How Did School Staffers Get Insulin Instead of Flu Vaccine?

Possible Fallout

While no one seems to be suffering long-term consequences from the medical error, adverse events are always possible with insulin being needlessly injected, since it drops the blood-sugar levels.

"It's basically going to make them hypoglycemic," said Dr. Sue Kirkman, senior vice president for medical affairs for the American Diabetes Association. "That might cause anything from just feeling shaky and jittery and hungry all the way down to making it difficult to think."

Kirkman explained that a person can become unconscious if their blood-sugar drops too low, but noted that this type of error could be corrected by certain injections or "you can have the person eat carbohydrates to bring the blood sugar back up," depending on the severity.

It remains unclear what, if any, impact this incident will have on public demand for flu vaccine.

Both nurses seemed to think, however, that the incident, while unfortunate, would likely improve safety in people still getting vaccinated without reducing the number of people willing to get the shot.

"When you have stories out there, then people are going to be asking the person administering -- the nurse -- what are you giving me?" said Renny. "What I think it does is help the administrator administer the right vaccine, because it's forefront in their mind."

"I do think people who are actively going to seek a shot are going to be proactive about asking the nurse, which is a good thing," said Lowery. At the same time, she said, "We still need to encourage the public to get both their H1N1 vaccination," noting that it remains unclear if H1N1 will return and the traditional peak of seasonal flu has not yet arrived.

"Don't let an incident as isolated as this affect your choice," she said. "Make sure you get vaccinated and prepare for the flu season."

More Answers Needed

One complicating issue that has not been resolved yet is how the error was made, given that the H1N1 doses had come in prefilled syringes, while insulin doses are filled at the time from a vial.

Insulin "typically would not be in pre-filled syringes," said Kirkman, adding that "there are some situations where a home health nurse, for example, might pre-fill syringes for someone who's homebound. I think it's just impossible to speculate."

"It does seem odd," said Lowery. "However, having been a school nurse, it involves more than giving out Band-Aids," she said, noting that kids and teachers are coming in for a variety of ailments. "I can see, unfortunately, where it would be very easy to get flustered and confused."

A woman answering the phone for the Wellesley superintendent's office indicated that the investigation is ongoing and no answer could be provided for that particular question yet.

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