Nurses’ experiences of the seasonal influenza vaccine in residential care

Abstract

The experience of nurses who work in the residential elderly care setting regarding the seasonal influenza vaccine is often overlooked, with a paucity of published qualitative studies. The aim of this study is to present an insight into the issues concerning nurses with regard to the seasonal influenza vaccine. The study purposively sampled registered nurses (n=11) working in a large long-term care facility for older people (n=142) in Ireland. Using a broad qualitative research approach, data were collected through interviews, transcribed, analysed and grouped into the following themes: knowing: the seasonal influenza vaccine; mandatory vaccination: balancing autonomy and control; and meaningful education. This study reveals the complexity of issues and concerns for nurses when it comes to the seasonal influenza vaccine. These issues and concerns include influences such as family, friends, peers, the media and how nurses inform themselves. The position of nurses within the organisation and recommendations for meaningful nurse education are also discussed. The findings of this study provide an insight that could inform future influenza policy and education, which should be explored before the introduction of any mandatory influenza campaigns.

Seasonal influenza vaccination of healthcare workers: systematic review of qualitative evidence

“…Many participants perceived themselves as at low risk of contracting influenza as they are healthy or ‘never get sick’ [ 12 – 25 ]. Some argued that they have a strong immune system due to working in healthcare and being exposed to infection [ 15 , 18 , 19 , 23 ]. Several studies reported a perception that high-risk populations comprise older people and people with chronic illnesses, not healthy working-age adults: [ 14 – 16 , 19 , 20 , 22 , 25 ] “what people get from the advertisements is you really only need it if you’re sick or in the nursing home or you have a lot of health issues” (participant [ 25 ]).…”

“…Many participants believed the vaccine was effective, and cited as reasons to accept vaccination: protecting patients against infection, particularly vulnerable groups such as older or immuno-compromised patients; [ 12 , 14 , 16 – 20 , 22 – 24 , 26 – 29 ] protecting their own health [ 12 , 14 – 17 , 19 , 20 , 22 – 24 , 28 , 29 ] or that of their families; [ 12 – 17 , 22 , 23 , 28 ] and avoiding time off work [ 12 , 14 – 18 , 23 , 24 , 29 ]. Few participants mentioned herd immunity or population health [ 16 , 17 , 26 ].…”

“…Some participants pointed to the mutation of the virus and the possible mismatch of vaccine strains as reasons why the vaccine is sometimes ineffective [ 14 , 15 , 20 , 23 ]. Some suggested that the scientific evidence on the effectiveness of the vaccine was insufficient to provide a convincing case for vaccination programmes: [ 18 , 24 , 31 ] “ I think it’s the skeptics that in actual fact are specifically the medical staff who are very analytical people, so therefore when you’re actually trying to actually use evidence as a means of mechanism of influencing people, I think that sometimes the evidence is a little rubbery ” (participant [ 31 ]). Several argued that other infection control procedures (such as handwashing and not working when ill) should suffice to prevent influenza without recourse to vaccination of HCWs [ 14 , 19 , 20 , 22 , 23 ].…”

“…Many participants expressed concern about possible side-effects of the vaccine, [ 12 – 25 , 32 , 33 ] including causing influenza or influenza-like symptoms, [ 13 – 18 , 22 – 24 ] or discomfort at the injection site [ 13 , 14 , 16 ]. A few also mentioned more serious possible side-effects such as Guillain-Barré syndrome [ 12 , 20 , 25 ].…”

“…A few also mentioned more serious possible side-effects such as Guillain-Barré syndrome [ 12 , 20 , 25 ]. These views tended not to be based on evidence but on personal experience of adverse effects, [ 13 – 18 , 20 , 22 – 24 ] or in fewer cases, the experiences of colleagues [ 13 , 22 ] or patients [ 18 , 25 ]. Participants in two studies cited uncertainties about the scientific consensus on vaccine safety [ 16 , 17 ].…”