Do they still line up kids at school and give them shots?

I have forgotten the state capitals, but one intact memory of elementary school in Bethesda, Maryland is lining up to get shots (vaccines?) from some sort of “gun”. These were administered roughly every 15 seconds either by the school nurse or a county health worker. It went so fast that I wonder if we were all effectively sharing one needle (HIV and hepatitis were not concerns for schoolchildren circa 1970).

The other day I was waiting for a friend at CVS so decided to use the time to get my “free” (i.e., included in my $10,000/year Obamacare policy) flu shot. Ten minutes later my friend showed up. It took roughly another ten minutes before the shot was “ready.” It turned out that three health care professionals had to process various forms on a computer screen, get a one-page questionnaire from me, and finally deliver the shot with a simple needle (less than one minute). A licensed pharmacist was required as part of the paperwork pipeline.

Here’s what I got in hardcopy:

  1. Two-page document regarding the vaccine (Flucelvax Quad). It says “This is an OFF-WHITE SYRINGE.”
  2. CVS Health Notice of Privacy Practices, a two-page document in 6 pt type. It is a paper copy that, among other things, says “You have the right to obtain a paper copy of our current Notice at any time.” It also says what will happen if I am or become “an inmate of a correctional institution.”
  3. A five-page “Vaccine Information Statement” that discusses the side effects (overlaps to some extent with Document #1)
  4. A Vaccine Consent and Administration Record
  5. A three-foot-long receipt for $0.00 (coupons following)
  6. A $5 off any $25 purchase special coupon specific to having gotten a “free” flu shot (i.e., for giving CVS the opportunity to bill the health insurer)

Is there now this much paperwork and process attached to what was, in my youth, a 15-second paperwork-free experience?

[I posted a shorter version of the above on Facebook and it generated the predictable encomiums about the wisdom of Obamacare requiring insurance companies to pay for flu shots:

I think the insurance companies cover shots as a preventative measure, hoping we won’t incur more healthcare expenses related to the flu we’d contract if we didn’t take the shot.

It should be free and universal. That will save the most money, and the evidence for that is stone-cold solid.

In other words, the central planners working for the government are smarter than the actuaries who work at insurers, which didn’t previously pay for flu shots. I decided to poke at this assumption a bit with “If it made actuarial sense to do this, why wouldn’t the UK bureaucrats be smart enough to figure it out? They don’t offer free flu shots to everyone. (source) Are the U.S. central planners smarter than the UK ones who’ve been doing it for decades?” That proved to be an impossible conundrum!]

11 Comments

  1. Neal

    January 12, 2018 @ 1:05 pm

    1

    My flu shot was paperwork free and took about 10 minutes of which about 9.5 minutes was waiting in line (as you undoubtedly had to do in grade school as well) during which I was asked about any contraindications twice.

    I’m pretty sure the old mass inoculations used air injectors not a shared needle.

    “Are the U.S. central planners smarter than the UK ones who’ve been doing it for decades?”

    The CDC hasn’t also been doing it for decades?

  2. Mememe

    January 12, 2018 @ 1:10 pm

    2

    Fun fact — before goverment got into the medical insurance business, doctors were notorious at the IRS for failing to report accurate income, since they received so much payment in cash, in kind (e.g. chickens from a cash-poor chicken farmer), or just did not receive full payment from poor patients.

  3. Jim

    January 12, 2018 @ 3:07 pm

    3

    No, they don’t vaccinate at school anymore because there are too many over-protective parents worried about little Johnny having some discomfort. Or they have some misguided notion that the vaccine is more dangerous than the disease.

    Parents in my day were thrilled to have this done at school. Some even brought little brothers & sisters that day so they could get the shot.

  4. Neal

    January 12, 2018 @ 4:13 pm

    4

    “They don’t offer free flu shots to everyone.”

    They offer free flu shots to everyone who meets their medical criteria for needing a flu shot. In contrast, the US does NOT do this, even for people meeting the more restrictive NHS medical criteria.

  5. J. Peterson

    January 12, 2018 @ 4:46 pm

    5

    My anecdotal evidence from observing family members is flu shots are completely ineffective (the challenge of vaccination companies trying to guess which virus strain will actually be prevalent a year in advance supports this).

    I’m interested to hear if the recipients actually avoid the flu for the rest of the year.

  6. Neal

    January 12, 2018 @ 5:56 pm

    6

    J. Peterson: According to NPR this year’s vaccine is about 30% effective against the H3N2 strain which is currently surging and can lessen the severity of illness in the other 70%. It takes two weeks to become effective. The article says that this year’s vaccine is more effective against other strains which are also out there.

    https://www.npr.org/sections/health-shots/2018/01/12/577632089/flu-season-is-shaping-up-to-be-a-nasty-one-cdc-says

  7. Jim

    January 13, 2018 @ 11:56 am

    7

    J. Peterson: From my own personal experience I can say that flu shots have been very effective. While you still may catch a version of the flu, or a common cold, my experience is that it is far less severe.

    That said, they’re making an educated guess when they make the vaccine. But the fact remains there is virtually no harm for the vast majority of folks to get the vaccine. They always ask if you’re allergic to latex & eggs.

    My question is..why not get the vaccine? it’s a no-brainer.

  8. Neal

    January 13, 2018 @ 12:39 pm

    8

    “In other words, the central planners working for the government are smarter than the actuaries who work at insurers, which didn’t previously pay for flu shots.”

    It may not be a matter of “smarter” or “dumber”. The phenomena of herd immunity means that the interests of actuaries at insurers may not align with those of the community as a whole. If this is a collective action problem (net benefits accrue to the community only if a certain fraction of the population gets their flu shot), then both the CDC and actuaries who work at insurers may be acting rationally even though their recommendations directly contradict each other.

  9. ZZAZZ2

    January 13, 2018 @ 3:14 pm

    9

    Don’t let any of this fallacious reasoning keep you from getting a flu shot every year–it could mean your life.

  10. tekumse

    January 14, 2018 @ 12:49 am

    10

    Hmm, I remember they used to send me forms to agree for kids flu shots at school. It was very convenient. I am not sure when it stopped or why. They still do it at work for me. It’s actually the office complex that organizes it.

  11. Jack D

    January 14, 2018 @ 10:13 am

    11

    The vaccination you received (probably polio or maybe smallpox) was administered by a jet injector gun.

    https://en.wikipedia.org/wiki/Jet_injector

    Although needle free these did turn out to have cross-contamination issues as you suspected. There are newer versions on the market that change out all the “wet” parts after every shot so there is no (or at least less) risk of cross-contamination but since the reputation of jet injectors was damaged by past issues (and since having to change out everything obviates the cost benefits of having an injector gun in the 1st place) these are not particularly popular.

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