Uptake of the Influenza Vaccine by Health Care Workers (HCWs)

Why Behavioural Science holds the key to increasing uptake of the Influenza Vaccine by Health Care Workers (HCWs).

For months now, our attention has been riveted to the progressive onslaught of SARS-COV-2. Hear the word ‘vaccine’ and you’d be forgiven for assuming the person you overheard was referring to the global race to immunise against COVID-19. But there is another vaccination that is almost as important but which is achieving far less attention.

‘Flu’ is a particularly unpleasant disease. Most people who experience it recover after a week but others suffer complications that require hospital admission with ~2% of cases ending in death. Particularly virulent between the months of November and March, Flu descends at a time when NHS is experiencing peak patient admissions, which is why the influenza vaccine really needs to be administered prior to November.

A key aspiration for the Government is to achieve “universal vaccination” of all Health Care Workers. But despite being freely available, current uptake sits around 70.3% of the workforce. Not great, but a lot better than in 2016, when almost half of England’s HCWs elected not to be vaccinated. 

This year the aspiration of “universal vaccination” has taken on far more significance. Come Autumn, our hospitals face the terrifying prospect of co-circulation of SARS-COV-2 and influenza. No-one at this point really knows how this will present.

In order to ensure adequate staffing levels in the NHS and in social care settings, it is more important than ever that we close the vaccination gap. By vaccinating HCWs we protect patients, we protect staff and we help to ensure the NHS is able to withstand any second wave of COVID-19

But to achieve this we need to first understand why approximately one third of all HCWs are set to decline the influenza vaccine this year 

The health belief model would suggest high concern about vaccine side effects; beliefs the vaccine does not work and/or a low perceived risk of catching influenza would reduce the likelihood that someone would decide to vaccinate.

Behavioural Scientists would add to this discussion by suggesting that, even when people are willing to be vaccinated, they are less likely to act on this if the desired action is not easy to achieve. There may be several points of friction (cognitive and structural) between the desire to do something and enactment of that desired behaviour. Once we understand why people do not follow through on their intentions, we can begin to dismantle or overcome these barriers one by one.

We also need to understand if there are particular groups of healthcare workers who are most at risk of missing out on a vaccine. For example, are domiciliary carers more at risk of missing out on a vaccine because travelling between patient homes reduces their opportunity to access a vaccine? Once we understand who is most at risk, we know how to target resources in ways that are likely to achieve greatest overall impact.

It would also be interesting to explore whether the COVID-19 pandemic has altered attitudes toward influenza and vaccinations among HCWs.  Has the focus on the health and care workforce operating as a health “army” united in an ongoing battle against COVID-19 mean that messaging around the pro-social aspects of vaccination will be more salient to the workforce than ever before?

When applied as a diagnostic model, Behavioural Science leads to better insights into the motivations and drivers of behaviour. Unlike other insight models such as; consumer insights, data science or social marketing, it offers a way to understand and interpret seemingly illogical choices or behaviours, increasing our ability to spot previously unseen opportunities and to leverage those insights in ways that help people to make a better choice for themselves & society as a whole.

Behavioural Scientists will seek to make the desired choice or action more salient, desirable and easy to adopt than an alternative, sub-optimal choice.

So-Mo are a leading behavioural design consultancy. Our Behavioural Scientists have successfully applied Behavioural Science to understand why some people do not take medication as prescribed and have also investigated the effects of the MMR scandal on MMR vaccine uptake among mothers with and without mental illness, resulting in the largest study to date.

The optimum vaccination window occurs between September and November. This means that the clock is ticking. The UK’s healthcare managers, commissioners and decision makers have a time-limited opportunity to achieve significant impact.