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Mandatory vaccination for seasonal influenza: what are nurses' views?

12 November 2020
Volume 29 · Issue 20



Preventing seasonal influenza is a public health priority but, although the benefits of vaccinating healthcare workers (HCWs) are emphasised, seasonal influenza vaccine uptake rates remain low. Voluntary vaccination policies have been less successful in achieving high vaccine uptake when compared to mandatory policies and the persistently low vaccine uptake among HCWs has fuelled debate on whether mandatory vaccination programmes should be implemented in the interest of patient safety.


This study explored nurses' views on mandatory vaccination policy for seasonal influenza.


A self-selected sample (n=35) of qualified nurses working in two large hospital sites in Ireland participated in five focus groups. Data were analysed using Braun and Clarke's framework.


Two themes were identified: (1) mixed views on mandatory vaccination and (2) leave nurses to make their own choice on vaccination.


This study provides an understanding of nurses' views regarding mandatory vaccination policy for seasonal influenza and highlights that individual choice and autonomy are crucial for vaccine acceptance.

Vaccinating healthcare workers (HCWs) against seasonal influenza is recommended to reduce the risk of nosocomial infection between patients and HCWs (European Council, 2009; Fiore et al, 2010; World Health Organization (WHO) 2012a; National Immunisation Advisory Committee, 2017). Each year, epidemics of seasonal influenza contribute to a significant increase in mortality and morbidity among high-risk groups, especially older people (Iuliano et al, 2018), with rates of serious illness and death highest among those aged ≥65 years, children aged <2 years and any person with an underlying medical condition (WHO, 2012b).

Internationally there has been substantial interest in addressing the issue of poor vaccine uptake among HCWs (European Centre for Disease Prevention and Control (ECDC), 2018). In the interests of patient safety, vaccinating HCWs against seasonal influenza is recognised as a key public health measure with coverage rates of ≥75% recommended by the WHO since 2003 (WHO, 2003). HCWs influenza vaccine coverage rates for three consecutive seasons (2015–2016, 2016–2017 and 2017-2018) were reported by 12 European member states and ranged from 15.6% to 63.2%. The highest vaccine uptake rates were reported by Belgium, the UK-England and the UK-Wales (2016–2017), with vaccine uptake increasing in Greece, Ireland and the UK; however, coverage rates remained below the goal of 75% (ECDC, 2018).

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