The flu vaccine and the psychology of reward


Sir, – It is regrettable that the serious topic of influenza prevention has been trivialised in recent banter between the Irish Nurses & Midwives Organisation and the HSE. Influenza represents a serious risk to hospitalised patients of all ages, many of whom require intensive care and some of whom die annually from a vaccine-preventable disease. Prior to the flu season, hospitals prepare for the inevitable by offering flu vaccination to clinical staff. While the vaccine has its limitations, it is recognised as part of a range of preventive measures, including compliance with best practice in infection control, to reduce the spread of influenza in hospitals each year. This is a particular challenge in our overcrowded congested hospitals.

An understanding of behavioural psychology is necessary to understand the complex transaction which is played out between employer and employee in this context. Improving uptake in staff requires a balance between removing barriers to uptake and encouraging engagement with the vaccine programme. This requires strong leadership from clinicians, medical and nursing, as well as senior managers. The psychology of reward is an important element of this process and is used widely to improve engagement whether it be to a workplace vaccination programme or a response to a questionnaire survey.

In a report published in 2015, we found that 13 per cent of healthcare staff believed that the provision of a chocolate bar as an incentive was helpful. It is one of a number of measures used to increase uptake that also includes making it easy to access the vaccine while at work. The flu vaccine helps to save the lives of patients as well as all healthcare workers and undoubtedly contributes to reducing the risk of flu transmission within institutions. Surely all efforts to increase its uptake are commendable? – Yours, etc,


Consultant Occupational Physician,

Dean of Faculty of Occupational Medicine,

Royal College of Physicians of Ireland,

Frederick House,

South Frederick Street,

Dublin 2.