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HEALTH

EXPLAINED: How to get the flu vaccine in Norway 

Flu season is upon us, but who is eligible for a influenza jab? Where can you get one in Norway, and what does it cost? 

Here's how you can get the flu-jab in Norway. Pictured is a doctor preparing an injection,
Here's how you can get the flu-jab in Norway. Pictured is a doctor preparing an injection,Photo by Sam Moqadam on Unsplash

A bout of flu is never nice, and in some cases, you can get seriously ill, with some risk groups more prone to severe illness than the rest of the population. Influenza can lead to severe pneumonia, among other things, and also exacerbate any existing conditions one might have. 

In Norway, nearly 1.6 million people are advised to get a flu jab this year, according to the Norwegian Institute of Public Health. But, so far, only four out of ten of those in risk groups have received the shot. 

Seasonal flu vaccines in Norway contain four types of flu virus; two A strains (one of the H1N1 subtype and one of the H3N2 subtype) and two B strains (Victoria and Yamagata). 

Municipalities began receiving shipments of flu jabs in mid-October, with the rollout in most places beginning shortly after. 

Who is recommended to get a jab? 

Everyone over the age of 65 is recommended to get a flu jab annually, as well as care home residents, women who are more than 12 weeks pregnant (or those in the first trimester that belong to a risk group), and premature babies born before week 32 of pregnancy aged between 6 months to 5 years. 

In addition to this, children and adults are advised to get a flu jab if they have chronic lung disease, heart disease, diabetes, liver and renal failure, an impaired immune system, a neuromuscular disease that affects breathing, multiple disabilities, or if they are severely obese.

If you think you may have a health condition that means you are more at risk, you can ask to be assessed by your doctor. 

The seasonal influenza jab is also recommended for those working in health, pig farming, and those living with or in close contact with immunosuppressed people. 

Everyone else who wants to receive a flu vaccine will need to pay (more on that below). You can read more on who can get a flu jab on the Norwegian Institute of Public Health’s website here

Where to get one

Municipalities handle the rollout process, so how, where, and who you get your vaccine from will depend on your local authority. 

To find out where you can get the vaccine in your area, you should check with your local authority or GP’s office. 

If you belong to a risk group, your local GP or the municipal flu vaccine service should contact you. If you are in a risk group or eligible and haven’t heard from the authorities regarding your flu jab its best to get in touch with them. 

You can also book an appointment for a flu jab at a pharmacy. However, as this is not included in Norway’s flu vaccination program so will come with additional costs. 

How much does it cost?

This year the flu vaccine is free for everyone who belongs to a risk group or for employees who are obliged to be offered a flu vaccine by their employer. 

This means health workers and other personnel in the health and care sector who have regular contact with patients can get jabbed for free. 

For those getting vaccinated at a GP, there will be a deductible of 50 kroner for the service. For those who have a free card, the vaccine will be free. Free cards are issued to those who pay the maximum annual amount of yearly deductibles. 

READ ALSO: How Norway’s health insurance scheme works and the common problems foreigners face

Vaccines taken as part of an offer from the municipality are completely free. 

The cost will be considerably more for those who opt to take a flu vaccine at a pharmacy. This is because the pharmacy will charge for the vaccine and also the vaccination service. This also applies to those in target and risk groups. 

The price of a vaccine at pharmacies will vary due to differing prices for the jab and services, but as an example, a vaccine from Apotek 1 costs 399 kroner.

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HEALTH

EXPLAINED: What to do if you face a long wait for healthcare in Sweden

Sweden theoretically has a "healthcare guarantee" limiting your wait to see a GP to three days, and to see a consultant to three months. The reality is somewhat different. Here's what you can do if you face a long wait.

EXPLAINED: What to do if you face a long wait for healthcare in Sweden

What is Sweden’s ‘healthcare guarantee’? 

Sweden’s “National Guaranteed Access to Healthcare” or vårdgaranti, is a right to care, protected by law, that has applied in Sweden since 2005. You can see the latest version of the relevant laws here and here. Here is a summary of the guarantee on the website of the Swedish Association of Local Authorities and Regions (SKR).

Under the system, all patients are guaranteed:

  • contact with a primary care centre by phone, in-person, or by video-link on the day they seek care 
  • an appointment with a doctor, nurse, physio, or psychotherapist within three days of seeking help 
  • an appointment with a specialist doctor or consultant within 90 days of seeking help 
  • treatment or operation within 90 days, if the specialist considers this necessary 

Does the guarantee mean I have a right to treatment? 

No. If the doctor at the primary care centre, after examining you and questioning you, decides that there is no reason to refer you to a specialist doctor, they do not need to do so. 

Similarly, if the specialist doctor, after examining you, decides that no treatment is necessary, then your case is considered completed.  

Can the waiting times to see a specialist or to get treatment be longer than 90 days? 

Absolutely. In fact, they very often are. 

According to the Swedish Association of Local Authorities and Regions (SKR), in February, 32 percent of patients had been waiting 90 days or more to see a specialist, and 43 percent of those who had seen a specialist had been waiting for treatment for more than 90 days.  

The situation in primary care was a little better, with 80 percent of those seeking care in contact with their primary care centre on the same day, and 83 percent having their case assessed by a doctor or nurse within three days. 

In addition, if you agree with your specialist doctor that you are willing to wait longer for an operation, then that wait doesn’t get counted in the statistics. 

So what can I do if I’ve been waiting longer than the guaranteed time? 

In reality, it’s actually less a guarantee than a target.

In primary care, there is no way for individual patients to complain that they have had to wait too long to see a doctor or nurse, or to cut their waiting times by citing the guarantee. 

“There’s no system for enforcing that guarantee,” says Emma Spak, the primary care doctor who doubles as section chief for SKR’s healthcare division. 

It would make no sense to set up a complaints line for those who have had to wait too long for phone contact with their primary care centre, she points out, when they could instead talk to patients seeking a primary care appointment in the first place. 

“It’s more of an incentive system for the regions,” she explains.

Every primary care unit and every region reports their waiting times to the national waiting time register, and then as part of the access agreement between SKR and the government, the regional health authorities receive a bonus if they meet their waiting times goal, or if they improve their waiting times. “That’s one way of sort of enforcing this guarantee,” she says. 

When it comes to specialist treatment, though, patients do have the right to demand to be examined or treated by an alternative specialist or hospital if they’ve had to wait longer than 90 days.

If your primary care centre issues you a referral to a specialist, and the specialist cannot then offer you an appointment within 90 days, the specialist, at the same time as offering you a later appointment, will often put you in contact with a unit at the regional health authority who will offer to find you an alternative specialist, either within the region or elsewhere in Sweden. 

The regional health authority will then have to reimburse any extra travel or hotel costs incurred by the patient.  

Similarly, if after examining you, a specialist cannot offer you treatment within 90 days, they will normally put you in contact with the same unit. 

Some regions have a phone line for people who have been waiting too long, or else you can contact your specialist or primary care centre and ask for information on seeking an alternative specialist. 

What happens if I don’t want to travel to see a specialist or get treatment? 

If your regional health authority offers you an alternative specialist, either within your region or in another region, so that you can get treated within the 90 day period, and you are unwilling to travel, then you lose your rights under the guarantee. . 

“If you’re in Gothenburg, and they say you have to go to Stockholm to get your treatment, and you say, ‘no, I want to go here, then then you’ve sort of forfeited your right, and you have to take what’s on offer,” Spak says. 

What happens if I agree with my specialist to wait longer? 

If your specialist says that they can treat you in four months, but also offers you treatment elsewhere within the guaranteed 90 days, and you choose to be treated by your specialist, then that counts as a patient choice, which will not then be counted in the statistics. 

“The specialist might say, ‘I don’t think you will get any worse for waiting two months extra, and if you wait five months, then I can make sure that you get your surgery done here, and we can make sure that you get all the aftercare and everything here as well,” Spak says. 

But these patient decisions are also counted in the statistics, and if a region sees a sharp rise in patients choosing to wait, SKR will tend to investigate. 

“If some region all of a sudden has a lot of patients choosing a longer waiting time, then we will call them and ask what’s going on here, because patients don’t tend to want to wait extra,” Spak says.  

Can I get financial compensation if I’ve been waiting too long? 

No. 

What other ways are there of speeding up the wait for treatment? 

Don’t underplay your symptoms

When drawing up their timetable for treatment and assessment, specialists will tend to give different patients different wait times depending on the urgency of their case.

For this reason, it’s important not to underplay your symptoms when visiting a primary care doctor, as they will tend to include a few lines on the urgency of your case when they write their referral. 

Stress your flexibility 

If you are unemployed, a student, retired, or have a very flexible job, it is worth telling your primary care doctor about this, because they may write in your referral that you are able to make appointments at very short notice. The specialist may then put you on their list of people to ring if one of their patients cancels. 

“Sometimes I write in my referrals that this patient could easily come at short notice, so please put the patient on the list for people you can call if there’s a time slot available,” Spak says. 

If you haven’t told your primary care doctor this, it’s not too late. You can ring the specialist yourself and tell their receptionist that you are very flexible, and ask to be put on the back-up list. This is particularly useful if you’re waiting for a scan, but you could also potentially work even if you’re waiting for heart surgery or a hip replacement. 

“If they’ve accepted you as a patient, and they’ve made sure that you fulfil the criteria for having that scan or whatever, then you can call them and say, ‘I have a really flexible job, I can come anytime if you have a gap,'” Spak says.

“A lot of people do that, because they can have [back-up] waiting lists. If you tell them ‘I work around the corner and I only need 15 minutes to be there’, then they might call you if someone doesn’t show up.” 

Ring up your specialist 

The queue system tends to be quite ad hoc, with no strict rules over who should be treated first, so it is often possible to reduce your wait by ringing up your specialist a few times a month, just to bring your case to their attention. Sometimes the receptionist will remember a slot that has just come free and bring forward your treatment while you are still on the telephone. 

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