This week’s blog has been written by Dr Carol Gray Brunton, from Edinburgh Napier University, UK and highlights the vital role that nurses and health professionals play in addressing beliefs around vaccines.
Vaccination is one of the most successful public health interventions in developing countries through the eradication of infectious diseases. Achieving high vaccination rates are important for ‘herd’ immunity to protect the general population against disease [1]. World Immunisation Week 24-30th April 2023, “The Big Catch-Up”, aims to support countries to reach pre-2019 immunisation target rates that have been missed or negatively impacted by the global pandemic [2].
The COVID-19 pandemic highlighted the global importance of vaccination. It also signalled the prominent role of nurses and other health and social professionals in vaccination campaigns: as priority groups for receiving their COVID-10 vaccines given their frontline work, as advocates for vaccination and also as trusted sources of information by the public [for example 3]. However, the very idea that nurses and other health and social care professionals might refuse or delay their own COVID-19 vaccine could be seen as a contentious issue given their professional roles and commitment to evidence-based practise. Vaccine ‘hesitancy’, defined as delays or refusals, is considered a major public health issue globally for complex and context-specific reasons [4-5].
In our recent online mixed-methods study, we considered the topic of COVID-19 vaccine hesitancy amongst nurses and other health and social professionals/those in-training. We adapted an online survey [6] and online focus group discussions for one large University’s Health and Social Care School in a small pilot sample. Results showed that most participants held positive views about the COVID-19 vaccine, vaccines in general, and reported having received at least two doses of the COVID-19 vaccine at the time of the study (June – September 2022). Around 10% of participants, however, had not yet received any COVID-19 vaccines and held strongly negative views about the vaccine. This small vaccine ‘hesitant’ group resembles large general population surveys reported earlier [6].
In the online qualitative discussions, professionals expressed mostly positive views about the COVID-19 vaccine, but they talked about instances where the vaccine could be seen as problematic in their professional or personal encounters with the public. Common vaccine concerns were discerned including avoiding ‘overloading’ the immune system with multiple vaccines; protecting vulnerable groups by not risking harm or ‘omission bias’ [7]; and that some vaccines were seen as less necessary, for example influenzae vaccines.
Given the prolific and ever-changing flux of vaccine information over the course of the pandemic it is challenging, but important, for professionals to stay up to date with the latest evidence. Nurses and other professionals remain integral to vaccination campaigns given their trusted and front-facing roles with the public and can allay common vaccine concerns in their professional and personal encounters. Research and evidence-based training during vaccine campaigns could address commonly held public concerns about vaccines that may seep into public perceptions and amongst some professionals so that professionals remain confident in addressing these concerns. This is not following an information-deficit model to provide greater scientific information [8] but rather in the context of the management of emotions and professional relationships to enhance informed decision-making [9].
Dr Carol Gray Brunton PhD, MSc, BA(Hons) CPsychol AFBPsS FHEA (@GrayBrunton)
[1] How do vaccines work, World Health Organisation. [Accessed 25/04/2023] How do vaccines work? (who.int)
[2]. World Immunisation Week 24-30th April 2023, “The Big Catch-Up: World Health Organisation. [Accessed 25/04/2023] World Immunization Week 2023 (who.int)
[3] Petrova D, Gray Brunton C, Jaeger M, Lenneis A, Munoz R, Garcia-Retamero R, Todorova I. The Views of Young Women on HPV Vaccine Communication in Four European Countries. Curr HIV Res. 2015;13(5):347-58. doi: 10.2174/1570162×13666150511124743. PMID: 26149158.
[4] Ten threats to Global Health in 2019. World Health Organisation. [Accessed 25/04/2023 ] https://www.who.int/news-room/spotlight/ten-threats-to-global-health-in-2019
[5] MacDonald NE. Vaccine hesitancy: Definition, scope and determinants. Vaccine. 2015 Aug 14;33(34):4161-4.
[6] Freeman D, Loe BS, Chadwick A, Vaccari C, Waite F, Rosebrock L, Jenner L, Petit A, Lewandowsky S, Vanderslott S, Innocenti S, Larkin M, Giubilini A, Yu L-M, McShane H, Pollard AJ, Lambe S. COVID-19 vaccine hesitancy in the UK: the Oxford coronavirus explanations, attitudes, and narratives survey (Oceans) II. Psychological Medicine. Cambridge University Press; 2022;52(14):3127–41.
[7] Ritov I, Baron J. Reluctance to vaccinate: Omission bias and ambiguity. Journal of behavioral decision making. 1990 Oct;3(4):263-77.
[8] Lehner, L., Gribi, J., Hoffmann, K. et al. Beyond the “information deficit model” – understanding vaccine-hesitant attitudes of midwives in Austria: a qualitative study. BMC Public Health 21, 1671 (2021). https://doi.org/10.1186/s12889-021-11710-y
[9] Kennedy, C., Gray Brunton, C. & Hogg, R. ‘Just that Little Bit of Doubt’: Scottish Parents’, Teenage Girls’ and Health Professionals’ Views of the MMR, H1N1 and HPV Vaccines. Int.J. Behav. Med. 21, 3–10 (2014). https://doi.org/10.1007/s12529-013-9356-4