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FluMist®: A refresher

October 8, 2013

The 2013-2014 flu season is fast approaching. Pharmacists who are competent to do so may administer FluMist® (a Schedule 2 product).

What does “competent to do so” mean? As with any aspect of pharmacy practice, you must comply with your ethical responsibilities, practice according to the standards, apply your professional judgment, and limit your practice within your personal competencies.

In the case of administering a vaccine, regardless of the route of administration, competence includes being able to:

  • assess the appropriateness of the vaccine for each patient,
  • provide the right medication in the right dose,
  • store and handle the vaccine appropriately so that its potency is not compromised,
  • dispose of the vaccine and supplies properly so as to ensure public safety, including the safety of staff, and
  • deal with an adverse reaction, including an anaphylactic reaction.

Inform patients of choice
You have a responsibility to make patients and their families aware of the universal publically funded influenza immunization program before offering any alternative that is not included in the public program. As instructed in the Code of Ethics, all pharmacists must provide each patient with any information that the patient needs to make informed decisions about their health and health care and discuss that information with the patient (Principle 2, Statement 3).

Follow standards for Schedule 2 products
A pharmacist who sells a Schedule 2 drug must ensure that an appropriate entry is made in the patient’s record (Standard 18.2). Documentation must include the:

(a) name of the patient for whom the drug was dispensed or sold
(b) the date the drug was sold
(c) the name, strength, and dosage form of the drug sold
(d) the DIN of the drug sold
(e) the quantity of drug sold
(f) a unique prescription or transaction number
(g) identification of the selling pharmacist

In addition, make a record of any drugs administered as part of the record of care. For a list of information to consider, see the information that is required when administering a drug by injection in Appendix A of the Standards of Practice for Pharmacists and Pharmacy Technicians.

Be prepared
FluMist® is a live vaccine and it is not administered in the same way as other nasal sprays. Thorough preparation is warranted before adding it to your practice. To help you prepare, refer to the following resources:

  • FluMist® product monograph
  • AHS influenza immunization info
  • Centers for Disease Control and Prevention Q’s and A’s (Note: this is an American website)
  • Alberta Influenza Immunization Program Resource Guide for Alberta Pharmacists
  • Cold Chain Management

Note: Although FluMist® is a Schedule 2 product, it is to be administered by a healthcare professional and is not to be self-administered by the patient.