Nurses shirking duty, or informed choice:

1 September 2011

A recent UK Nursing Times editorial argues it is little wonder that patients don’t follow treatment regimens when nurses are so divided over the ‘flu vaccine.

The editorial followed some negative online comments about the effectiveness and safety of the vaccine in response to a National Health Service (NHS) media campaign to get its employees vaccinated.

The NHS argued that the risk of a serious reaction to the seasonal flu vaccine was less than one in a million, much lower than the risk of getting seriously ill from the flu itself, but not all nurses are convinced. “If well informed, well educated and health-interested professionals can express such divided views over something that is intended to protect and preserve their well-being, then it’s little wonder that patients, who are given half as much information in a 10-minute appointment go away in disbelief about the importance of following their treatment regimen,” argues the UK Nursing Times editorial.

The editorial prompted correspondents citing the Cochrane Review on the effectiveness of vaccines to prevent influenza in healthy adults. That review looked at 50 research reports and concluded vaccination had a modest effect on time off work and had no effect on hospital admissions or complication rates. The Cochrane Review, by lead author Tom Jefferson, has for several years sparked strong debate in the pro and anti-vaccine camps, particularly in the US in 2009 when New York state made the call for mandatory immunisation of healthcare workers against the H1N1 (swine flu) virus.

A nursing study by a nurse academic and former hospital health and infection control director, published last year by the American Nurses Association’s online journal, examined the case for and against mandatory vaccination of healthcare workers. The Paula Sullivan study looked at research into side effects and the effectiveness of staff vaccination in reducing patient illness and mortality, including a Jefferson-led Cochrane review of influenza vaccination for healthcare workers of the elderly.

She said low rates of ‘flu vaccination among healthcare workers was definitely a contributing factor to the spread of influenza, but this was only one of many factors, including the universal low vaccination rate across the whole population and failure by healthcare workers to adhere to infection control practices.

Sullivan’s study concluded that the experts agreed that vaccination was an effective measure to decrease the spread of an influenza outbreak and had very few serious side effects. She rejected mandating immunisation for healthcare workers and instead supported mandating that hospitals offer comprehensive programmes to eliminate barriers to voluntary immunisation, while respecting the right of the individual to decline vaccination for religious, medical or philosophical reasons.