A growing number of health-care workers in Nova Scotia are not getting their annual flu shots, according to figures released by their employer, Nova Scotia Health.

In response to a request by CBC News, authority spokesperson Jennifer Lewandowski wrote: “As of December 14, 2023, 7,231 (22.5%) employees have had the flu vaccine during the 2023-24 flu season.”

That’s the lowest flu vaccination rate in at least a decade, according to statistics posted on the Nova Scotia Department of Health’s webpage. Vaccination rates range from 45.1 per cent during the 2015-16 flu season to 29.8 per cent last year.

Although Nova Scotia Health tracks employee vaccination rates, Lewandowski said some health-care workers may have gotten their shots on their own, at pharmacies and clinics, without informing their employer. There’s no obligation to report.

Strang concerned

Despite that, the drop in the vaccination rate worries Nova Scotia’s Chief Medical Officer of Health Dr. Robert Strang.

“We’re nowhere near where we really need to be in vaccine uptake,” Strang said Thursday.

“Nova Scotia is not alone in terms of what I would call [the] underuse of influenza vaccine by health-care workers. It’s an issue across the country and beyond.

“But I personally [am] still mystified that health-care workers, many of whom are well educated on influenza and see the impacts of influenza, still decline to get the protection from the vaccine.”

Janet Hazelton, the president of the Nova Scotia Nurses’ Union, called the decline disappointing but understandable.

“I think it’s very important for health-care workers, for everyone, to get the flu shot, but especially for health-care workers because they’re around vulnerable people,” said Hazelton.

“But I also understand that health-care workers are just fatigued. They’ve been through a rough couple of years.”

Robert Huish is an associate professor of international development studies at Dalhousie University. (Steve Lawrence/CBC)

Robert Huish, an associate professor of international development studies at Dalhousie University, was also surprised by this year’s 22.5 per cent vaccination rate.

“For only one in five health workers, that’s a new low,” said Huish who is writing two books on COVID 19 and the response by governments to the pandemic, including the use of vaccines.

“Physicians are usually at the highest rate of those who go for flu shots or vaccines, whereas nurses [are] lower. And then health aides and even paramedics are the least likely to participate in that.”

Mandatory vaccinations considered

In 2019, Strang suggested mandatory vaccinations might be needed in response to a 41 per cent flu vaccination rate for health-care workers classified as acute-care staff.

Given the province’s experience with the COVID-19 vaccination program, and the ongoing controversy over vaccines, the province’s top public health official is no longer convinced that’s the answer.

“That mandatory policy was very justified in an acute pandemic,” said Strang. “It’s harder to justify those mandatory approaches in a non-pandemic time. But we certainly need to look at all ways that we could use to get more health-care workers and the general population vaccinated.”

Both Hazelton and Huish think the same way.

“I think in order to make something mandatory there has to be a health crisis like COVID, and even that met with a fair bit of resistance,” said Hazelton. “I don’t think the flu shot is something that we should mandate.”

Huish said “there’s a bit of saltiness still in the air for some health workers after the COVID-19 pandemic, where their employers said you must be vaccinated or you can pack your bags and leave.”

“And a lot of nurses,” he said, “a lot of paramedics [and] other people who work in the health system as well, chose to say no.”

All three agree that educating people and making the vaccine readily available will convince more health workers to get their flu shots.

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