockrum <David.S.Cockrum@hitchcock.org>
Sent: Thursday, July 23, 2026 7:17 AM
To: MCOH-EH <mcoh-eh@mylist.net>
Cc: Behrman, Amy <behrman@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@ConnectedCommunity.org>
Sent: Wednesday, July 22, 2026 5:24 PM
To: David S. Cockrum <David.S.Cockrum@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
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Re:
At Home Flu Vaccine [community.acoem.org]
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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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