It is that time of year again. With the nights closing in and the winter woollies coming out - it is time for a flu vaccination! And this plea is not for patients, but for healthcare workers to present themselves for vaccination. The posters are about and the clinics offered - so we just have to turn up and roll up our sleeves. But not even 50% of us actually do.
The number of healthcare workers who have a vaccination is low: last year 44.6% of us had a vaccination, an improvement from 34.7% the previous year. Nurses generally have a low uptake, with 39.3% having a vaccine last year.
Those in general practice have the highest uptake in front line nursing staff – probably due to having close proximity to vaccination clinics (being highly likely to be doing the flu clinic themselves) and ready access to the vaccine that is generally offered to nurses by their employing GP. Vaccine uptake across NHS organisations varies from under 10% to above 90%.
As healthcare workers it is assumed we are aware of the risks and benefits of immunisation. Illness from influenza can be mild to severe, even among people who are healthy, with the young at risk of severe complications.
In England, there were 602 deaths from influenza in 2010-11, with around 9,000 patients admitted to hospital, where 2,200 of these ended up in intensive care. Deaths per year are high compared to other infectious diseases with two thirds of these in the 15-65 age group. This is regrettable for a disease that is largely preventable through vaccination.
Evidence indicates frontline healthcare workers are more likely to be exposed to the influenza virus, especially during winter. A quarter of us may become infected with influenza - a much higher incidence than expected in the general population.
Influenza is highly transmissible. We may transmit the illness to patients even if we are mildly or sub-clinically infected. Sick and hospitalised patients are more vulnerable to the severe effects of influenza.
The Green Book recommends that healthcare workers directly involved in patient care be vaccinated annually. It is encouraged by the National Medical Council and the Royal College of Nursing and seen as being good clinical practice.
So why do clinicians refuse the flu vaccine? We know they want to do the best for patients. We know the vaccine is effective.
A recent survey of healthcare workers found a third of us felt that universal infection control practices are sufficient. The survey reported they were not vaccinated because they had a good diet and/or take vitamins or supplements that work equally as well as the influenza vaccine.
These actions alone will not prevent influenza - vaccination is the best option for protecting ourselves, our family and vulnerable patients from the virus. ‘Herd immunity’ of healthcare workers will reduce the risk of introduction and transmission of the virus. The evidence is overwhelmingly clear for influenza vaccination.
So let’s be true leaders - step forward for vaccination and tell the world you are proud to be protecting patients, family and colleagues as well as yourself. Challenge others to practice what we preach to patients.
It makes sense: flu makes you a liability, it makes you feel really ill and staff sickness increases the workload pressures.
If you have had the jab, well done. If not, seek it out - it is not too late to do the right and honourable thing for the society we are part of. Some mutter it should be a part of the Nursing and Midwifery Council code and employment contract of all eligible nurses. What do you think? What are your suggestions for improving the uptake?
BA(Hons) PGCE RN RM RHV FWT NP
Nurse Adviser and Independent Trainer
As well as working on the Nursing in Practice advisory board, Marilyn is also Lead Nurse for a teaching PCT, supporting nurse-led services and the development of practice nurses and healthcare assistants. She enjoys being a respiratory trainer and a nurse opinion leader and is passionate about expanding and blurring nursing boundaries in primary care.
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