Retail clinics provide an alternative to long waits at doctors’ offices during flu season.
Every season has its telltale signs: with spring, comes blossoming flowers; with fall, it’s a slight nip in the air; and with the dreaded flu season, there are chills, fatigue, and body aches. Sniffling, feverish patients cram waiting rooms during this sickly season, which occurs in the fall and winter and peaks in January and February. The steady expansion and popularity of retail clinics has provided an alternative to the long waits at doctors’ offices for those seeking influenza immunization or treatment of the flu.

Flu shots have been in use on a national scale since 1976; they are highly recommended in the health care industry. In fact, the accessibility and promotion of the flu shot seems to have skyrocketed in recent years: in 2009, 94% of all vaccination visits at retail clinics were to obtain an influenza vaccination, for a total of 1.8 million flu shots.1

Enter Retail Clinics
Retail clinics give the masses an additional location at which they can receive the flu vaccine. Nurse practitioners or physician assistants treat patients at these retail clinics and are able to administer a variety of vaccinations to patients at a low cost—even no cost with some insurance plans.

Receiving a seasonal flu shot at the right time ensures its efficacy throughout the flu season. The Centers for Disease Control and Prevention (CDC) recommends getting the flu shot in early autumn, preferably before October.2 As a result, retail clinic visits spike during fall, a side effect of flu season preparation, according to a study published in the medical journal Health Affairs.3

Why are so many people getting their flu shots at retail clinics? Affordability and convenience are the chief reasons. Retail clinics accept most insurance plans, and the Affordable Care Act requires most preventive services, including flu shots, to be provided without cost. If an individual does not have health insurance and is paying out-ofpocket, however, the price of a flu shot at a retail clinic is likely to be lower than at a primary care physician’s office. Depending on what type of influenza immunization a patient chooses, costs range from $25 to $50 at retail clinics. In regard to accessibility, retail clinics have extended hours and accept patients on a walk-in basis, making getting a flu shot just another errand that can easily be accomplished at any time—without the long wait at a doctor’s office.

For neighborhoods without a retail clinic, pharmacists can administer a seasonal flu shot to children aged 7 and older. Pharmacies also accept a wide array of insurances and offer low-cost flu shots for those without health insurance.

A study published in the medical journal Vaccine in 2009 found that older individuals, who are more susceptible to the virus, are more likely to head to retail clinics than other locations for a seasonal flu shot. “Alternative locations address some population segments not captured by the traditional health care system,” the study authors indicated. “Retail stores capture patients who are older, nonwhite, and [at] high-risk for influenza.”4

In 2014, CVS Health proclaimed September to be “Senior Vaccination Month” to encourage senior citizens to become vaccinated before the winter. This promotion for CVS Minute Clinic and CVS Pharmacies educated senior citizens about their need for higherdosage flu shots, such as Fluzone High Dose, which has 4 times the antigens as a regular flu shot.5 People older than 65 years have weakened immune systems and are more liable to become sick with any disease, including the flu. According to the US Department of Health and Human Services, 90% of flu-related hospitalizations and deaths occur in people older than 65 years.6

Data from the Vaccine study also revealed that the majority of customers who receive flu vaccinations at retail clinics are not paying out-ofpocket and still receive traditional health care services outside of the retail clinic setting. This customer also tends to be older, the study suggests.7

Incentives
Incentives are another means of promotion for retail clinics to bring in a wider array of customers. For instance, CVS MinuteClinic and CVS Pharmacy will provide patients with a 20% off coupon or $5 ExtraBucks to be used within the store after receiving a flu shot. At Rite Aid pharmacy and RediClinic, a flu shot recipient is gifted with 25 Wellness+ points, which are rewards that can be used toward store discounts.

The CDC recommends an annual flu shot for everyone older than 6 months in order to ensure optimal protection against the virus. Traditional flu shots are trivalent. Seasonal flu shots contain the flu strain predicted to be the most rampant during the upcoming flu season. For the 2014-2015 season, the CDC stated that the flu shot was 23% effective: about 70% of the H3N2 flu viruses observed this year “drifted.” This is why the H3N2 flu shot for this past season was not as effective, according to the CDC.8

Despite the drifting viruses, the CDC encourages people to get the flu shot because “vaccination can still prevent some infections and can reduce severe disease that can lead to hospitalization and death.” Additionally, if other strains of the virus pop up later in flu season, a vaccine containing various strains of the virus will still be advantageous. This is the reason seasonal flu shots are available at retail clinics and continuously promoted throughout flu season. When the flu shot is not successful and a strain of the virus causes an infection, many people will seek medical care at retail clinics.

Flu Tests
Flu symptoms are similar to those of the common cold. A flu test is most often given to determine if the influenza virus is the cause of a patient’s symptoms. Retail clinics typically have tests for both influenza A and B. If the test is positive, an antiviral drug is prescribed in order to shorten the lifespan of the virus. At most retail clinics, flu tests cost extra. However, retail clinics have price menus, so the cost of the test will be known beforehand. If a patient has a primary care physician, a copy of the patient’s test results and medical record can be sent over to his or her doctor’s office and a follow-up appointment scheduled.

Demographics
Statistics show that the people who get their flu shots at retail clinics are not the same as those who will walk in to a retail clinic for flu treatment; acute conditions make up the bulk of medical treatment visits at retail clinics. In contrast to the demographic of people who receive flu shots at retail clinics, those who frequent clinics for flu treatment often pay out-ofpocket and do not have a primary care physician.9

Retail clinics are available to everyone during flu season, for both immunization and care. They are, however, predominantly vaccinating older, highrisk patients against the flu and treating younger, low-risk patients who have contracted the virus. In essence, the retail clinic setup is attracting people from diverse demographics and generations to prevent and treat the flu. 


Katrina Rossos is a freelance writer and journalist living in New Jersey. She graduated from Tulane University with a BA in English and film studies. She was an editor for AOL, and her work has appeared in New Jersey Life magazine and Our Town newspaper, as well as on Azula.com and TheDodo.com.

References
  1. Uscher-Pines L, Harris KM, Burns RM, Mehrotra A. The growth of retail clinics in vaccination delivery in the U.S. Am J Prev Med. 2012;43(1):63-66. doi: 10.1016/j.amepre.2012.02.024.
  2. Key facts about seasonal flu vaccine. Centers for Disease Control and Prevention website. www.cdc.gov/flu/protect/keyfacts.htm. Accessed February 23, 2015.
  3. Mehrotra A, Lave J. Visits to retail clinics grew fourfold from 2007 to 2009, although their share of overall outpatient visits remains low. Health Aff (Millwood). 2012;31(9):2123-2129. doi: 10.1377/hlthaff.2011.1128.
  4. Lee BY, Mehrotra A, Burns RM, Harris KM. Alternative vaccination locations: who uses them and can they increase flu vaccination rates? Vaccine. 2009;27(32):4252-4256. doi: 10.1016/j.vaccine.2009.04.055.
  5. September is senior vaccination month at CVS/Pharmacy and MinuteClinic [press release]. Woonsocket, RI: CVS Caremark Corporation; August 28, 2014. http://info.cvscaremark.com/newsroom/press-releases/september-senior-vaccination-month-cvspharmacy-and-minuteclinic. Accessed February 14, 2015.
  6. Seniors. Flu.gov website. www.flu.gov/at-risk/seniors/. Accessed February 20, 2015.
  7. Uscher-Pines L, Harris KM, Burns RM, Mehrotra A. The growth of retail clinics in vaccination delivery in the U.S. Am J Prev Med. 2012;43(1):63-66. doi: 10.1016/j.amepre.2012.02.024.].
  8. Protection from flu vaccination reduced this season [press release]. Atlanta, GA: Centers for Disease Control and Prevention; January 15, 2014. www.cdc.gov/media/releases/2015/p0115-flu-vaccination.html. Updated January 15, 2015. Accessed February 20, 2015.
  9. Mehrotra A, Wang MC, Lave JR, Adams JL, McGlynn EA. Retail clinics, primary care physicians, and emergency departments: a comparison of patients’ visits. Health Aff (Millwood). 2008;27(5):1272-1282. doi: 10.1377/hlthaff.27.5.1272.