International Travelers May Need to get Virus Vaccinations

[mcrcruiser]

By the way, nothing is stopping you from making an appointment with your own physician (however long that takes) going to his/her office, and discussing the COVID vaccines.  This might cost you at least $100 (or your insurance company will pay something less) and then your physician can give you a prescription to go get that shot at a distribution center (probably a pharmacy).  This is no different then when you bet a script for any drug and pick it up at a pharmacy.  

 

 Hank I appreciate your thoughts . In our particular case we will be more comfortable speaking directly with our doctor even though  his office will not do the covid vaccine shots  .Our  insurance covers unlimited doctors  visits . Reason that I brought this up is because when we get the flu shot at his office (he is a geriatric /internist) he never has the senior flu injection because he claims that there have been adverse side effects . Well there are people who literally   should never take vaccines because of health issues . My wife's first cousin has such issues .Any vaccine can activate a dormant gene of  Lou Gerachs disease 

 

 There is still too much we ,the public ,do not know 

 

 Cliff

 

 

 

[kazu]

43 minutes ago, SJSULIBRARIAN said:

I think that having pharmacists administer vaccines in the U.S. is one of the best medical decisions ever made. It is convenient and these practitioners are trained to administer injections. They certainly do far more injections  than any physicians I have known. 

 

I totally agree with you even though I am in Canada.

 

I am not going to tie up an appointment with my physician for a flu shot.  I go to my pharmacy.  It’s well arranged.  

My physician appreciates it as her time is valuable and there are many more people that need her than I do to get a shot.

I see her when needed but resources are short especially in these times and for a simple vaccine, my pharmacist is trained and very good.

 

Pharmacists are a godsend as they take some of the burden from the physicians and make it easier to administer so many vaccines to many more people.  JMO.

[mcrcruiser]

On the other hand  there are people whose lives would be at risk if they did not consult with a MD or know from their history that they have genes in their family history that taking the vaccine could trigger a bad disease . We know of one such case ,it would trigger Lou Gericks disease  .

 

 We simply can not always place a blanket over every one & say it is right for every one to get this new & very quickly developed vaccine  .As in some cases it can back fire . Thus ,for many people seeing your MD for advice imo is practicing caution 

 

 Perhaps this & possibly other reasons is why about 42% of American;s will not take the vaccine .This is what we have heard on  national  TV news casts 

 

  

 

  

Edited December 10, 2020 by mcrcruiser

[mcrcruiser]

From my post above ,if a  family MD  sees a patient & tells the patient it is ok to take the vaccine ,then by all means a pharmacy can administer the vaccine 

 

 Although we all would like this virus to go away & never come back ,we also must be cautious in our recommendations to others  .We are not clones of one another  when it comes to our medical histories 

[mcrcruiser]

Cruising imo is a luxury & one that we have enjoyed going on 90 cruises . We certainly  like  inter acting with crew members who take  on these jobs in lengthy contracts away from their families . We feel deeply for these people . The cruise industry supports 1.2 million jobs around the world is what we heard . 

 

 I feel in time like these we all should be grateful that we have a good family environment & jobs that pay the bills  .for there are many others who severely are lacking 

Edited December 10, 2020 by mcrcruiser

[oaktreerb]

16 hours ago, kazu said:

 

I totally agree with you even though I am in Canada.

 

I am not going to tie up an appointment with my physician for a flu shot.  I go to my pharmacy.  It’s well arranged.  

My physician appreciates it as her time is valuable and there are many more people that need her than I do to get a shot.

I see her when needed but resources are short especially in these times and for a simple vaccine, my pharmacist is trained and very good.

 

Pharmacists are a godsend as they take some of the burden from the physicians and make it easier to administer so many vaccines to many more people.  JMO.

Does the pharmacist communicate with your physician so that the vaccination is recorded in your medical file?

[Cruising-along]

15 minutes ago, oaktreerb said:

Does the pharmacist communicate with your physician so that the vaccination is recorded in your medical file?

I know here they definitely do.

Personally I have done both, gotten vaccines at my clinic (usually the nurse, not the doctor, and usually during a regular appointment anyway, no special appointment needed).  As for flu shots, they have a special area set up for that, no appointment needed (pre-Covid anyway). 

I can see both sides.  A good friend is a pharmacist and she was not too pleased to learn that she had to start administering vaccines during her already long and busy day.  

[iancal]

Yes, our medical history is now on line (universal healthcare).  We have access to it as do our health providers and hospitals.

 

We have had flu shots for each of at least the last nine years.  No, we certainly do not consult our physician each time we get one.   No need for either of us to do this.

 

We do however have to fill out a questionaire prior to getting the flu shots.  All the usual including any any known  drug allergies, current medication, etc.

[rafinmd]

39 minutes ago, iancal said:

Yes, our medical history is now on line (universal healthcare).  We have access to it as do our health providers and hospitals.

 

We have had flu shots for each of at least the last nine years.  No, we certainly do not consult our physician each time we get one.   No need for either of us to do this.

 

We do however have to fill out a questionaire prior to getting the flu shots.  All the usual including any any known  drug allergies, current medication, etc.

I think you're in Canada.  It the same here (at least with Maryland), and has been for some time with the pharmacist forwarding a record to my physician.  That has changed a bit recently, with all vaccinations from any provider being maintained by our State Health department in a database.    It's accessible to citizens, including a section with recommendations for needed shots based on our age and includes a "Certification of Vaccination" which is currently used only for shots required for schools but could also be expanded to include Covid for the rest of us.

 

Roy

[mcrcruiser]

The yearly flu injections are ok once a  person has been approved to get the vaccination by their doctor , From there on in  ,it is easier  .in our case our  geriatric /internist  office gives us the flu shots after our appt with the doctor .

 

 From this thread it is apparent that many people get their vaccinations from different health care professionals . Canadian medicine although similar is  a far different form than here in the USA . I once had to be in a Canadian hospital in Vancouver  because I was dizzy . Requesting to see a specialist was unheard of  ,at that hospital  . Here in the USA we can go to any doctor who accepts our medicare with out waiting long periods of time 

[iancal]

1 hour ago, rafinmd said:

I think you're in Canada.  It the same here (at least with Maryland), and has been for some time with the pharmacist forwarding a record to my physician.  That has changed a bit recently, with all vaccinations from any provider being maintained by our State Health department in a database.    It's accessible to citizens, including a section with recommendations for needed shots based on our age and includes a "Certification of Vaccination" which is currently used only for shots required for schools but could also be expanded to include Covid for the rest of us.

 

Roy

Yes, Canada.   The only thing not on line is our past- prior to when we went on line.  So our hep, yellow fever, tetanus, and other vaccinations etc  are not there but they are on our yellow International Record of Vaccinations booklet that we sometimes carry depending on where we are travelling.

 

 

[Hlitner]

5 hours ago, oaktreerb said:

Does the pharmacist communicate with your physician so that the vaccination is recorded in your medical file?

Yes, they do send an e-mail.  But I must admit to being surprised that someone is CA is not aware that pharmacies have been giving shots for several years.  This is not new and is often advertised in a big way.  It is common to see Pharmacies like CVS, Walgreens, and Rite Aid offering special promotions such as a discount card if one gets a vaccine.  In many cases the vaccines are free to the recipient if they have insurance (the pharmacy will tell you before you make a commitment).   My own physician's office stopped stocking most vaccines once the pharms offered the service.  As an example, I happened to be in our major supermarket today and they had a big sign "Free Flu Shots."   Our nearby CVS carries most common vaccines such as MMR, DTap, Flu, Shingles, Hepatitis, etc.   

 

But since you live in the "Peoples Republic of CA" there is a central registry (California Immunization Registry).  When you get a vaccination the pharmacy must report it to this registry so that your State is aware of who gets what vaccines.  Yes, Big Brother Newsom is watching :).  You also have a State Law that mandates that pharmacies must report the vaccination to your primary care physician (if known) within 14 days.  In CA you sure would not want to trust anyone but the government to make sure it is done right :).

 

Hank

[Hlitner]

Just now, Hlitner said:

Yes, they do send an e-mail.  But I must admit to being surprised that someone is CA is not aware that pharmacies have been giving shots for several years.  This is not new and is often advertised in a big way.  It is common to see Pharmacies like CVS, Walgreens, and Rite Aid offering special promotions such as a discount card if one gets a vaccine.  In many cases the vaccines are free to the recipient if they have insurance (the pharmacy will tell you before you make a commitment).   My own physician's office stopped stocking most vaccines once the pharms offered the service.  As an example, I happened to be in our major supermarket today and they had a big sign "Free Flu Shots."   Our nearby CVS carries most common vaccines such as MMR, DTap, Flu, Shingles, Hepatitis, etc.   

 

But since you live in the "Peoples Republic of CA" there is a central registry (California Immunization Registry).  When you get a vaccination the pharmacy must report it to this registry so that your State is aware of who gets what vaccines.  Yes, Big Brother Newsom is watching :).  You also have a State Law that mandates that pharmacies must report the vaccination to your primary care physician (if known) within 14 days.  In CA you sure would not want to trust anyone but the government to make sure it is done right :).  You might also be interested to know that all 50 States allow trained pharmacists to administer most vaccines without a prescription to anyone 3 years old plus.

 

Hank

 

[oaktreerb]

24 minutes ago, Hlitner said:

Yes, they do send an e-mail.  But I must admit to being surprised that someone is CA is not aware that pharmacies have been giving shots for several years.  This is not new and is often advertised in a big way.  It is common to see Pharmacies like CVS, Walgreens, and Rite Aid offering special promotions such as a discount card if one gets a vaccine.  In many cases the vaccines are free to the recipient if they have insurance (the pharmacy will tell you before you make a commitment).   My own physician's office stopped stocking most vaccines once the pharms offered the service.  As an example, I happened to be in our major supermarket today and they had a big sign "Free Flu Shots."   Our nearby CVS carries most common vaccines such as MMR, DTap, Flu, Shingles, Hepatitis, etc.   

 

But since you live in the "Peoples Republic of CA" there is a central registry (California Immunization Registry).  When you get a vaccination the pharmacy must report it to this registry so that your State is aware of who gets what vaccines.  Yes, Big Brother Newsom is watching :).  You also have a State Law that mandates that pharmacies must report the vaccination to your primary care physician (if known) within 14 days.  In CA you sure would not want to trust anyone but the government to make sure it is done right :).

 

Hank

I was just curious about the process.  Actually, nationally and also in California I would guess that a lot of people do not have a primary care physician.  Many younger people don't even go to the doctor and use the emergency room for care.  With more states seeing the need for affordable universal health care this may change.  The federal government lets me choose my coverage and I have chosen a large HMO and have been very happy with my access to care.   I'm hoping my HMO will be able to provide the vaccine so that I can soon be cruising again, or I may have to go to the nearby CVS.  It's important to me that my healthcare provider has my official immunization records should I need them.

Edited December 11, 2020 by oaktreerb

[mcrcruiser]

5 hours ago, oaktreerb said:

I was just curious about the process.  Actually, nationally and also in California I would guess that a lot of people do not have a primary care physician.  Many younger people don't even go to the doctor and use the emergency room for care.  With more states seeing the need for affordable universal health care this may change.  The federal government lets me choose my coverage and I have chosen a large HMO and have been very happy with my access to care.   I'm hoping my HMO will be able to provide the vaccine so that I can soon be cruising again, or I may have to go to the nearby CVS.  It's important to me that my healthcare provider has my official immunization records should I need them.

Yes a valid point that if we were to get the covid vaccine at CVS  that our primary care doctor   gets that record ,especially since we are in a 2nd tier group for the vaccine  . However ,i first will make sure that it will be ok from our   health points to get  vaccinated  in pre discussion with our doctor 

 

 This whole issue is so new that we are sure that more insight will be available as we get closer to the time of vaccination 

[iancal]

Our jurisdiction in Canada has at least three goals as it pertains to flu shots, etc. by pharmacies.  Cost to administer, maximizing the number of people who get the shot, and convenience/ease of access.  If we had to get the shot at our physician's office or a health authority office we probably would not be as vigilant about getting them.

 

Over the past several years the percentage of those getting the flu shot has increased gradually.  Bigger uptake this year because of covid.  We typically get ours when we walk in to Costco and see the sign advertising availability.  Never waited more than 5 minutes.  Health authority folks visit all retirement homes and provide flu shots.  There is no charge.

 

Physicians do not generally do flu shots in their office I understand. .   Health Authority offices typically have a wait, can be in inconvenient locations, etc.  

 

Prior to getting the jab, each person is required to fill out a hard copy medical history questionaire.

Edited December 11, 2020 by iancal

[mcrcruiser]

On 12/10/2020 at 4:17 PM, Hlitner said:

Yes, they do send an e-mail.  But I must admit to being surprised that someone is CA is not aware that pharmacies have been giving shots for several years.  This is not new and is often advertised in a big way.  It is common to see Pharmacies like CVS, Walgreens, and Rite Aid offering special promotions such as a discount card if one gets a vaccine.  In many cases the vaccines are free to the recipient if they have insurance (the pharmacy will tell you before you make a commitment).   My own physician's office stopped stocking most vaccines once the pharms offered the service.  As an example, I happened to be in our major supermarket today and they had a big sign "Free Flu Shots."   Our nearby CVS carries most common vaccines such as MMR, DTap, Flu, Shingles, Hepatitis, etc.   

 

But since you live in the "Peoples Republic of CA" there is a central registry (California Immunization Registry).  When you get a vaccination the pharmacy must report it to this registry so that your State is aware of who gets what vaccines.  Yes, Big Brother Newsom is watching :).  You also have a State Law that mandates that pharmacies must report the vaccination to your primary care physician (if known) within 14 days.  In CA you sure would not want to trust anyone but the government to make sure it is done right :).

 

Hank

Hank not all medicare advantage medical plans are accepted for vaccinations at CVS  .This year our medicare Advantage plan  will NOT allow us free of charge to have gotten the yearly flu shot . We needed to get the shot from our internist/geriatric doctors office  .not only did he not advise getting the senior dose of flu because he feels the side effects to his patients were dangerous 

 

  Another thing that people in the USA must consider are that medical information is not to be passed along to others eyes  because of our HIPA laws  .Even many health care workers are not allowed to view a patients records unless the patient authorizes  in writing that they give permission  .There are MANY diifferences in our medical practices from Canadian medical practices  & not to take for granted they are similar or the same 

 

 I personally would not take medical nor legal advice from any of this  boards contributors   .Just so many variables in both fields  . Recalling cooks of many but master of none

 

 Cliff 

 

  

[Hlitner]

6 hours ago, mcrcruiser said:

Hank not all medicare advantage medical plans are accepted for vaccinations at CVS  .This year our medicare Advantage plan  will NOT allow us free of charge to have gotten the yearly flu shot . We needed to get the shot from our internist/geriatric doctors office  .not only did he not advise getting the senior dose of flu because he feels the side effects to his patients were dangerous   

 

  Another thing that people in the USA must consider are that medical information is not to be passed along to others eyes  because of our HIPA laws  .Even many health care workers are not allowed to view a patients records unless the patient authorizes  in writing that they give permission  .There are MANY diifferences in our medical practices from Canadian medical practices  & not to take for granted they are similar or the same 

 

 I personally would not take medical nor legal advice from any of this  boards contributors   .Just so many variables in both fields  . Recalling cooks of many but master of none

 Cliff

 

  

Cliff,

I am not aware of any Advantage plan that fails to pay for flu shots although that is no guarantee that CVS would work with every plan.  As to COVID, the vaccine will be free to all Americans (at least initially) since it has been paid for by the Federal Government.

 

Getting back to HIPAA, there is nothing in HIPAA that precludes any individual from releasing their own records to others.  So for example, with the California CAIR2 system (a Statewide Immunization Registry) the individual has the right to opt out of making their info available to authorized folks but otherwise that data base is used by quite a few organizations for data, statistics, health planning, etc.

 

There are several facets of HIPAA (I will not bore folks with the admin details) such as the record keeping provisions, physical design of physician offices, etc.   Even with HIPAA there are many folks in the healthcare and insurance industry that have access to a lot of medical information.  So, for example, when I worked for a living I could look up medical info on millions of folks (without their knowledge) but I was bound (under the law) not to disclose most sensitive info to others who were not authorized.  But as I said in another post, there is absolutely nothing in HIPAA that would prevent Americans from disclosing their vaccination information.  That being said, in many cases an Americans could restrict vaccine information to only a select few (citing HIPAA).  So for example, if a person did not want a cruise line to be aware that they had been vaccinated against COVID they could likely prevent the cruise line from getting this info.  However, the cruise line could then simply deny that person the ability to embark on any of their ships.  

 

So what does all this mean to cruises?  Consider a scenario where cruise lines require every soul coming aboard to have received COVID vaccinations.  The cruise lines would, of course, require proof of vaccination.  Under current Law/Regulations the individual could deny the cruise line that information (i.e. "it is none of your business") after which the cruise line could simply deny them the ability to cruise.  It might be the same with all the airlines.  So just like you cannot fly without presenting acceptable identification it might also come to be that you cannot fly without showing adequate proof of being vaccinated against COVID.  None of this is contrary to HIPAA.

 

Hank

 

Also keep in mind that HIPAA is a Federal Act (Law) that has been enabled by thousands of Regulations (mostly promulgated by HHS).  Congress has the power to amend HIPAA so they could, for example, amend the act to allow for a National Immunization Data Base accessible to just about anyone.  Also, HHS could amend their enabling regulations to essentially do the same thing (without an actual change in the Act).  The way things really work in the USA is that Congress passes Acts (Laws) that are often somewhat vague in their language.  It is then up to the various Federal agencies to promulgate regulations to implement the intent of the Act.  But there is a lot of flexibility in how the agencies write regulations.  For much of my career I wrote State healthcare regulations and also participated in some Federal committees/groups involved in writing Federal Regulations (such as HIPAA).  If Americans would read the Federal Register they would quickly realize that the real power of the country lies in the regulatory process (part of the so-called Deep State).  The reason I am posting all this detail is to make it clear that the Biden Administration will have an awful lot of flexibility on how they deal with the vaccination related issues.

 

Hank 

 

 

 

[iancal]

I hardly think that the process of setting up flu shots is indicative of an entire health care system.  The US and Canadian systems are different.   One could argue the benefits and drawbacks of each until the cows come home.  Does it matter.  

 

Everyone has an opinion, positive or negative, about their health care system.  Perhaps the better measure might be health care outcomes, mortality rates etc., on a national basis.  

Edited December 12, 2020 by iancal

[mcrcruiser]

So what does all this mean to cruises?  Consider a scenario where cruise lines require every soul coming aboard to have received COVID vaccinations.  The cruise lines would, of course, require proof of vaccination.  Under current Law/Regulations the individual could deny the cruise line that information (i.e. "it is none of your business") after which the cruise line could simply deny them the ability to cruise.  It might be the same with all the airlines.  So just like you cannot fly without presenting acceptable identification it might also come to be that you cannot fly without showing adequate proof of being vaccinated against COVID.  None of this is contrary to HIPAA.

 

 Hank

         I totally agree when it comes to cruises ,airlines or any other form of public transportation ,vaccinations are in todays covid era essential  & those lines are entitled to know .

 

 Cliff

 

[T8NCruise]

On 12/9/2020 at 6:22 PM, kazu said:

 

I totally agree with you even though I am in Canada.

 

I am not going to tie up an appointment with my physician for a flu shot.  I go to my pharmacy.  It’s well arranged.  

My physician appreciates it as her time is valuable and there are many more people that need her than I do to get a shot.

I see her when needed but resources are short especially in these times and for a simple vaccine, my pharmacist is trained and very good.

 

Pharmacists are a godsend as they take some of the burden from the physicians and make it easier to administer so many vaccines to many more people.  JMO.

Your post reminded me of a few years ago, when I worked in downtown Vancouver, we couldn't even get into the local pharmacies because coachloads of US citizens were coming in every day to get flu shots at the pharmacy.  When you only had lunch time to get your errands - and maybe a flu shot - done, it was really annoying.  We have options - shots at at GP office, pharmacy, nurse practioner.  Glad I don't have to go to another country for it.

 

[mcrcruiser]

9 minutes ago, T8NCruise said:

Your post reminded me of a few years ago, when I worked in downtown Vancouver, we couldn't even get into the local pharmacies because coachloads of US citizens were coming in every day to get flu shots at the pharmacy.  When you only had lunch time to get your errands - and maybe a flu shot - done, it was really annoying.  We have options - shots at at GP office, pharmacy, nurse practioner.  Glad I don't have to go to another country for it.

 

Something doesn't make sense here  .Why would supposed coach loads of USA  citizens want to get their flu shots in Canada  & pay for them when they could  get them in the USA for free ?

Edited December 13, 2020 by mcrcruiser

[mcrcruiser]

We once got 1/3 off   with our US Dollar  .We love Vancouver island & when we got that discount  the English tudor homes where selling for  $300 K Canadian ,so we bought 2 for spec ,Best RE we  ever did . 

[Roz]

6 hours ago, T8NCruise said:

Your post reminded me of a few years ago, when I worked in downtown Vancouver, we couldn't even get into the local pharmacies because coachloads of US citizens were coming in every day to get flu shots at the pharmacy.  When you only had lunch time to get your errands - and maybe a flu shot - done, it was really annoying.  We have options - shots at at GP office, pharmacy, nurse practioner.  Glad I don't have to go to another country for it.

 

 

That doesn't make sense to me either.  We have lots of options (most low or no cost or included with insurance) for getting a flu shot.  

[rafinmd]

I suspect it was more prevalent before the affordable care act.

 

Roy