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A flu shot during surgery can nix needle trauma

Last flu season, Santa Clara became the first Kaiser Permanente hospital in Northern California to offer flu shots to young patients during surgery.

As many parents can attest, taking a child to get a flu shot or a vaccination of any kind can cause stress, anxiety, and tears.

“As children get older, they become more aware and fearful of needles. When this happens, some kids really refuse to get vaccinated or it becomes very stressful, even traumatic,” said Perioperative Clinical Manager Judy Moreno, RN. 

Moreno and colleagues at the Kaiser Permanente Santa Clara Medical Center identified an opportunity to provide the seasonal influenza shot to vulnerable patients between 6 months and 18 years old. They would give them the shot while under anesthesia for planned procedures or surgery, such as gastroenterology diagnostic tests, eye surgery, or dental restoration.

Santa Clara is the first Kaiser Permanente facility in Northern California with a flu vaccination program targeting surgical pediatric patients.

During this initiative’s inaugural 2023 flu season, 202 patients were inoculated this way.

“The impact, so far, has been quite encouraging,” said Greg Neukirchner, MD, pediatric anesthesiologist. He presented the idea to Santa Clara colleagues after learning about perioperative vaccination programs during a Society of Pediatric Anesthesia meeting.

Considered a success with young patients at Santa Clara, the program then expanded to offer the vaccine to developmentally challenged adults.

The benefits

“The benefit of administering the flu shot while under anesthesia is it’s done seamlessly during a planned event,” said Moreno. “It’s really a non-event for the patient.”

During a patient’s pre-op appointment, the medical team informs the parent or guardian of the option to receive the flu shot during the procedure, and the day of they can opt-in to receive the shot.

“We have received a lot of positive feedback from many families, with especially positive responses for those patients with either needle phobia or disabilities where interactions in a health care setting are stressful,” said Neukirchner.  “It’s a lot less stress on everyone, and they can receive the optimal preventive care they deserve.”

The program captures children who are at more risk for complications associated with flu.

“It’s an important opportunity to protect this population, as many of them are at greater risk because of other health concerns,” explained Moreno. “The more children we can vaccinate, the healthier our communities are.”

A best practice

The Centers for Disease Control and the American Academy of Pediatrics both recommend providing the influenza vaccine to children and teenagers while under anesthesia for a surgery.

With preparations underway for the 2024 flu season, the Santa Clara team hopes to exceed last year’s vaccination numbers. They seek to share their learnings and best practices with colleagues at other Kaiser Permanente facilities.

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