Frequently Asked Questions

About NHSN HPS Component-Influenza Modules

• When reporting an adverse reaction to an influenza vaccine, why should I report to both VAERS and NHSN HPS Influenza Vaccination Module?
• How should I enter an adverse reaction to a vaccine if the HCW received two vaccines (e.g., a seasonal and a non-seasonal vaccine) on the same day? To which vaccine should I attribute the reaction?
• How do I report declination of seasonal influenza vaccine and acceptance of non-seasonal (e.g., 2009 H1N1) vaccine for a healthcare worker (HCW)?
• How do I enter a 2-dose series of influenza vaccine?
• NHSN requires that the facility participates for a minimum of 6 months in a calendar year. What if we don’t have 6 months of data to enter?
• Why is vaccinator (the person who vaccinates the HCW) information required?
• What if I don’t know why an HCW received antiviral medications? The symptoms for seasonal influenza and non-seasonal influenza are similar.
• What if an HCW receives more than one antiviral medication at the same time?
• What will be used as the denominator for calculating vaccination uptake?
• How does a facility participate in the Influenza Vaccination without Exposure Management Module? There is no appropriate Monthly Reporting Plan selection.

 

When reporting an adverse reaction to an influenza vaccine, why should I report to both VAERS and NHSN HPS Influenza Vaccination Module?

The purposes of the Vaccine Adverse Event Reporting System (VAERS) and the NHSN HPS Influenza Vaccination Module are different. VAERS (vaers.hhs.gov/) is a national vaccine safety surveillance program co-sponsored by the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA). VAERS collects and analyzes information from voluntary reports of adverse events following immunization for evaluation of vaccine safety. NHSN Influenza Vaccination Module collects information to allow healthcare facilities to monitor and analyze trends in adverse events in their own facility.

The data elements collected by NHSN and VAERS are also different. Vaccinee’s occupation is not reported to VAERS. In addition, since VAERS only reports nationally aggregated data, healthcare facilities would have to maintain a separate database in order to analyze data for their own facility. NHSN would allow facility-level, state-level, and national-level surveillance of adverse reactions specifically among HCP receiving seasonal and non-seasonal (e.g., 2009 H1N1) influenza vaccination.

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How should I enter an adverse reaction to a vaccine if the HCW received two vaccines (e.g., a seasonal and a non-seasonal vaccine) on the same day? To which vaccine should I attribute the reaction?

Unless you can definitively attribute the reaction to a specific vaccine (e.g., localized pain around the injection site), you should attribute the adverse reaction(s) to both vaccines. Enter the adverse reaction(s) on both vaccination records, i.e., enter the reaction(s) twice into NHSN.

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How do I report declination of seasonal influenza vaccine and acceptance of non-seasonal (e.g., 2009 H1N1) vaccine for a healthcare worker (HCW)?

Two separate vaccination records would have to be entered into NHSN. For each vaccination record, you will only be able to select seasonal or non-seasonal vaccine, not both for the record. If the HCW declines the seasonal influenza vaccine, then select “Seasonal”, enter the years and select "Declined" and fill in the reason for declination. Save the record. Then enter a new vaccination record. Select “Non-seasonal”, enter the years, select "Onsite" or "Offsite," and then fill out the rest of the vaccination details. You will now have two separate vaccination records in the system.

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How do I enter a 2-dose series of influenza vaccine?

You will be able to enter more than one seasonal or non-seasonal influenza vaccine during the vaccination year. For a 2-dose series, each dose will have a separate vaccination record if the dates of the vaccination doses are different. For example, an HCW cannot receive both doses of a 2-dose series of non-seasonal influenza vaccine on the same day. However, they could receive a seasonal and a non-seasonal influenza vaccine on the same day and have two separate vaccination records.

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NHSN requires that the facility participates for a minimum of 6 months in a calendar year. What if we don’t have 6 months of data to enter?

It is possible to have less than 6 months of data for a calendar year, for example, if the facility completes its vaccination campaign early or if there are very few BBF exposures. If you were diligent about looking for these events but none of them occurred during the month, you need do nothing more. If you indicated in a Monthly Reporting Plan that you were monitoring exposures or vaccinations in a given month but were not able to complete this according to the protocols, then the Plan should be edited to reflect this (i.e., deselect the option). In a future release of the NHSN reporting tool, we plan to add a feature that will allow you to indicate that there were no vaccinations and/or exposures for that month. This way, NHSN will know that the number is zero rather than missing when calculating rates.

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Why is vaccinator (the person who vaccinates the HCW) information required?

Vaccinator name, title, and work address are only required if the facility plans to use NHSN to satisfy federal-record keeping for the administration of vaccine covered by the Vaccine Injury Compensation Program. If you selected “Yes” to this question on the HCW Influenza Vaccination form, then vaccinator information is required as well as which Vaccine Information Statement was given to the vaccinee. If you selected “No” to this question, then only the HCW demographics, where the vaccine was administered, influenza sub-type, vaccination date, vaccine product, vaccine lot number and any adverse reaction after vaccination are required; vaccinator information will not be required.

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What if I don’t know why an HCW received antiviral medications? The symptoms for seasonal influenza and non-seasonal influenza are similar.

If you cannot differentiate the influenza subtype for which the HCW is taking antiviral medications, indicate “Unknown” for the influenza subtype on the Influenza Prophylaxis/Treatment Form.

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What if an HCW receives more than one antiviral medication at the same time?

Each antiviral medication should be entered on a separate line on the form.

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What will be used as the denominator for calculating vaccination uptake?

The denominator will be the numbers of full-time employees, part-time employees, contractors, volunteers and others that you entered into Question 2 of the Post-Season Survey on Influenza Vaccination Programs (Q2: “Which of the following types of employees do you plan to include in your annual influenza vaccination program?”). The numbers that you entered for the Pre-Season Survey will be auto-entered into the Post-Season Survey in the application. You can edit these numbers in the Post-Season Survey to reflect the final target vaccination population by the end of the vaccination year (i.e., season). For example, if you end up with >100% participation rate, you should edit the denominator numbers in Question 2 of the Post-Season Survey to reflect, more accurately, your targeted vaccination population.

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How does a facility participate in the Influenza Vaccination without Exposure Management Module? There is no appropriate Monthly Reporting Plan selection.

Reporting exposure management (i.e., antiviral prophylaxis/treatment) is optional when participating in the Influenza Vaccination Module. Thus, to participate in the Influenza Vaccination without Exposure Management, the facility would select Influenza Vaccination with Exposure Management/Treatment for the Monthly Reporting Plan but would not fill out Form CDC 57.210 or enter any data on antiviral medication use.

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