Is it a student nurse's duty to have the seasonal flu jab?

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31 October, 2011

After having a discussion with my tutor group about public health and health promotion, my tutor decided to canvass some opinion about the seasonal flu jab.

Out of sheer curiosity she wanted to know how many students would be having the inoculation.

I raised my hand and looked around the class expecting to see a large number of the 23 students with their hands in the air. However, to my astonishment, there were only seven - around 30%.

What value for money is the government getting out of the advertising and the publicity surrounding the importance of having the seasonal flu jab? Why was the government spending so much time and resources trying to encourage the elderly and those at risk to have this inoculation, when the group that should be the most receptive and knowledgeable were largely opting out?

The tutor looked dumbfounded as she began to try and find out what the reasons were for people’s decision.

In amongst rumblings of indecision and admissions of from some that they actually hadn’t given it much thought, there were two answers that stuck in my mind.

One student said that she had had the jab one year and more-or-less straight afterward, contracted flu. The common misconception that you are injected with a live virus and that the cure is worse than the disease is more prevalent than I would like admit. My other fellow student said that she knew of somebody who had had the injection and it had led, as a direct result, to her becoming paralysed, and through a fear that the same could happen to her she was not going to risk having the injection.

At the end of our conversation, our tutor asked us what the importance was of having the flu jab.

We concluded that as individuals we may be healthy, fit and able; we may be lucky enough not to succumb to seasonal ailments and afflictions. However, the unfortunate fact is that many people do suffer and as students looking to become nurses, one of the ways in which we can protect our patients is to ensure that we are inoculated against a virus that is potentially fatal.

Finally, what about herd immunity.

We need to have enough of the population inoculated against diseases in order to ensure that the virus cannot have a fertile breeding-ground. Surely the starkest example of when herd immunity fails is the MMR tragedy, where a media propagated scare against the safely of the MMR jab led the concerned parents of middle England to choose not to inoculate their children. As a result, we lost that baseline level of immunity and diseases which we thought a thing of the past began to show up again.

These are my views, but what do you think? Where do you stand? Will you be having the seasonal flu jab?

Adam Roxby is Student Editor of Student Nursing Times. Follow him on Twitter @AdamRoxby

Readers' comments (22)

mike | 31-Oct-2011 10:48 am
Adam, I know this is aimed at student's but I still feel as a qualified Nurse I have to answer this one.

No, it is in no way ANY health professional's duty to get an injection, and that view is very pernicious and dangerous. We have the same right to free choice as we would offer to any of our patients, and if an educated health professional looks at and weighs up the clinical evidence for these flu jabs (which by the way is far from conclusive), and they DECIDE to get the jab (as I did), then great. If they DECIDE not to get it based on that, then that is their free choice.

For our patients, all we can do is offer as much balanced clinical information as we can so they can then make a free informed decision. We have that same right, and NO ONE ever has the right to tell me, or anyone else, that it is our duty to get this or any other injection.
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Anonymous | 31-Oct-2011 1:11 pm
Our management clearly cares more about sickness rates and the cost of using bank/agency staff than whether or not we infected a patient with the flu.

I agree with Mike, why should I have that injected into me if I don't want it just because I'm a nurse!?!? If they want to pay me to take the injection, then I'd reconsider.
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NHS flu fighter campaign | 31-Oct-2011 1:19 pm
Great article Adam and it's good to see the next generation of medical professionals engaging in the debate. It's important that people make their individual decision based on the facts and not the myths. The vaccine does not contain the live virus so it is impossible to catch the flu by getting the jab. To see Dr Phil Hammond busting the most common flu myths visit www.nhsemployers.org/flu
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Anonymous | 31-Oct-2011 3:07 pm
I want the vaccination, yet we, student nurses, are not offered it from occupational health. And when inquiring at the GP they tell us to ask occupational health! What are we to do?
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Anonymous | 31-Oct-2011 4:58 pm
Like the previous poster, as students we can't get it from the uni occupational health, the Trust occupational health, or the GP. Each says one of the others is responsible.
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Anonymous | 31-Oct-2011 5:16 pm
Most GP will vaccinate student nurses if you ask the practise nurses.
Although at my hospital OH are practically chasing you about the building to vaccinate staff. All grades are welcome nurses, porters, doctors and domestic staff.
For the record no l'm not having the vaccine because l did come down with the flu following the last vaccination l had. Probably something to do with the vaccine not always being the one for the current bug. . .
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Suzanne Doherty | 31-Oct-2011 5:38 pm
I have had the same problem. Occupational health told me that I should have it, but weren't prepared to give it. I went to my surgery, they also agreed I should have it, but they also won't give it. It's ridiculous really.
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Anonymous | 31-Oct-2011 5:56 pm
As other students have said, our OH are not offering it, though they do reccomend it.
I was given it by my practice nurse as I am Asthmatic but would not have been given it otherwise, several students have tried to get it at their GPs and been told no, they do not fall in to any of the categories.
Some of my fellow students have paid to have it, but I think it should be free, cost should not be a barrier!!
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Karen Alderson | 31-Oct-2011 6:51 pm
As nurses we respect patient choice, and the same applies for us. I work in the community and give flus daily, and always have one too, as I feel for me it's not about employer pressure ( I haven't had a day off sick in 3 years anyway) but it's about protecting myself, my patients, and my family. Most of my colleagues decline the flu every year for the reasons quoted, but that's their choice, too.
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M D | 31-Oct-2011 7:31 pm
From a personal perspective I think yes you should have it. Anybody who works in health-care with patients with weaker immune systems is not really looking after their patients best interests. Most people have a series of vaccinations when they join nursing, so I don't really by all this my human right baloney in relation to flu vaccines. In some wards I've worked in London if you present with Influenza symptoms your sent home which seems sensible to me. I also think if a patient has a concern that a nurse has a cold they should be entitled to decline care (I would). The bigger question I think that needs answering is: Do the general public think nurses having flu vacancies is mandatory? It would be very interesting to see what they believe...
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Anonymous | 31-Oct-2011 7:34 pm
I am in the same position as other student nurses have mentioned above. My GP tells me I should have it but he won't get paid for it so he won't give me it and tells me my university should give it through Occupational Health. My university has stopped its agreement with Occupational Health now (unfortunately) and have been told to go to our GP because they will give it!! What do I do?!
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Anonymous | 31-Oct-2011 7:42 pm
I do not see the point of being vaccinated each year against a virus that constantly mutates. Are the patients' friends and families being vaccinated before visiting their loved ones on the wards and touching them with unwashed hands? My cohort of student nurses were told that we HAD to have the Hepatitis B vaccine to protect ourselves from patients. Those of us who protested were warned "No vaccine - no placement". I do not wish to be injected with formaldehyde and other toxic adjuvants thankyou very much just to line the big drug companies pockets. We are more at risk in London of contracting HIV from patients than we are Hep B (look at the facts and figures) and yet nobody makes a fuss about HIV....is this perhaps because there's no vaccine for this yet???
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Little One | 1-Nov-2011 1:44 pm
I have to agree with Mike on this, it is my body and my right to choose if I have an innoculation or not, I should not be forced into it just because I work in health care. I have had flu once, and it was the one year I had the flu jab, regardless of whether it contains a live vaccine or not, I do not think it is coincidence. I also have to agree with Anonymous above, would relatives of ill patients be forced into having the vaccine too? I'm very particular and fussy regarding what I put into my body and a vaccination I do not think is necessary doesn't really do it for me. I'm also terrified of needles and have to be sedated and the day off work, so I think it is somewhat impractical. Until it becomes mandatory, which I don't think it will/should be, I have every right to say no thank you.
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NHS flu fighter campaign | 1-Nov-2011 4:28 pm
For those people keen to have their flu jab, but being sent round in circles between your GP and OH department, you may find it helpful to know that the Chief Medical Officer wrote to the NHS on 25 May 2011 to set out arrangements for the 2011/12 seasonal flu vaccination programme. Her letter stated that:

‘employers are responsible for ensuring that arrangements are in place for the vaccination of their frontline health and social care workers…Decisions on offering immunisation should be made on the basis of a local risk assessment…Employers should make vaccine available free of charge to employees if a risk assessment indicates that it is needed…Students and trainees in these disciplines and volunteers who are working with patients should also be included.’

It may help when speaking to your OH departments, the CMO letter is available at
http://www.dh.gov.uk/en/Publicationsandstatistics/Lettersandcirculars/Professionalletters/Chiefmedicalofficerletters/DH_127048
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NHS flu fighter campaign | 1-Nov-2011 6:25 pm
For those people keen to have their flu jab, but being sent round in circles between your GP and OH department, you may find it helpful to know that the Chief Medical Officer wrote to the NHS on 25 May 2011 to set out arrangements for the 2011/12 seasonal flu vaccination programme. Her letter stated that:

‘employers are responsible for ensuring that arrangements are in place for the vaccination of their frontline health and social care workers…Decisions on offering immunisation should be made on the basis of a local risk assessment…Employers should make vaccine available free of charge to employees if a risk assessment indicates that it is needed…Students and trainees in these disciplines and volunteers who are working with patients should also be included.’

It may help when speaking to your OH departments, the CMO letter is available at
http://www.dh.gov.uk/en/Publicationsandstatistics/Lettersandcirculars/Professionalletters/Chiefmedicalofficerletters/DH_127048
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Grant Byrne | 1-Nov-2011 8:45 pm
I think it ought to be mandatory frankly. The fact is we work day in day out with vulnerable people who don't need us adding flu to their risk of worries. It takes next to no time, and while I understand some people have a fear of needles it's important. We as nurses, ought to try and do as much as possible to do right by our patients. You can argue that it's not fair that this is the case purely because we're healthcare workers, that we should have the choice, but we chose to go into Nursing, and therefore have a duty of care to our patients. Surely that should include protecting them from an illness that proves fatal for hundreds in the UK every year?
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Anonymous | 2-Nov-2011 1:35 pm
Grant Byrne, by insisting that certain procedures should be mandatory is starting down a very dangerous path.
Would it stop at innoculation? What about making it mandatory for all Health Care Professionals to give up smoking? or making all of us that are overweight go on a diet, or making it illegal for us to eat MacDonalds or KFC or drink alcohol to excess.
Would you insist that all HCPs are automatically included on the organ donor register when they are employed?
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Anonymous | 2-Nov-2011 9:53 pm
There are many other healthcare workers in contact with vulnerable patients, should they all be made to have the flu jab? And what about patients' relatives, carers, friends?
The only thing that ought in my humble opinion to be mandatory is NO SMOKING anywhere!

And talking about duty, our first duty is to ourselves.
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Anonymous | 2-Nov-2011 10:33 pm
As a nurse I feel I should protect my patients; as a wife with a husband and daughter that are on medications to suppress their immune systems I feel very strongly that I need to protect them from my patients and yes I would hope all those who help care for my family would do their best to protect them as losing them would be unbearable. Yes I have had the flu injection for many years now and yes there is risk with every thing and whilst I would not agree with it being mandatory I would like everyone to think long and hard about it and the effect it has on others in our country.
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Anonymous | 2-Nov-2011 10:45 pm
Grant, I agree we all chose to go into nursing and obviously want to give the best possible care to our patients, but the point I and others have made above is that we could have all the vaccines going, however, that won't stop our patients' friends and relatives bringing their germs in and breathing/sneezing/coughing them all over the place, neither will it force them to wash/gel their hands on entering the ward, something else I get very annoyed about when my hands are red raw from the constant washing. Like anonymous above said, what about all the other healthcare staff, Doctors etc. should they be forced to have vaccinations too? Colds and flu are caused by viruses that are constantly mutating to survive, and vaccines are only effective (if they really are)against previous strains which most people will have already built some resistance to. Again, it's everyone's personal choice and I, personally, will not ever be forced again into receiving any vaccine. Autonomy for patients - Autonomy for the staff.
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