THE HSE IS facing an uphill battle in reaching its flu vaccination target among health workers, particularly in nursing homes, where staff apathy towards the vaccine has been high in previous years. 

This year, amid the coronavirus pandemic, the HSE is hoping to see 75% of healthcare workers vaccinated against the flu. However, the vast majority of HSE-run nursing homes and long-term care centres fell far below that target during the 2019 flu season. 

According to figures from the Health Protection Surveillance Centre, 43.1% of healthcare workers in long-term care facilities received the flu vaccine. 

Only nine of over 200 HSE-run facilities surveyed would have reached the 75% vaccination target announced for this year. 

Some facilities reported flu vaccine uptake rates among staff below 10%, despite the vaccine being free for healthcare workers. 

The Covid-19 pandemic has added an extra element of urgency to the HSE’s efforts to ensure that as large a proportion of staff as possible receives the flu vaccine. 

The organisation is now set to take a targeted approach to ensuring that uptake increases, with regional and local communications being used to ensure that the number of staff receiving the vaccine grows. 

Last month, HSE CEO Paul Reid told the Dáil’s Covid-19 committee that the widespread variation in vaccination rates is “not sustainable” heading into a winter alongside a growing number of Covid-19 cases. 

In guidance issued to healthcare workers this month, the HSE said that small year-to-year increases had been “encouraging” but warned that “uptake remains well below the target”. 

One manager of a long-term care centre, who didn’t want to be named, told TheJournal.ie that it was a struggle every year to get staff vaccinated. 

“Staff here are very anti-flu vaccine,” they said. They said they didn’t know why staff felt such reluctance to get the vaccine, adding that the pandemic hasn’t made a difference in attitudes. 

Changing attitudes

Conor Leonard, CEO of the Royal Hospital in Donnybrook, said that healthcare workers often have an “ingrained” attitude towards the flu vaccine. 

“There is that perception among nursing staff that they’re constantly exposed and they believe they have quite strong immune systems,” he told TheJournal.ie. 

But he said some of those attitudes were changing. While last year’s flu vaccine uptake among healthcare staff at the HSE-funded, independently-run hospital reached 47%, previous years have seen rates reach 60%. 

He said that the introduction of ‘peer to peer’ vaccination schemes, where trained staff vaccinate colleagues, had proven a success, while he also said that offering incentives – from fleeces to KeepCups – also made a difference. 

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Leonard also stressed that vaccination rates were typically high among patients. 

It’s particularly important for healthcare workers, who often work with sick and vulnerable individuals, to get the vaccine. Every year, between 200 and 500 people die from flu. The vaccine, which helps a person’s immune system to produce antibodies to the virus, is used to stop the spread.

There are various, complex reasons healthcare workers typically avoid getting the flu vaccine. One study, published in 2019, found that flu vaccine take-up among Irish healthcare workers was “sub-optimal”, with some citing a belief that the vaccine would cause illness. 

A spokesperson for the HSE did not offer an explanation for why vaccination rates were so low among Irish healthcare workers. 

They said that “each year the HSE works with a wide group of stakeholders to encourage influenza vaccine uptake in all target groups, including healthcare workers”.

“This year, influenza vaccine is also available to healthcare workers free of charge through a GP or Pharmacist of their choice. Awards for the best-performing facility for staff vaccine uptake also take place to incentivise flu vaccine uptake in healthcare staff,” the spokesperson said. 

The spokesperson also said that the HSE is working with Nursing Homes Ireland, which represents private nursing homes, as well as private hospitals, to promote vaccine uptake.