Despite COVID-19 emergency, 25% of nurses still won’t get immunised

The percentage of doctors refusing vaccination against influenza is expected to drop from 23% in 2019 to just 6% this winter, a survey among medical practitioners published in the latest edition of the Malta Medical Gazette reveals.

But despite concerted efforts by the health department to minimise the risks of a dual impact of seasonal influenza and COVID-19 on the country’s healthcare system in winter, a quarter of nurses are still adamant on not taking the jab according to a questionnaire sent to all healthcare workers in July.

The survey, described as “encouraging” by the authors, indicates an increase in the ‘projected’ vaccine uptake across all healthcare workers, with the percentage of nurses refusing vaccination expected to drop from 45% to 25% in 2020.

When all health workers are taken into account, the percentage of non-immunised workers is expected to drop from 41% last year to 21%.

Globally, seasonal influenza infects 5%-15% of the population, with a total of 3-5 million cases of severe illness and 500,000 deaths. Hospital-acquired influenza has a particularly high mortality, and healthcare workers are frequently the source of these infections.

Since the survey was held three months ago, it does not take into account the impact of information campaigns in subsequent months, which are expected to further increase the uptake of health professionals taking the vaccine.

The anonymous questionnaire was sent to all healthcare workers in Mater Dei Hospital, district primary care health centres, St Vincent de Paul home, Mount Carmel mental health hospital, Karin Grech rehabilitation hospital and other smaller facilities. A total of 735 health workers answered the questionnaire.

Respondents were asked whether they had taken the influenza vaccine last winter and whether they intend taking the vaccine this coming winter.

But while the numbers are encouraging the authors decried the fact that some medical practitioners still decline the vaccination, warning that this behaviour is “unethical” and that “there is really is no excuse not to take the vaccine” since any side effects are mild and typically resolved within two days.

They also call on the authorities to consider making the vaccine mandatory for doctors, nurses and other health workers.

Since healthcare workers accept professional responsibility for the care and well-being of their patients, they are obliged to “follow evidence-based practices” while the “institutions are obliged to enforce universal vaccination of their health care workers against seasonal influenza.”

The Society for Healthcare Epidemiology has recommended that annual influenza vaccination should be a condition of employment for healthcare workers.

The study also calls on the authorities “strongly promote employee vaccination uptake with educational campaigns that target misconceptions and reinforce the contention that vaccination is integral to ethical, beneficent, and professionally competent care.”

The authors of the study attribute the higher proportion of healthcare workers intending to avail themselves of influenza vaccination this year to “the strong advice already being given in this regard by the Public Health Department” to minimise the risks of a potential dual impact of seasonal influenza and COVID-19 on the country’s healthcare system in winter 2020.

The reluctance of a significant percentage of health workers to take the jab is attributed to “insufficient knowledge about the vaccine and its safety with irrational apprehension.”

International studies show that the influenza vaccination of healthcare workers reduces mortality in influenza-vulnerable populations, especially among the elderly and in care homes.

The vaccine is available for free for healthcare workers, or at a nominal price of circa €10 if taken privately.

The study was authored by paediatricians Victor Grech and Simon Attard Montalto, public health superintendent Charmaine Gauci, and Mater Dei Chief Operating Officer Steve Agius.