Some healthcare workers ‘deterrents’ to vax uptake

vaccination older lady elderly woman

Pharmacy staff, chiropractors found among selection of healthcare practitioners voicing anti-vaccination beliefs to patients, according to Australian study

A qualitative study has looked at the perspective of older people relating to influenza and pneumococcal vaccinations.

Researchers interviewed 36 participants aged between 65 and 84 years, recruited from Queensland and New South Wales, between July 2017 and January 2018.

Uptake of the flu vaccine was 78% among the sample – higher than the national vaccination rate of 74.6% in this age group.

Nearly 40% that reported being vaccinated against pneumococcal disease had also received the flu vaccine.

Five key themes were health practitioner influence; anti-vaccination influence; social responsibility; work-based vaccination; and perceptions of age.

“As participants described their perspectives on vaccination, it became clear during analysis that decisions to vaccinate for many participants were the result of accumulating influences,” wrote the authors from the School of Human Services and Social Work at Griffith University in Queensland.

“Some of these were highly individual, for example, exposure to pandemics, death of a parent due to pneumonia, a child with a disability, and personal illness events contributed to their decisions to vaccinate or not,” they wrote in the journal Vaccine.

Even when receptive to vaccination, participants generally felt those in need of vaccination were less healthy or older than themselves.

“I associate [pneumonia] with old people. And I’m not that,” said a 73-year-old participant.

Prompts such as posters, brochures, reminder telephone calls and computer-generated letters to vaccinate against the flu were considered effective.

Providing flu vaccination in the workplace also had a positive effect on continuing this behaviour in later life.

The majority of participants placed their trust and confidence in recommendations and information from their GPs, and those who had been immunised against pneumococcal disease had done so at their doctor’s recommendation.

One [participant] preferred to ward off influenza by taking homeopathic drops provided by a naturopath.

However some health practitioners acted as deterrents to uptake behaviours, the researchers found.

Two nurses expressed anti-vaccination beliefs to two participants – one while administering an influenza vaccination.

Some pharmacy staff (number unspecified), three chiropractors and one GP who practised alternative medicine were openly anti-vaccination, as reported by participants.

Only participants who held pre-existing anti-vaccination beliefs uncritically accepted these perspectives, said the authors.

Where health professionals or close relatives rejected vaccinations, participants made their own decisions based on a range of factors including their own beliefs.

“My chiropractor is always going on about it [not having vaccinations] … But if you’re coming from one side you’re often not open to the reasons on the other side, so I think I probably make more of my own informed decision given all the information I get from other people,” said one participant.

There were “tensions” within families that had different perspectives – for example, two participants were vaccinated despite opposing views of their spouses.

The majority were open to vaccinations even when there was disagreement in their families.

Three participants held anti-vaccination beliefs; these did not support any vaccination, despite knowledge of disease and its consequences.

“One [participant] preferred to ward off influenza by taking homeopathic drops provided by a naturopath,” said the researchers.

Pharmacists in South Australia and Western Australia began administering approved vaccines, including the flu vaccine, in early 2015. Those in Tasmania, ACT, NSW, QLD and Victoria followed suit in 2016.

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