Free Flu Shots: Complications and Five Questions
September 26, 2020 12:46 PM Subscribe
I went for a free flu shot yesterday. I usually get them through work but, you know. The experience left me with a ton of questions. Unfortunately, there was a line behind me so I couldn't satisfy my curiosity, but I hope you guys can help!
In addition to the flu shot, they gave me a list of about a dozen other shots I could get, and asked me to choose four.
I said I didn’t know what to choose. The attendant recommended the tetanus shot, even if I didn’t know when my last tetanus shot was. He said it would be fine as a booster. (1) Is this true? (2) Are there other shots I could have gotten?
He said I wasn’t old enough for the other ones. I’m a middle-aged adult. (3) I guess these are for seniors?
Finally, when I got the injection, one of the shots made a bubbling sound. I was afraid this might cause a gas embolism, but it’s been 24 hours and I guess I’m ok. (4) Should I put aside my concerns?
(5) Also, what’s the incentive for all these retail joints to be offering free flu shots? They asked for proof of insurance and took down some info, so I guess there is an incentive, maybe a kickback, maybe insurers figured out widely distributing flu vaccines was actuarially cheaper than treating serious cases of flu?
(6) Are any of the places better than the others? CVS vs Walgreens vs Krogers, etc.
Thanks!
In addition to the flu shot, they gave me a list of about a dozen other shots I could get, and asked me to choose four.
I said I didn’t know what to choose. The attendant recommended the tetanus shot, even if I didn’t know when my last tetanus shot was. He said it would be fine as a booster. (1) Is this true? (2) Are there other shots I could have gotten?
He said I wasn’t old enough for the other ones. I’m a middle-aged adult. (3) I guess these are for seniors?
Finally, when I got the injection, one of the shots made a bubbling sound. I was afraid this might cause a gas embolism, but it’s been 24 hours and I guess I’m ok. (4) Should I put aside my concerns?
(5) Also, what’s the incentive for all these retail joints to be offering free flu shots? They asked for proof of insurance and took down some info, so I guess there is an incentive, maybe a kickback, maybe insurers figured out widely distributing flu vaccines was actuarially cheaper than treating serious cases of flu?
(6) Are any of the places better than the others? CVS vs Walgreens vs Krogers, etc.
Thanks!
Flu shots go into your deltoid (arm muscle) and not a vein or artery so you can stop worrying about bubbles completely.
posted by DarlingBri at 12:50 PM on September 26, 2020 [21 favorites]
posted by DarlingBri at 12:50 PM on September 26, 2020 [21 favorites]
I too am middle-aged and my doctor has recommended the hepatitis vaccine(s) and I've also had the shingles vaccine recommended (on preview: by family; I'm not 60).
posted by rhizome at 12:51 PM on September 26, 2020
posted by rhizome at 12:51 PM on September 26, 2020
If they took your insurance information, then your insurance is paying for the shot. They probably offered any other shots they thought your insurance would pay for.
posted by dforemsky at 12:53 PM on September 26, 2020 [9 favorites]
posted by dforemsky at 12:53 PM on September 26, 2020 [9 favorites]
5. The flu shots are free to YOU. Your insurance company will be billed for your shot at the pharmacy's negotiated rate, just as it would be if you got the shot at your doctor's office or the hospital. They just call it free as an incentive to get you there (and eliminate the barrier of extra cost concerns that might cause people to avoid getting the vaccine).
posted by mochapickle at 12:54 PM on September 26, 2020 [11 favorites]
posted by mochapickle at 12:54 PM on September 26, 2020 [11 favorites]
Pretty sure if they got your insurance info they’re going to bill your insurance company - it’s free *to you.* Hence the tetanus shot upsell - they get paid for that as well.
Pneumonia vaccines are also often recommended to older adults, that could be another possibility. Any of these vaccines may be available to you with a doctor’s specific recommendation but they aren’t going to be automatically paid for by insurance, that’s where the “too young” comes in.
posted by mskyle at 12:54 PM on September 26, 2020
Pneumonia vaccines are also often recommended to older adults, that could be another possibility. Any of these vaccines may be available to you with a doctor’s specific recommendation but they aren’t going to be automatically paid for by insurance, that’s where the “too young” comes in.
posted by mskyle at 12:54 PM on September 26, 2020
Pneumonia, shingles and hepatitis as mentioned above are usually recommended for seniors. (Though the new shingles is for younger folks now, but insurance hasn't caught up and won't usually pay until 60.)
Tdap - teatnus, diptheria and pertussis (whooping cough) is every 8-12 years. If you can't remember, it's good to get it and shouldn't harm you if you get another within that window. I got mine after about 14 years and it was very painful for a week after, so I really lost my immune response.
MMR is measles, mumps and rubella and not often necessary for adults unless you fit a window of seniors that have an older version that wanes. If you have an outbreak in your area and don't know if you have an updated measles vaccine, then it's not a bad idea, especially if you're around kids or immune compromised folks.
Others might be chicken pox or gardisil (for HPVs that cause cancer).
It's absolutely far more cost effective for insurance companies to prevent these preventable diseases than to pay for visits and treatments. And for many people, it feels like they're "using" their insurance so it reinforces that feeling that they care about you. To be fair, insurance companies are invested in your heath ... not so much in your disease.
As for what place is best, I think it varies by how a particular clinic in a drug store is run. Some are super smooth and generate a lot of confidence, others seem so disorganized I've walked out. In many counties there are also free to you (no need to show insurance) clinics run by the health department for flu and mmr vaccines.
Thanks for getting your flu shot. The country feels better already. (I'm serious.)
posted by typetive at 1:08 PM on September 26, 2020 [7 favorites]
Tdap - teatnus, diptheria and pertussis (whooping cough) is every 8-12 years. If you can't remember, it's good to get it and shouldn't harm you if you get another within that window. I got mine after about 14 years and it was very painful for a week after, so I really lost my immune response.
MMR is measles, mumps and rubella and not often necessary for adults unless you fit a window of seniors that have an older version that wanes. If you have an outbreak in your area and don't know if you have an updated measles vaccine, then it's not a bad idea, especially if you're around kids or immune compromised folks.
Others might be chicken pox or gardisil (for HPVs that cause cancer).
It's absolutely far more cost effective for insurance companies to prevent these preventable diseases than to pay for visits and treatments. And for many people, it feels like they're "using" their insurance so it reinforces that feeling that they care about you. To be fair, insurance companies are invested in your heath ... not so much in your disease.
As for what place is best, I think it varies by how a particular clinic in a drug store is run. Some are super smooth and generate a lot of confidence, others seem so disorganized I've walked out. In many counties there are also free to you (no need to show insurance) clinics run by the health department for flu and mmr vaccines.
Thanks for getting your flu shot. The country feels better already. (I'm serious.)
posted by typetive at 1:08 PM on September 26, 2020 [7 favorites]
A little air in the shot is ok. It takes a lot of air to cause a problem. I used to give myself daily shots and had a lot of anxiety about accidentally injecting air bubbles, but my doctors reassured me, so now I can reassure you on this point.
The incentive is preventive care and better public health. Thank you for getting your flu shot; it's especially important this year.
posted by k8lin at 1:12 PM on September 26, 2020 [4 favorites]
The incentive is preventive care and better public health. Thank you for getting your flu shot; it's especially important this year.
posted by k8lin at 1:12 PM on September 26, 2020 [4 favorites]
Shingles vaccine is for people 50 and older. I got mine last year, as soon as I was able. You do not want shingles.
posted by poppunkcat at 1:15 PM on September 26, 2020 [4 favorites]
posted by poppunkcat at 1:15 PM on September 26, 2020 [4 favorites]
4: You also do need a relatively lot of air to cause a problem, into a vessel and not just muscle or skin. I've found that the most common commercial vaccines come prefilled from the manufacturer these days: IAC for professionals: "Some single-dose manufacturer-filled vaccines come with an air pocket in the syringe chamber. Do we need to expel the air pocket before vaccinating?
No. You do not need to expel the air pocket. The air will be absorbed. This is not true for syringes that you fill yourself; you should expel air bubbles from these syringes prior to vaccination to the extent that you can do so."
1-3: Yes, some of them are indicated for folks over 50 or 65 or otherwise with immune conditions; otherwise healthy 19-50/65 year olds generally don't need them yet. Here is the current CDC recommendation chart. But honestly, unless you have a high risk of getting Hep A, are travelling, or never got your pre-18 year old vaccines or infections (varicella), the tDAP is pretty much it until it's Pneumovax time.
6: This is completely operator dependent. I've had less good vax experiences at the hospital occupational health and a particular pharmacy, and I've had them go great at my gyn's office, a nurse colleague's kitchen, and other pharmacies, both of different and the same corporate owner as the one crappy one.
posted by cobaltnine at 1:18 PM on September 26, 2020 [2 favorites]
No. You do not need to expel the air pocket. The air will be absorbed. This is not true for syringes that you fill yourself; you should expel air bubbles from these syringes prior to vaccination to the extent that you can do so."
1-3: Yes, some of them are indicated for folks over 50 or 65 or otherwise with immune conditions; otherwise healthy 19-50/65 year olds generally don't need them yet. Here is the current CDC recommendation chart. But honestly, unless you have a high risk of getting Hep A, are travelling, or never got your pre-18 year old vaccines or infections (varicella), the tDAP is pretty much it until it's Pneumovax time.
6: This is completely operator dependent. I've had less good vax experiences at the hospital occupational health and a particular pharmacy, and I've had them go great at my gyn's office, a nurse colleague's kitchen, and other pharmacies, both of different and the same corporate owner as the one crappy one.
posted by cobaltnine at 1:18 PM on September 26, 2020 [2 favorites]
To clarify: are you saying you went in for a flu shot and they pushed you to get other shots as well, without a copy of your immunization record?
I've had flu shots at CVS, Walgreens, Rite Aid, and my doctor's office, and have never ever had someone push me like that. I am very pro-vaccine and would entirely understand if they suggested specific vaccines that you were due for, but saying "pick 4" from a list when neither you nor they have your records seems really sketchy.
posted by needs more cowbell at 1:29 PM on September 26, 2020 [8 favorites]
I've had flu shots at CVS, Walgreens, Rite Aid, and my doctor's office, and have never ever had someone push me like that. I am very pro-vaccine and would entirely understand if they suggested specific vaccines that you were due for, but saying "pick 4" from a list when neither you nor they have your records seems really sketchy.
posted by needs more cowbell at 1:29 PM on September 26, 2020 [8 favorites]
6. If you're willing to pay a little out of pocket, I'd suggest going to CVS's minute clinic for your shots or even your doctors. You get a window of time just for you behind closed doors to talk to the nurse practitioner or doctor & they can answer all your questions about the shots. Shots are good, if they didn't work, insurance companies wouldn't make them free to you. Places tend to bundle them not only because they can get money from the insurances company but because bundling shots like that means they know you have them, getting them all at once if you can is just more efficient & takes less time on their part & yours.
Side note get your Tdap I've had whooping cough, it was 2 months of coughing until I went blue, not sleeping hell. Keep your Tdap up to date.
posted by wwax at 1:38 PM on September 26, 2020 [1 favorite]
Side note get your Tdap I've had whooping cough, it was 2 months of coughing until I went blue, not sleeping hell. Keep your Tdap up to date.
posted by wwax at 1:38 PM on September 26, 2020 [1 favorite]
The shingles and hep shots are delivered in two stages, with a different amount of time between each. Maybe not something a walk-in clinic would offer.
posted by scruss at 2:16 PM on September 26, 2020 [1 favorite]
posted by scruss at 2:16 PM on September 26, 2020 [1 favorite]
6 - I go to the grocery store pharmacy near me where I know both of the pharmacists are very, very good at giving immunizations. I avoid the chain pharmacy where a pharmacist was not great at it.
posted by Ms Vegetable at 3:06 PM on September 26, 2020
posted by Ms Vegetable at 3:06 PM on September 26, 2020
You don't get the flu from a flu shot, but the vax does prompt your body to create antibodies, so you can have a flu-ish response as your immune system does its work. Getting my flu shot in a few days, yay us!.
I find pharmacists to be well-trained, helpful, conscientious, and you can call and ask questions later.
posted by theora55 at 3:18 PM on September 26, 2020
I find pharmacists to be well-trained, helpful, conscientious, and you can call and ask questions later.
posted by theora55 at 3:18 PM on September 26, 2020
CVS Minute Clinic does offer the two stage Shingles vaccine.
posted by TWinbrook8 at 6:27 PM on September 26, 2020
posted by TWinbrook8 at 6:27 PM on September 26, 2020
By the way, the reason that insurance covers vaccines fully is because the Affordable Care Act (aka ObamaCare) forces the insurance companies to cover vaccines and a number of other preventive health services. Until this law went into effect, copays for vaccines or not covering them at all was quite common.
posted by rockindata at 6:45 PM on September 26, 2020 [13 favorites]
posted by rockindata at 6:45 PM on September 26, 2020 [13 favorites]
(and if you need a data point where US health care is better than Canada: my employer's insurance in Canada doesn't cover preventative medicine, so the shingles vaccine cost me ~$400 US)
posted by scruss at 7:26 PM on September 26, 2020 [1 favorite]
posted by scruss at 7:26 PM on September 26, 2020 [1 favorite]
Just FYI, the last time I went to a CVS Minute Clinic (sore throat, they did a swab), they billed my insurance as a specialist visit, which ended up hitting me with a much higher copay. My guess is they did so because I already had a PCP, but I really don't know.
posted by Thorzdad at 5:13 AM on September 27, 2020
posted by Thorzdad at 5:13 AM on September 27, 2020
(scruss, provincial insurance usually covers vaccines, except travel vaccines. Employer insurance in Canada only covers stuff beyond what provincial insurance covers.)
posted by eviemath at 6:46 AM on September 27, 2020 [1 favorite]
posted by eviemath at 6:46 AM on September 27, 2020 [1 favorite]
scruss here's a link to Ontario's free shingles vaccine page
posted by yyz at 7:16 AM on September 27, 2020 [1 favorite]
posted by yyz at 7:16 AM on September 27, 2020 [1 favorite]
Another incentive for a retail store to offer free shots (again, free to you, they get paid by insurance) is the chance you will buy something while in the store, since you are there anyway.
posted by soelo at 1:22 PM on September 30, 2020
posted by soelo at 1:22 PM on September 30, 2020
This thread is closed to new comments.
posted by bq at 12:50 PM on September 26, 2020 [3 favorites]