My hospital has been offering the J&J vaccine to patients on discharge. I feel uncomfortable with this because I know how many people feel quite ill for a time period after getting vaccinated and I don't feel this is the right time to be giving hospitalized patients their vaccine. They are already weak and still recovering from whatever brought them in the hospital and a harsh vaccine response may complicate their recovery. I also wonder if patients may delay coming back to the hospital for readmissions because they think they are just dealing with vaccine side effects when in reality it is their diagnosis that needs attention. Thoughts? More Like This CDC Decides to Stop Tracking Community Transmission of COVID-19 by Praveen, MSN, RN Does the shot mess with your DNA? by Floor_Nurse Canadian Nursing Shortage: Why Canadian Nurses are Leaving Permanent Staff Positions by LOMalleyCommunications Ethical Arguments Against Mandatory Vaccination by ldhrn73
toomuchbaloney 10,803 Posts Specializes in NICU, PICU, Transport, L&D, Hospice. Has 44 years experience. Aug 17, 2021 Mild illness is not a contraindication to vaccination. Quote a vaccination might be indicated in the presence of a precaution if the benefit of protection from the vaccine outweighs the risk for an adverse reaction. The presence of a moderate or severe acute illness with or without a fever is a precaution to administration of all vaccines (Table 4-1). The decision to administer or delay vaccination because of a current or recent acute illness depends on the severity of symptoms and etiology of the condition. The safety and efficacy of vaccinating persons who have mild illnesses have been documented (8-11). Vaccination should be deferred for persons with a moderate or severe acute illness. ACIP
CaliRN2019, BSN 26 Posts Has 5 years experience. Aug 17, 2021 I guess the debate then is "mild illness". Many patients I discharge I feel are more then mildly ill. Many go home with after extensive multiple surgeries, PICCS for long term ABX, drains, complicated wounds, and many are so weak they are not able to currently ambulate at the present time. I know this puts them at high risk for complications from covid, but at the same time I feel like the possibility of adding harsh side effects from the vaccine might not be a good idea in their current delicate state. Perhaps the J&J vaccine has less side effects since it isn't MRNA like Moderna and Pfiser.
SmilingBluEyes 20,964 Posts Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis. Has 26 years experience. Aug 17, 2021 29 minutes ago, CaliRN2019 said: I guess the debate then is "mild illness". Many patients I discharge I feel are more then mildly ill. Many go home with after extensive multiple surgeries, PICCS for long term ABX, drains, complicated wounds, and many are so weak they are not able to currently ambulate at the present time. I know this puts them at high risk for complications from covid, but at the same time I feel like the possibility of adding harsh side effects from the vaccine might not be a good idea in their current delicate state. Perhaps the J&J vaccine has less side effects since it isn't MRNA like Moderna and Pfiser. Then I would consult with the doctor and get his/her advice on when it is appropriate, or not, to give this vaccine on discharge. Get orders to do so when appropriate.
toomuchbaloney 10,803 Posts Specializes in NICU, PICU, Transport, L&D, Hospice. Has 44 years experience. Aug 17, 2021 36 minutes ago, CaliRN2019 said: I guess the debate then is "mild illness". Many patients I discharge I feel are more then mildly ill. Many go home with after extensive multiple surgeries, PICCS for long term ABX, drains, complicated wounds, and many are so weak they are not able to currently ambulate at the present time. I know this puts them at high risk for complications from covid, but at the same time I feel like the possibility of adding harsh side effects from the vaccine might not be a good idea in their current delicate state. Perhaps the J&J vaccine has less side effects since it isn't MRNA like Moderna and Pfiser. Likely, the preferring provider is responsible for determining if the illness is mild enough to vaccinate or severe enough to delay. This assessment is SOP in the vaccination world. Mild illness doesn't buy most children out of routine childhood immunizations when they present at their provider office...or at least they shouldn't. If you have concerns you should discuss them with the provider.
CaliRN2019, BSN 26 Posts Has 5 years experience. Aug 17, 2021 At my hospital it isn't up to the provider. The hospital offers it to anyone on discharge, just like the flu vaccine during flu season. There are no stipulations at all.
toomuchbaloney 10,803 Posts Specializes in NICU, PICU, Transport, L&D, Hospice. Has 44 years experience. Aug 17, 2021 24 minutes ago, CaliRN2019 said: At my hospital it isn't up to the provider. The hospital offers it to anyone on discharge, just like the flu vaccine during flu season. There are no stipulations at all. If you think there is a medical contraindication for vaccination with a patient, shouldn't you contact the discharging provider & note your concerns in the record? You should not administer any vaccine that you believe is contraindicated. IMV Having said that, we are in a pandemic and the way to the end is with vaccination of most people living in any given area. The society and your community is trying to make every encounter with health care an opportunity to identify unvaccinated individuals and convince them to vaccinate.
