Five Ways to Convince Patients they Need Flu Shots

Nurses should never force patients to take any treatment, but sometimes we have to be a bit more persuasive in our approach to a particular procedure. One such treatment is the flu shot, and there are several myths and fears surrounding this vaccine. Helping your patient understand the importance of the flu shot can go a long way to making them healthier.

Patients, especially chronically ill patients, need flu shots, but many in the general public have an open distrust for this vital vaccine. In fact, some people reject all vaccines, and that's a different issue entirely. Flu shots are still important, and some members of the public take a little convincing to get them to accept the shot. There are a great deal of myths and misconceptions about this shot, and some patients believe the hype.

As nurses, we have to try to do what's best for the patient, and sometimes that means educating about those myths. Of course, we could never force someone to take a shot that they are dead set against, but the persuasion of education may be enough to allow them to see that the need for the shot. If you come up against a patient who is chronically ill that refuses a shot, here are a few strategies to combat the myths they may believe.

Explain How Flu Shots are Created

Some patients do not understand exactly what the flu shot is, and this can lead to distrust and refusal. It helps to explain to them that it is an amalgamation of the various flu strains thought to be active for the coming season. You can also use this information to help explain why the shot needs to be performed every year. The flu strains change, and the new vaccine differs every year.

It helps to explain the flu and get patients to understand that it can knock them out for weeks. Emphasizing that the people in charge of creating the vaccine make it as safe as possible, but it isn't a guarantee against getting the flu. Some strains pop up every year that can infect even patients who have gotten the shot. Once this is explained, some patients are more open to the idea of getting a flu shot.

Emphasize Safety of Flu Shots

Flu shots are generally considered safe. You can use this information to educate the patient that they are better off with it than without it. Of course, there is often local irritation where the shot is administered, but most people don't tend to have reactions to the shot itself. The vaccine is rigorously tested for safety, and the possibility of a reaction is minimal.

You may also find patients who are afraid of getting a shot. It helps to explain that the shot only hurts for a minute, though they may have soreness later. The shot goes into the deltoid, an IM shot, and these are usually more painful than others. Explain that they will feel some discomfort at first, but it quickly goes away. Usually, the benefits of the flu shot are far more important than the momentary pain that some patients experience.

Assure Them They Won't Get the Flu from the Shot

One of the most prevalent myths about the flu shot is that it gives you the flu. This keeps more patients away from the shot than any other excuse. It is your job to explain to them that the preparation is a dead one. This means that the virus isn't active and helps the immune system recognize and destroy the virus when it comes around to infect.

Some patients do get the flu after a flu shot, but this is usually because they were already infected when they got the shot. In this case, it is difficult to convince the patient that the shot didn't lead to their symptoms. If you were the patient, you would have a hard time believing it, too. Tell the patient that getting the shot as early in the season as possible will prevent this phenomenon, but it is still possible.

Educate about Symptoms of Flu

Those who refuse the flu shot should be told the symptoms for several reasons. First, it is more likely that they can get the flu without the shot, and they should know what to look for in case they do become infected. Second, they may decide to have the shot once they realize how miserable it is to actually have the flu. The public is not usually educated about the signs and symptoms of the flu, and they may change their mind once they know.

You should tell them to watch for high fever, over 101 degrees F. The symptoms of the flu often are confused with that of the common cold. Stuffy head, congested chest, and muscle aches are all common symptoms. The difference is that the flu is generally more severe and lasts for a longer time. While the cold can last for a few days, the flu can linger for weeks, and this can cause inconvenience and health problems for the patient.

Explain the Complications of Flu

Healthy people do not usually suffer complications of the flu. Yes, they are miserable, can't go to work, and generally inconvenienced, but it doesn't descend into a medical crisis. This isn't true for those who are very young, very old or have a chronic disease. The immune system in these patients is not generally as robust, and this means that the flu can take hold and lead to further problems.

The most common problem that arises from the flu is the manifestation of pneumonia. In those with a compromised respiratory system, pneumonia can lead to a stay in the hospital and possibly a trip to the ICU. Even those with diabetes are at risk for the condition developing into pneumonia because of the general decrease in immune function due to high blood sugars. For the very young and the very old, pneumonia can be devastating and particularly hard to treat. Explaining these complications can help to convince even the most recalcitrant patient to accept the vaccination.

Specializes in Med/Surg, Academics.
"Current evidence supporting the effectiveness of influenza vaccine in preventing hospitalizations in older adults is insufficient": Effectiveness of seasonal vaccine in preventing confirmed influenza... - PubMed - NCBI

The quote you used was from the background portion of the study. In other words, it was a quote supporting the need for the study you linked to. The findings of the study showed the vaccine prevented 61.2% of hospitalizations.

"Influenza vaccines can provide moderate protection against virologically confirmed influenza, but such protection is greatly reduced or absent in some seasons. Evidence for protection in adults aged 65 years or older is lacking. LAIVs consistently show highest efficacy in young children (aged 6 months to 7 years). New vaccines with improved clinical efficacy and effectiveness are needed to further reduce influenza-related morbidity and mortality":Efficacy and effectiveness of influenza vaccines: a systematic revi... - PubMed - NCBI

This is a review of literature study. The researchers had strict criteria for including a study in their review, and it found moderate protection in most seasons for people 18 to 65. Lack of evidence for ages 65 and older was due in part to their exclusion of studies that didn't meet their criteria.

Specializes in telemetry, med-surg, post op, ICU.

Wow, I am so overwhelmed at the response to my article. To those of you who posted statistics, thank you! It gives us something evidence based instead of the whisperings that sound more like conspiracy theorists than scientific medical professionals. I also appreciate that some of you refuted those findings. This is an important part of getting to the bottom of this.

I think the flu vaccine will remain controversial, but I had no idea how much so when I was writing this article. As a result, I may have done things a little differently with my presentation. That said, though, I still think we need to objectively present the flu shot to patients, no matter what our feelings. I don't think nurses should be forced to take them if they are healthy, but I understand management's reasons for insisting upon them.

I am a student of history, and I remember the flu epidemic of 1918. It killed so many, and the flu shot is our only protection against something similar, flawed as it is.

Also, saturated fats and carbs . . . will they ever figure it out? AHA says sat fats. Who do you believe? You can get a statistic to prove anything, yet that is the scientific, evidenced based paradigm we are supposed to use. Flaws abound!

Specializes in Nurse Leader specializing in Labor & Delivery.

You remember the flu epidemic of 1918?

Specializes in telemetry, med-surg, post op, ICU.

LOL, no, I didn't live through it. I remember it as history, much like Pearl Harbor Day. I didn't need to live through it to remember it and learn from it.

Specializes in Nurse Leader specializing in Labor & Delivery.

I think, by definition, you DO need to have experienced it first hand in order to remember it. Just saying.

It shouldn't be distributed to the general public in the wide way it is, but the very young, the severely ill, and the very old would be in great danger not to take it. That's my opinion on it. I believe in preventative medicine, and this is the best we have.

I'm curious as to why you think flu vaccine shouldn't be distributed to the general public as it currently is.

Most of us have some contact with people who might be greatly harmed by the flu. I have a friend with an immune disorder, a friend with serious lung disease, and other friends who are very old. In the past, I had one parent undergoing chemotherapy and another parent in LTC. Is it not better for them if I don't get the flu?

My info is purely anecdotal, but I've only known one person who had serious reaction to flu vaccine. Most people who get it are just fine. Even though the vaccine isn't 100 percent effective, aren't we all better off if fewer people are spreading a serious disease?

Full disclosure -- I'm not a nurse; I've never been forced to get a flu shot and probably never will be. I do understand that people don't like being coerced into doing anything. I wouldn't like it either, just as a matter of principle. But outside of that, I don't understand why this is even a question.

Specializes in cardiac, ICU, education.

I think the OP's subject line was the most worrisome to me. "How to Convince"

These are very dangerous words with a paternalistic slant. We should not convince our patients of anything. Our job is to inform without guilt. I remember this when I had my first child and I had every intention of breast feeding, however, the la leche consultant was a complete bully, and that is putting it mildly. It was breast feeding or nothing and I ended up not getting questions answered because I was so turned off. If your priority is to convince someone, then it is a debate mindset instead of an educational one, and more talking is done than listening.

And without trying to change the subject too much, it also always interests me why nurses think the flu shot is really going to be the answer for our chronically ill patients. We have so many chronic diseases because we as healthcare professionals fail to educate our patients on the real health issues - proper food/nutrition, maintaining a health weight, and proper amount of sleep. We would not have nearly as many health issues and reasons for so many medications if we promoted what would lead to the healthiest lifestyles.

Msn10- The OP already realized her poor choice of words for the title of the article. How to educate patients would have been more appropiate.

Having had two debilitating flus, I have since willingly had a flu vac every year and so have any of my kids under 18, however I don't believe it is my role to recommend it to my patients.

And my anecdotal evidence says it's the excessive carbs!

My issue with the flu vaccine is that it is clearly not enough. My current assignment had nearly a third of the beds fill up with flu patients over the weekend. More are expected to come, and quickly. I wish there was a rapid vaccine that could be made after the predominant strain shows itself, so that more people can be vaccinated effectively. Perhaps, if this outbreak is virulent enough, even quarantining may be appropriate.

Is it paternalistic to want the herd to be immunized to protect the weak? Maybe. I am okay with that. I do not espouse autonomy at the expense of others. My belief is that the strong are supposed to protect the weak. There has been a "me first" mentality slowly taking over society ever since the baby boomers, but I have noticed it is quickly becoming "me ONLY." That makes me sad.

I think education should focus on the greater consequences for not taking the vaccine. Right now the information sheets focus on the risks, which naturally scares people. I would like to see PSAs that show grandma living happily flu free because her grandkids were vaccinated and didn't pick it up in school. Maybe there could be a promo that shows a baby living flu free because the uncle holding her got his vaccine and didn't pick it up at the grocery store. Then maybe a shot of someone on a ventilator who wasn't so lucky.

I don't know. These are just my views on getting the information out there in a way that encourages people to be responsible for each other and not just themselves.

Specializes in cardiac ICU.
Just curious -- are you old enough to remember polio? If not, have you read about it? Do you think that there should have been no polio vaccines?

I'm not a health professional, but as a child I wanted to be a nurse, so I remember photos of the "iron lung" and kids using crutches and braces to walk. I remember the sheer terror of my mother -- of course she tried to conceal it, but everyone was so frightened. You couldn't miss the moms discussing polio in hushed tones.

As an adult, I have read the history and I know there have been serious problems associated with polio vaccine at times. I had just gotten vaccinated when the Cutter Incident was announced (didn't affect me).

Nonetheless, even with problems and a few very bad outcomes, I think we are better off now than we were before polio was eradicated in most of the world.

I always raise this issue with anti-vax people and have never gotten much of a response.

To answer you question would simple: I am not old enough to remember. Also I am not against vaccines in general. In fact I would strongly advocate anti-polio vaccine as well as Td and Tdap (Tetorifice, Diphtheria) as well as pneumonia vaccine amongst some select other ones. Nowhere in my post did I mention other vaccines but the influenza one. That's the only one I have issues with.

Specializes in Med-Surg and Neuro.
I think respect for other points of view is paramount in nursing. Many people find the flu vaccine questionable, that doesn't mean that they are fanatical anti-vaxers deserving of disdain.

Calling opinions that you disagree with "crap" is unprofessional and disrespectful. If the subject matter troubles you so, simply skip the thread.

Agreed. I was glad to get DTaP and other vaccines we know work, so I'm not an anti-vaxxer. But the flu shot has a record of inconsistency. This year is about 50% effective, in a good year it is 70%. I don't think I should be forced to put something in my body that doesn't have a high rate of effectiveness.

Additionally, I also had a friend stricken with GB after a flu shot. As nurses, we're always teaching patients that medicines and procedures have risks and side effects, and the pros and cons of any medicine or procedure needs to be carefully considered by the patient. Why don't we have that attitude toward vaccines? Getting GB, no matter how small the risk, is not a risk I want to take, unless the vaccine has great benefits to me that outweigh the risks. But because I'm a nurse I should shut up, stop thinking, and get a shot because my boss and the government says so? What kind of attitude is that?

How Effective Are Flu Shots? - NationalJournal.com