wileyonlinelibrary.com/journal/jonm J Nurs Manag. 2018;26:158–166.
© 2017 John Wiley & Sons Ltd
Accepted: 13 June 2017
Factors that influence influenza vaccination rates among the
elderly: nurses’ perspectives
Moriah Ellen Phd
Jerusalem College of Technology, Jerusalem,
Institute for Health Policy, Management and
Evaluation, University of Toronto, Toronto,
McMaster Health Forum, McMaster
University, Hamilton, ON, Canada
Moriah Ellen, Jerusalem College of
Technology, 21 HaVaad HaLeumi Street,
Jerusalem College of Technology
Aims: To explore which factors nurses perceive to help and hinder influenza vaccina-
tion rates among the elderly.
Background: Influenza- related illnesses and deaths have disproportionately high prev-
alence among the elderly. Vaccination is an effective tool to prevent complications.
Methods: Semistructured interviews were conducted with nurses focusing on barri-
ers, facilitators and health care providers’ roles in influencing patients to be vacci-
nated. Interviews were recorded, transcribed and thematically analysed.
Results: Nurses identified that the prevalent barriers were fear of the vaccine’s side
effects, feelings of good health and technical considerations. Facilitators included ease
of access and encouragement from health providers, media and social networks. The
health care team was influential in raising vaccination rates through direct recommen-
dation, providing concrete information or leading by example.
Conclusions: The health care team can influence patients to vaccinate. Investments in
training nurses in the knowledge and skills needed to educate patients, and providing
nurses with the necessary resources to engage patients in these discussions may be
beneficial. Nurse managers can be instrumental in enhancing nurses’ roles and actions
to increase influenza vaccination rates among the elderly.
Implications for Nursing Management: It is essential to reinforce the nurses’ role in
promoting vaccination among seniors. Given that nurses are the largest number of
health professionals, their potential outreach to large numbers of people is strong.
elderly, influenza vaccination, nurse management
1 | INTRODUCTION
Influenza, one of the most commonplace seasonal maladies, and one of
the most lethal, leaves behind it a long history of causing illness, death
and financial loss (Nagata et al., 2013). Although the virus no longer
carries the same gravitas as it once did, the World Health Organisation
estimates that 5–15% of the world’s population is infected with influ-
enza every year and causes about 250,000–500,000 deaths (World
Health Organisation, 2014). Complications and deaths caused by in-
fluenza continue particularly among vulnerable populations such as
children, the immunosuppressed and the elderly (Longini & Halloran,
2005; World Health Organisation, 2014). Among the elderly, asso-
ciated deaths continue to be high (Centers for Disease Control and
Prevention (CDC), 2015a; McBean, Babish, & Warren, 1993; Pop- Vicas
& Gravenstein, 2010; Simonsen, Taylor, Viboud, Miller, & Jackson,
2007). Vaccination is one of the most effective tools to prevent influ-
enza and its related complications (Ehreth, 2003; Talbot et al., 2011;
Udell et al., 2013). However, globally, vaccine coverage rates are low
and World Health Organisation’s target of at least 75% vaccination
among the elderly is not being met by most countries (Palache, Oriol-
Mathieu, Fino, & Xydia- Charmanta, 2015; World Health Organisation,
2003). Global influenza vaccination rates for those aged 65 + range