REVIEW
The challenges of influenza vaccine hesitancy in hospital pharmacy staff
Vaccine hesitancy is a complex issue that affects hospital pharmacy staff receiving the influenza vaccine . This article discusses the drivers for uptake and hesitancy , and proposes interventions to address this
Ryan Hamilton PhD PGDip ( ClinPharm ) PractCert ( IP ) MRPharmS MFRPSI AFHEA School of Pharmacy , De Montfort University , Leicester , UK ; Pharmacy Department , Kettering General Hospital NHS Foundation Trust , UK
Adam Baker BSc CertHE School of Pharmacy , De Montfort University , Leicester , UK
Every year , 4,000,000 – 50,000,000 people across
Europe ( EU / EEA ) develop symptomatic influenza , of which 15,000 – 70,000 will die . 1 Influenza vaccines are safe and effective , preventing millions of infections every year and protecting thousands of individuals from developing serious disease or dying . Vaccination is also deployed to protect groups at risk of severe disease such as older people , pregnant women , and people with conditions such as chronic obstructive pulmonary disease and diabetes . Notably , being vaccinated offers extended protection to those in close-contact due to reduced transmission . Pharmacists , and the wider pharmacy team , undertake a range of patient-facing and non-patient-facing roles that will expose them to influenza . These pharmacy staff can then disseminate the virus to vulnerable patients , other health professionals , and their family and friends . 2 Therefore , it is imperative for pharmacy staff to be vaccinated every winter .
Pharmacy teams can also play an important role in providing vaccination . During the 2020 – 21 influenza vaccination programme in England ( UK ), community pharmacists administered around 2.6 million influenza vaccines , an increase from 1.7 million delivered the previous year , 3 possibly driven by society ’ s reliance on community pharmacies during the COVID-19 pandemic . Pharmacy ’ s involvement has been focused in primary care and there are few data on the role of secondary care pharmacy professionals , possibly because it is not an expected role for secondary care .
A significant proportion of pharmacy staff do not receive their annual vaccine against influenza . National and European ( through ECDC ) monitoring programmes and published research often fail to appreciate the diverse workforce within hospital pharmacy services and often groups pharmacists and pharmacy colleagues in with other allied health professionals or clinical support services . This makes it difficult to truly understand influenza vaccine uptake among hospital pharmacists , pharmacy technicians , and other support colleagues .
Vaccine hesitancy The SAGE working group on vaccine hesitancy defines it as a “ delay in acceptance or refusal of vaccination despite the availability of vaccination services . Vaccine hesitancy is complex and context specific , varying across time , place , and vaccines . It is influenced by factors such as complacency , convenience and confidence ”. 4
Global research suggests influenza vaccination uptake among hospital pharmacists varies between 39 % and 95 %, depending on the country and setting . 5 – 7 Hamilton et al 8 is the only group to report
FIGURE 1
Vaccination and intention rates among hospital pharmacy staff at three hospitals in England 8
Vaccinated Not vaccinated - intends to be vaccinated Not vaccinated - does not intend to be vaccinated
Pharmacist 57.6 25.8 16.7
Pharmacy Technician 47.7 13.6 38.6
Pharmacy Assistant 43.5 8.7 47.8
Clerical staff 61.5 7.7 30.8
Trainee ( preregistration ) pharmacy technician 18.2 18.2 63.6
Trainee ( preregistration ) pharmacist 85.7 14.3
22 | Issue 99 | 2021 | hospitalpharmacyeurope . com