First the mundane: Last fall, my spouse agreed to test the Walgreens/VA free flu shot partnership.  The pharmacist asked for his private insurance card and VA ID.  He was given the shot, but his Medicare Advantage plan, as first payer, picked up the tab. That saved the VA $30.00 and manpower so a win for the VA and a win for us because we saved gas and time. 

If Walgreens sent his flu information electronically to the VA, it was lost in translation. There are other VA flu options.  Our son, a veteran, said that Burlington Clinic gives prescriptions for free flu shots at RiteAid.

This year, the VA is pushing Walgreeens (LINK) with a new snazzy group code:

No appointment is required; simply go to any Walgreens, tell the pharmacist you receive care at a VA facility and show your Veterans Identification Card and another form of photo ID. Use Group Code # 5933XBAYV.

Your immunization record will be updated electronically in your local VA electronic health record.

However, flu-shot related trouble may be heading to your pharmacy.  One medical device company won a victory in 2014; the FDA approved PharmaJet injectors for Afluria flu shots such as the one pictured below (LINK).

CLICK FOR VIDEO WITH PHARMACIST AND DEMO Image: PharmaJet

BIG RED FLAGS.  This new improved  reusable device, which uses a multi-dose vial, (CDC LINK), is supposed to be safe for ages 18-64. But not older or younger. (Why not?)   

[Update: age question is answered here (link).

The device (LINK);  has been tested on pigs I gather.  I defer to Nod, Sylvia, and others to opine on its design in comparison with the old gun and its potential for contamination.

Then there is the nasty problem of the preservative used-thimerosal. The CDC explains (LINK):

What is thimerosal?

Thimerosal is an ethyl mercury-based preservative used in vials that contain more than one dose of a vaccine (multi-dose vials) to prevent germs, bacteria and/or fungi from contaminating the vaccine.

Why are preservatives sometimes used in vaccines?

Preservatives are used to protect vaccines packaged in multi-dose vials. Each time a vaccine dose is drawn from a multi-dose vial, bacteria or fungi can enter the vial. Receiving a vaccine contaminated with bacteria or fungi can be dangerous. Preservatives are needed to prevent contamination of multi-dose vials each time individual doses are drawn.

Do flu vaccines contain thimerosal?

Flu vaccines in multi-dose vials contain thimerosal to safeguard against contamination of the vial. Most single-dose vials and pre-filled syringes of flu shot and the nasal spray flu vaccine do not contain a preservative because they are intended to be only used once.

Hmmm. Bacteria?  Germs? Fungi?  What, no viruses like HCV and HIV–perhaps they fall within the “germs” category.  

Well, it sure looks  prettier than the old gun-models, more like a plastic electric toothbrush, but the concept and the risks look similar from my POV.  If you are under 18 or over 64, you can get a single-use syringe.  If you aren’t, this may be your only choice in some locations.  

The CDC clearly states that multi-dose vials with flu vaccines can become contaminated without the mercury preservative.  If these devices can become contaminated, we may be looking at  new waves of infections transmitted via jet injectors in the years to come.  Please let us know if your provider whips out a PharmaJet.  This whole effort spells “epidemic” not “prevention” and “corporate greed” not “public health” to me.