The Department of Health’s director of immunisation Professor David Salisbury has said nurses have a responsibility to be vaccinated against swine flu, after a Nursing Times survey reveals one third of frontline nurses do not want the jab.
Up to a third of frontline nurses are not currently planning to get immunised against swine flu when the vaccine becomes available later this year, a snapshot survey by Nursing Times reveals.
Top among the reasons for rejecting the vaccine are concerns about its safety, and a perception of the infection as ‘mild’, suggests the online survey of nearly 1,500 Nursing Times readers, of whom 91% describe themselves as frontline nurses.
Overall 30% of survey respondents answered ‘no’ when asked if they would get immunised when the vaccine became available, compared with 37% who replied ‘yes’. A further 33% remained undecided and answered ‘maybe’.
Of those who said they would not get vaccinated, 60% said concern about the safety of the vaccine was the main reason. A further 31% of respondents said they did not consider the risks to their health from swine flu to be great enough, while 9% thought they would not be able to take time out of work to get immunised.
‘I would not be willing to put myself at risk of, as yet, unknown long-term effects to facilitate a short-term solution,’ said one respondent.
Another, who said they were yet to make up their mind over whether to have the vaccine, added: ‘I have had the seasonal flu vaccination three times and on each occasion was very poorly for several days afterwards. It can give you flu-like symptoms, which in my case were bad enough to put me in my bed.’
A further respondent said: ‘I have yet to be convinced there is a genuine health risk and it’s not just government propaganda.’
Speaking to Nursing Times in response to the survey results, Professor David Salisbury, the Department of Health’s director of immunisation, said it was unfortunate that nurses could ‘knowingly leave themselves at risk’.
‘They have a duty to themselves, they are at risk. They have a duty to their patients not to infect their patients and they have a duty to their families. I think you solve those responsibilities by being vaccinated,’ he said.
With regards to safety concerns about the vaccines, he added: ‘The evidence that we’ve had is sufficient to persuade the regulators that these are vaccines that will be licensed.’
Professor Salisbury’s comments follow a warning in July from chief medical officer for England Sir Liam Donaldson that swine flu could leave up to 12% of the NHS workforce on sick leave at any one time. The NHS Confederation also called on nurse managers to ensure that their staff were vaccinated, particularly those in the acute sector, in guidance published last month.
However the survey results suggest the threat of swine flu is unlikely to overcome reluctance of frontline nurses to get vaccinated. Only a third of survey respondents said they received the seasonal flu vaccine last winter.
Official statistics for the acute sector are even worse. Only around 13.5% of hospital nurses received seasonal flu vaccination last winter, according to the Department of Health’s report on flu vaccine uptake among healthcare workers in 2008–2009.
Some trusts – Newcastle upon Tyne Hospitals NHS Foundation Trust and Mid Staffordshire NHS Foundation Trust – vaccinated fewer than 3% of their nursing staff.
The DH report said: ‘Overall influenza vaccine coverage for [healthcare workers] directly involved in patient care remains disappointingly low.’
Nursing Times understands that the Department of Health is in discussions with groups, including the RCN, on ways to ensure a high uptake of swine flu vaccine was high among frontline nurses.
Greta Thornbory, professional development director of the Association of Occupational Health Nurse Practitioners, said occupational health nurses would need to help frontline nurses make an educated judgement about the vaccine.
She said: ‘Occupational health nurses will have to be completely clued up about the evidence on the swine flu jab, so they can give up-to-date information to nurses and anyone else who might have the vaccine.
‘This advice should not just be verbal, occupational health staff should consider putting it in a leaflet. Putting this kind of advice on posters will not work,’ she added.
However, one survey respondent suggested pressure from occupational health nurses could have an adverse effect on uptake.
‘I think many nurses resent the pressure put on them by occupational health staff to have the seasonal flu vaccine, and this may influence their decision regarding the swine flu vaccine,’ the respondent said.
As widely reported last week, Sir Liam Donaldson also set out the government’s proposed timetable for vaccinating priority groups against swine flu, which includes frontline healthcare workers (see box).
Frontline nurses – working in primary care settings as well as acute settings – can expect to be offered vaccination in October, subject to the granting of licences by the European Medicines Agency.
A decision on licensing is expected from the EMEA at the end of September once versions of the vaccine have undergone multicentre trials – run by the University of Leicester and the Health Protection Agency – to assess immunity levels and identify any side-effects.
Nurses who opt to have the vaccine can expect to be given one of two products, both of which will require two jabs roughly three weeks apart.
The majority of swine flu vaccine will be the adjuvant version manufactured by GlaxoSmithKline, which contains 4mcg of antigen. The second type, manufactured by Baxter, is a whole virus vaccine containing 7.5mcg of antigen.