Story courtesy of UNLV School of Nursing.
By Joseph Gaccione (Communications and Outreach Specialist, UNLV School of Nursing)
UNLV School of Nursing alumna Sarah Lugo wanted to enlarge her nursing scope to help vulnerable populations, so she sought out a greater awareness of improving public health. Originally a Med Surg nurse, she worked her way to become senior community health nurse for the Southern Nevada Health District (she also has a Master’s in Nursing Leadership and Management and is pursuing a Master’s of Nursing for Nurse Family Practitioner at UNLV) .
Lugo’s focus now is on flu season and immunizations, which is heightened by the threat of COVID-19. She recently sat down for a one-on-one interview to discuss her role at the Health District, and the importance of getting a flu vaccine, especially during a pandemic, and how COVID-19 is changing her training.
Q: Can you explain your role as senior community health nurse?
A: We are called the Immunization Outreach and Projects Team. We do all the background work for immunizations that most people don’t’ really know exist. I like to call us “the CIA of Immunizations”. Some of our programs include:
- Vaccines for Children – a CDC program that provides vaccine for uninsured and underinsured children. Our team ensures healthcare providers are maintaining their vaccine properly.
- Perinatal Hepatitis B Program – case manages mothers who are positive with Hepatitis B to prevent transmission to their babies
- Coordinate public health efforts of vaccinations and COVID testing in the homeless community in the encampments and shelters
- Coordinate immunization activities on SNHD’s mobile unit to overcome barriers for the community to receive immunizations.
Specifically, my position entails that we go out into the community and that we vaccinate, that we make sure people are protected. So my job is primarily to figure out where we’re going on to identify areas that are at higher risk or locations with higher populations that are at higher risk, that we can go out to and figure out how to immunize them, and then figure out a process for it. With the COVID pandemic, my job shifted focus and moved to COVID tested. My team developed a “Contactless L-Shape Model” to minimize exposure and make it replicable. We used this model to train hundreds of people in multiple entities and test thousands of people in our community and in targeted populations. So, I was able to use the knowledge base I have from immunization outreach in the community and targeted populations and apply it to COVID testing.
Q: What are the criteria when you’re looking for locations?
A: Our goal is to get flu protection through immunization out into the community. Specifically, we want to reach our higher risk populations such as our Hispanic community, African American community, and our 65 years and up community. People who are 65 and up, pregnant women, young children, and people with certain medical conditions have an increased risk of developing serious complications from the flu. In addition, CDC data indicates that the highest hospitalization rates related to the flu in the 2018-2019 flu season were in our African American, American Indian or Alaskan Native, and our Hispanic populations. We make a targeted effort in these communities to educate and protect them with flu immunizations. We want to make sure that we’re getting in there.
Q: What is the general timeframe for flu season?
A: Flu can technically be present all year, but it tends to peak in the colder months, typically in the fall and winter, with peaks December through February. After June 30th, this year’s flu vaccine will no longer be given. Once we start seeing the flu strands that are coming out and start testing for those, the pharmaceutical companies will start working on next year’s vaccine. So, it’s very far in advance when they start working on those. Sometimes with flu vaccine, flu changes and then the strands continue to change. So that’s why, by the time the next season comes, it may not always match perfectly. And we don’t know until flu season starts, but regardless of that, getting your flu vaccine will always help you with the different strands and what we offer as a quadrivalent vaccine. So, it covers the four most common strands. Some people may experience some symptoms from those, but even if you were in a little mismatch on there, it will help reduce the symptoms that you may have experienced.
Q: Obviously, it’s not a normal year for getting the flu vaccine due to COVID-19. What has preparation been like?
A: You’re absolutely right about that. As we’re going out there as nurses, our number one priority is to keep ourselves safe and to keep our clients that we’re serving safe. So, as we’re entering into this, we are trying to come up with processes to make sure that we have the least amount of contact, the least amount of exposure for our staff and for our clients, such as our PPE that we wear, which is more than what we would normally wear if we were in flu vaccine; disinfecting between clients; trying to make the paperwork as much online as possible. We still have to do our six-foot distancing, just like we would anywhere else, and we are not doing mass gatherings. For flu vaccine clinics, this looks different this year. This is something that we’re having to accommodate and also tweak as we continue to move forward.
Q: Some people might be afraid to go into the doctor’s office during the pandemic. Do you feel like people are more hesitant to get it, or do you think they’re more eager to, because they want to be more protected?
A: We have seen a great response to people protecting themselves and their families with the flu vaccine. There have also been a lot of people who have receive their flu vaccine for the first time. But what we’re seeing is we’re having a good acceptance rate of the flu vaccine. We’re seeing that people are wanting it. I think people are concerned with COVID being here, and the flu vaccinee being here. So, we are seeing good acceptance rate of the flu vaccine. As we know, immunizations are public health’s greatest accomplishment. Here in America for the past 50 years, we’ve given a million doses of flu and we know that it works.
Q: The CDC website says this year’s flu vaccine is more important than ever due to the pandemic. Do you agree?
A: I think regardless of the year, it’s always important, period. We know that a lot of people are hospitalized from the flu. We want to make sure that we protect against that. But in that aspect, we do have COVID and we want to make sure that we aren’t inundating our hospitals with flu and COVID. So, because of that, it is especially important to make sure that you get your flu vaccine this year.
Q: If less people are going out, do you think that’s going to impede the progress of people getting vaccinations?
A: I think that’s a good concern. I think there are some people that are hesitant to leave their house to get the flu vaccine. So, I think the Southern Nevada Health District and many other community partners within Clark County are trying to do our best to figure out innovative ways to get the flu vaccine out for people that do want it. You see things such as a drive-up clinic, which we recently hosted one of those, and there are several other entities in the County that are providing drive up clinics. Then, there are people just making it more convenient. If you go to the grocery store, if you go to Walgreen’s or one of the pharmacies that you certainly can get the vaccine. So that being just more convenient, not everyone has to go to those traditional settings of their doctor’s office anymore. They can go through those nontraditional settings and get the vaccine. it does make it easier while out at their normal activities.
Q: When the pandemic first started, there were quite a few comparisons to the flu, specifically numbers and symptoms. What should people remember about the flu that they shouldn’t confuse with COVID?
A: We do have clients that come in, and they want to know if this is going to protect them from COVID and it is two completely different viruses. They don’t have a vaccine yet for COVID. This is specifically for the flu. If you get the flu vaccine, that does not protect against COVID at all. They are still working on a safe and effective COVID vaccine. The big thing to remember is that every year we have a large amount of people that suffer from complications from the flu. That continues to go on this year. We have people die every year from the flu. We want to make sure that people are being protected. We are seeing more people die with COVID and their complications being more severe. Both are equally important to protect yourself and take precautions against.
Q: Did you ever think something like the pandemic would be part of your job working with the health district? Was there any hesitation?
A: Not at all, I’m a nurse. this was our time to step up as nurses and to show and help our community. My team was the team that was mobilized to do all the COVID testing. So, as we are continuing, we’re training more people for COVID testing, we’re moving into flu vaccine and preparation. We didn’t hesitate at all. We were ready for it. We were happy that we could give back to the community. I think as nurses that generally, that’s why we become nurses. We want to help people. I think I can speak on behalf of all my team of nurses that we were ready to serve in what capacity we could serve in.
Q: Have you ever had specific pandemic training or any similar education?
A: We work with Office of Public Health and Preparation. We do regular routine PODs (Point of Dispensing) on an annual basis. We all go through FEMA training. SNHD has plans in place and performs annual drills to practice large scale events similar to mass vaccination or dispensing medication. We were able to use those plans and training and apply it to mass COVID testing. Previous to this, we had our hepatitis-A outbreak here in our homeless population. We had already been working our hepatitis A outbreak, so it was a switch in gears.
Q: How has the pandemic changed how you operate vaccination protocols in the future?
A: The pandemic is altering our processes to ensure that all measures are taken to protect our staff and clients when we vaccinate in community settings. We have extra people on staff to help people maintain a 6 foot distance and wearing masks. We have extra staff to move clients through more quickly. We have altered our registration process to be contactless and soon it will be online. Tables and chairs are disinfected between clients. We are doing everything we can to get the flu vaccine out to our communities safely.
Q: What would be the best tips for people in a very heightened time?
A: My best tip would be don’t wait to vaccinate. Get it done now. There are lot of options available to get your flu vaccine: through your doctor, your local pharmacy, at the grocery store. The community can make an appointment at the health district or go online to ImmunizeNevada.org and find a local flu clinic.