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Step 3: What else do you need to make your decision?
What can you do to
Find out how well this decision aid helped you learn the key facts.
prevent influenza?
A decision aid for those working in a healthcare setting
Antiviral flu shot Don’t
& pills
1. Which option has the highest chance of you getting the flu?
What is influenza?
2. Which option has the lowest chance of patients dying from flu that
ƒ Influenza (the flu) is a common respiratory il ness caused by a virus.
ƒ The flu is spread easily from person to person.
3. Which option has the highest chance of a sore arm as a side effect?
ƒ It starts rapidly. People don’t feel well and get a fever and cough. They may also have a headache, runny 4. Which option has the highest chance of nausea and vomiting as side
ƒ ost people recover in 7 to 10 days, but some have complications such as pneumonia and death.
Correct answers at the bottom of the page.
ƒ f the elderly are in contact with people who have not had the flu shot, they are more likely to get the flu and What are your options to decrease your risk of getting or spreading the flu?
1. Knowledge: Do you know enough about the benefits and side effects of each option?
Take the influenza vaccine (flu shot) before flu season. Your employer arranges for you to have a flu shot
2. Values: Are you clear about which benefits and side effects matter most to you?
D in your arm in the fal. The government pays for the flu shot.
3. Support: Do you have enough support and advice from others to make a choice?
Wait until there is an outbreak of the flu. You wait to see if your employer declares a flu outbreak. Then you
4. Uncertainty: Do you feel sure about the best choice for you?
D have a flu shot. It takes 14 days to protect you from the flu. During those 14 days, you need to take antiviral pil s (Tamiflu) everyday.
Decline both the flu shot and antiviral pil s. In a flu outbreak, workers declining the flu shot and antiviral
 pils because of medical reasons would be reassigned if possible. Workers who decline without a valid medical reason will be placed on unpaid leave of absence until the flu outbreak is over.
Step 4: What are the next steps?
What other health factors may affect your choice?
You should take a flu shot if you OR someone you live
You should talk to your doctor BEFORE taking
 I have decided to take the flu shot before the flu season.
with has a chronic condition that needs regular visits to
the flu shot in some situations. Check  any  I have decided to wait for an outbreak and take the flu shot and antiviral pil s.
 I have decided to decline both the flu shot and antiviral pil s.
 Strong al ergic reaction to a previous flu shot  I need to discuss the options with my doctor and family.
 I need to read more about my options.
 Al ergy to other parts of the vaccine  Other medical conditions that concern you,  Other, please specify: ________________________________________________________  I have no medical concerns about flu shots Answers for the key facts: 1. Decline flu shot & pills 2. Flu shot 3. Flu shot 4. Antiviral pills
This information is not intended to replace the advice of a health care provider.
Working through the 4 steps of this decision aid may help you decide
This decision aid was developed by Canadian researchers who conducted an extensive review of the available scientific literature. Content Editors: A McCarthy MD, S Sul ivan MSc, J Sutherland MEd and the Ottawa Influenza Decision Aid Planning Step 1: What are the benefits and side effects of each option?
Group Funded in part by: CIHR, MOHLTC via SHRTN. All Authors have declared no conflict of interest. Format is based on the Step 2: Which reasons to choose each option matter most to you?
Ottawa Decision Guide 2000, A O’Connor, D Stacey, University of Ottawa, Canada August 2008 Step 3: What else do you need to make your decision?
Step 4: What are the next steps?
4 For additional information please contact the Occupational Health and Safety Department for the
“Facts and Numbers Behind the Ottawa Influenza Decision Aid”.
Step 1: What are the benefits and side effects of each option?
Step 2: Which reasons to choose each option matter most to you?
What does the research show?
Common reasons to choose each option are listed below.
Blocks of 100 faces show a ‘best estimate’ of what happens to 100 people who choose different options during a flu
For each question, circle how much each reason matters to you on a scale from 0 to 5. season. Each face  stands for one person. The shaded areas show the number of people affected. There is no way
of knowing in advance if you or your patients will be the ones affected.
‘0’ means it is not important to you. ‘5’ means it is very important to you.
When answering the questions below, if you decide a reason is important to you, your best options are shown on the right.
Benefits
No flu shot or no antiviral pills
Antiviral pills
15 get the flu
5 get the flu
4 get the flu
get the flu during an outbreak if
How important is it to you?
Not Important Very Important Options to consider
To avoid ALL side effects of taking flu shots To avoid a needle and side effects unless 85 avoid flu
95 avoid flu
96 avoid flu
 Fewer patients die from the flu
15 die from flu
11 die from flu
if their care provider has a
To avoid the inconvenience and side effects To avoid getting the flu for the whole flu 85 don’t die
89 don’t die
Side Effects
Antiviral pills
23 sore arms
52 sore arms
To avoid spreading the flu to family and shot report having a sore arm for
77 avoid this
48 avoid this
8 get nausea & vomiting
15 get nausea & vomiting
pil s report nausea and vomiting
Now, think about which option has the reasons that are most important to you.
92 avoid this
85 avoid this
Which option do you prefer? Check  one:  Platinum or  Gold symbols mean stronger study results.  Silver or ª Bronze symbols mean weaker study results.
Other notes on the flu shot: Guil ain-Barré syndrome is a rare nervous system disorder where the body’s immune system
attacks the nerves in the body. This can cause weakening and numbing of the muscles, and, in severe cases, paralysis may  Wait for an outbreak and take the flu shot and antiviral pil s for 14 days occur. The exact causes of the disorder are unknown, but it is commonly triggered by an infection. Influenza vaccine may slightly increase the risk of developing the disorder. If a mil ion people have a flu shot, one person may get Guil ain-Barré  Decline both the flu shot and antiviral pil s syndrome and 999,999 people avoid this. This ris k is the same as dying in an airplane or train accident. Some people wonder if the flu shot causes fever, fatigue, headache, or muscle pain. They are just as likely to get these symptoms if they are given a shot with a placebo (an inactive substance).
Step 1: What are the benefits and side effects of each option?
Step 2: Which reasons to choose each option matter most to you?
What does the research show?
Common reasons to choose each option are listed below.
Blocks of 100 faces show a ‘best estimate’ of what happens to 100 people who choose different options during a flu
For each question, circle how much each reason matters to you on a scale from 0 to 5. season. Each face  stands for one person. The shaded areas show the number of people affected. There is no way
of knowing in advance if you or your patients will be the ones affected.
‘0’ means it is not important to you. ‘5’ means it is very important to you.
When answering the questions below, if you decide a reason is important to you, your best options are shown on the right.
Benefits
No flu shot or no antiviral pills
Antiviral pills
15 get the flu
5 get the flu
4 get the flu
get the flu during an outbreak if
How important is it to you?
Not Important Very Important Options to consider
To avoid ALL side effects of taking flu shots To avoid a needle and side effects unless 85 avoid flu
95 avoid flu
96 avoid flu
 Fewer patients die from the flu
15 die from flu
11 die from flu
if their care provider has a
To avoid the inconvenience and side effects To avoid getting the flu for the whole flu 85 don’t die
89 don’t die
Side Effects
Antiviral pills
23 sore arms
52 sore arms
To avoid spreading the flu to family and shot report having a sore arm for
77 avoid this
48 avoid this
8 get nausea & vomiting
15 get nausea & vomiting
pil s report nausea and vomiting
Now, think about which option has the reasons that are most important to you.
92 avoid this
85 avoid this
Which option do you prefer? Check  one:  Platinum or  Gold symbols mean stronger study results.  Silver or ª Bronze symbols mean weaker study results.
Other notes on the flu shot: Guil ain-Barré syndrome is a rare nervous system disorder where the body’s immune system
attacks the nerves in the body. This can cause weakening and numbing of the muscles, and, in severe cases, paralysis may  Wait for an outbreak and take the flu shot and antiviral pil s for 14 days occur. The exact causes of the disorder are unknown, but it is commonly triggered by an infection. Influenza vaccine may slightly increase the risk of developing the disorder. If a mil ion people have a flu shot, one person may get Guil ain-Barré  Decline both the flu shot and antiviral pil s syndrome and 999,999 people avoid this. This ris k is the same as dying in an airplane or train accident. Some people wonder if the flu shot causes fever, fatigue, headache, or muscle pain. They are just as likely to get these symptoms if they are given a shot with a placebo (an inactive substance).
Step 3: What else do you need to make your decision?
What can you do to
Find out how well this decision aid helped you learn the key facts.
prevent influenza?
A decision aid for those working in a healthcare setting
Antiviral flu shot Don’t
& pills
1. Which option has the highest chance of you getting the flu?
What is influenza?
2. Which option has the lowest chance of patients dying from flu that
ƒ Influenza (the flu) is a common respiratory il ness caused by a virus.
ƒ The flu is spread easily from person to person.
3. Which option has the highest chance of a sore arm as a side effect?
ƒ It starts rapidly. People don’t feel well and get a fever and cough. They may also have a headache, runny 4. Which option has the highest chance of nausea and vomiting as side
ƒ ost people recover in 7 to 10 days, but some have complications such as pneumonia and death.
Correct answers at the bottom of the page.
ƒ f the elderly are in contact with people who have not had the flu shot, they are more likely to get the flu and What are your options to decrease your risk of getting or spreading the flu?
1. Knowledge: Do you know enough about the benefits and side effects of each option?
Take the influenza vaccine (flu shot) before flu season. Your employer arranges for you to have a flu shot
2. Values: Are you clear about which benefits and side effects matter most to you?
D in your arm in the fal. The government pays for the flu shot.
3. Support: Do you have enough support and advice from others to make a choice?
Wait until there is an outbreak of the flu. You wait to see if your employer declares a flu outbreak. Then you
4. Uncertainty: Do you feel sure about the best choice for you?
D have a flu shot. It takes 14 days to protect you from the flu. During those 14 days, you need to take antiviral pil s (Tamiflu) everyday.
Decline both the flu shot and antiviral pil s. In a flu outbreak, workers declining the flu shot and antiviral
 pils because of medical reasons would be reassigned if possible. Workers who decline without a valid medical reason will be placed on unpaid leave of absence until the flu outbreak is over.
Step 4: What are the next steps?
What other health factors may affect your choice?
You should take a flu shot if you OR someone you live
You should talk to your doctor BEFORE taking
 I have decided to take the flu shot before the flu season.
with has a chronic condition that needs regular visits to
the flu shot in some situations. Check  any  I have decided to wait for an outbreak and take the flu shot and antiviral pil s.
 I have decided to decline both the flu shot and antiviral pil s.
 Strong al ergic reaction to a previous flu shot  I need to discuss the options with my doctor and family.
 I need to read more about my options.
 Al ergy to other parts of the vaccine  Other medical conditions that concern you,  Other, please specify: ________________________________________________________  I have no medical concerns about flu shots Answers for the key facts: 1. Decline flu shot & pills 2. Flu shot 3. Flu shot 4. Antiviral pills
This information is not intended to replace the advice of a health care provider.
Working through the 4 steps of this decision aid may help you decide
This decision aid was developed by Canadian researchers who conducted an extensive review of the available scientific literature. Content Editors: A McCarthy MD, S Sul ivan MSc, J Sutherland MEd and the Ottawa Influenza Decision Aid Planning Step 1: What are the benefits and side effects of each option?
Group Funded in part by: CIHR, MOHLTC via SHRTN. All Authors have declared no conflict of interest. Format is based on the Step 2: Which reasons to choose each option matter most to you?
Ottawa Decision Guide 2000, A O’Connor, D Stacey, University of Ottawa, Canada August 2008 Step 3: What else do you need to make your decision?
Step 4: What are the next steps?
4 For additional information please contact the Occupational Health and Safety Department for the
“Facts and Numbers Behind the Ottawa Influenza Decision Aid”.

Source: http://www.chiin.ca/docs/OIDA.pdf