the attitudes and beliefs surrounding influenza and the vaccine , correlating this with vaccine uptake and intention , across the full spectrum of pharmacy professionals working in UK hospitals . The study , involving 170 participants , found that 50.6 % had been vaccinated , 17.1 % had not been vaccinated but intended to be , and 32.4 % had not been vaccinated and had no intention to be vaccinated . Differences were observed between staff groups ( Figure 1 ) and participant age . It is not clear what is driving this difference in vaccination attitudes and uptake between staff groups , but education and training , particularly preregistration training , could be an underlying driver . Younger age correlated with decreased vaccine uptake , which is also true of the general population .
The literature also suggests that access to influenza vaccines is a common barrier to vaccine uptake among busy hospital workers , even those holding positive beliefs and attitudes regarding vaccination . 9 , 10 However , UK research suggests the influenza vaccine is easily accessible to hospital pharmacy staff and this is not a barrier . 8 This could be due to hospital occupational health services coordinating peer-vaccination programmes , whereby health professionals are trained to administer influenza vaccines to their colleagues in their area of employment , such as dispensaries , wards , offices , and even dining and break areas , etc . Regardless of this easy and direct access to influenza vaccination in hospitals , many pharmacy staff are making a conscious decision to not be vaccinated .
Attitudes and beliefs that contribute to vaccine hesitancy are vast and there is rarely only a single negative belief that drives hesitancy ( Figure 2 ). As indicated in the definition by SAGE , vaccine hesitancy is complex and the literature suggests these beliefs and attitudes interlink and influence each other . 4 , 8 Research into this phenomenon has highlighted a number of key beliefs and attitudes that correlate to vaccine hesitancy , shown below .
Believe they are not at risk of influenza This can be further separated into two sub-groups .
• Individuals do not believe they are at risk of contracting the virus : This can be driven by misunderstanding influenza transmission , but equally , it can be a judgement based on their personal and work environments . For example , pharmacy staff working solely in a dispensary or office might perceive their risk to be lower than those working in patient-facing clinical roles . Research has shown that pharmacy staff working in a cardio-respiratory hospital were more likely to be vaccinated than those working at other hospitals . 8
• Individuals do not believe influenza is a severe disease or that they are not at risk of severe disease : This often correlates with the belief that the immune system protects the individual from influenza and severe disease . This is a welldocumented belief that drives vaccine hesitancy among pharmacists , other health professionals , and the general public . 4 , 11 Younger individuals holding this belief might claim their age and self-identified good health makes them less likely to have severe disease .
Do not believe the vaccine is effective Misconceptions regarding influenza vaccine efficacy are common among the general public and health professionals . 12 , 13 Individuals holding this belief may quote statistics from the media , particularly from years where the match between circulating and vaccine strains was poor , to suggest vaccination is not worthwhile . However , these individuals are often not aware of the extended benefits if they do contract influenza , such as preventing or reducing severe disease , hospitalisation , and death but also preventing transmission to others . 14
Concerned about adverse effects of the vaccine Concerns about adverse effects are broad and range from needle-phobia to injection-site pain in the days following vaccination . Some individuals are hesitant about future vaccination due to previous common adverse reactions to vaccines such as fainting , fever , malaise , aches and pains . 7 , 15 Interestingly , a number of health professionals still believe the inactive intramuscular vaccine can cause influenza disease , which has been linked to driving vaccine hesitancy . 7
Overcoming barriers Due to the complexities surrounding influenza vaccine hesitancy , no single intervention or
Global research suggests influenza vaccination uptake among hospital pharmacists varies between 39 % and 95 %, depending on the country and setting
FIGURE 2
Beliefs and attitudes reported in the literature that correlate with vaccine uptake among pharmacy professionals
Correlates with increased uptake
Vaccination for
staff is important
The vaccine will protect my
Flu vaccination should be mandatory for healthcare staff People working The in healthcare should have the vaccine flu vaccination will every year protect me
The vaccine is easy to access
family The vaccine
Sets a good example to patients will protect my patients
Concerned about being infected at work
Influenza can be serious illness
Correlates with reduced uptake
The vaccine will make me unwell
Getting a flu vaccination is too much trouble for me I am not at risk of serious influenza
The vaccine causes serious side effects
I do not have the time to get
I believe my vaccinated immune system is strong enough to protect me
The flu vaccine is not effective
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