Traditional health practices popular among older people who choose not to have flu vaccine

October 12, 2010

Eating steamed pears, having a soothing massage or bathing in a herbal mixture are just some of indigenous health practices used by older people to ward off or treat influenza, according to research published in the October issue of the Journal of Advanced Nursing.

Other traditional measures discovered by nurse researchers at the Hong Kong Polytechnic University included being rubbed with a coin, eating cheese, yoghurt and honey and having warm drinks made with ginger or lemon.

The team surveyed nine countries to find out why so many of them were failing to meet the 75 per cent annual influenza vaccination rate recommended by the World Health Organization. They found that people who chose not to be vaccinated were more likely to rely on indigenous health practices - together with good general health and hand hygiene - than those who decided to be vaccinated.

"Annual flu epidemics severely affect three to five million people worldwide every year and cause up to half a million deaths, with most deaths in industrialised countries occurring in people over 65" says co-author Professor Samantha Mei-che Pang from the University's School of Nursing. "That is why it is so important to find out why some older people have the annual flu vaccine, while others decide not to."

The range of countries chosen by the researchers represented different cultures, healthcare financing systems and flu vaccine uptakes. Healthcare is dominated by the private sector in Indonesia and China, while Greece, Turkey and South Korea all operate a national health insurance system. The UK and Canada have national health systems funded by taxation and the health systems in Brazil and Nigeria rely heavily on the private sector.

A series of focus groups were held with vaccinated and unvaccinated older people aged 65 plus and seven countries submitted completed questionnaires providing demographic data on 172 participants. This showed that two-thirds of the people who took part had been vaccinated, with vaccination rates highest in Canada (93 per cent) and lowest in Nigeria (31 per cent). Other countries ranged from 44 per cent to 82 per cent.

The team looked at the attitudes of the vaccinated and unvaccinated people in each group and this provided useful clues about what had influenced their decision.

People made the decision to be vaccinated if they: People who did not have the flu vaccine said they: "Our findings support the growing evidence that older people are much more likely to be vaccinated against flu if they feel vulnerable, see flu as a threat and believe that the vaccine will be effective with little, or no, side effects" says Professor Pang.

"It also revealed a finding that we do not believe has been observed in previous studies: that those who distrust the vaccine's effectiveness are more likely to rely on healthy lifestyles, good hand hygiene and indigenous health practices to protect them from flu.

"Cost was also a factor in countries where free healthcare was not available and some people did not have easy access to a local centre offering vaccinations. The importance of providing regular reminders was also important, as was creating a culture where receiving an annual flu vaccine was the norm for older people."

The study, which was funded by the International Council of Nurses, includes further details on each country's participants, together with quotes from the focus groups.
-end-
Notes to editors

Influenza vaccine preference and uptake among older people in nine countries. Kwong et al. Journal of Advanced Nursing. 6610, pp2297-2308. (October 2010). DOI: 10.1111/j.1365-2648.2010.05397.x

The Journal of Advanced Nursing (JAN) is an international, peer-reviewed, scientific journal. JAN contributes to the advancement of evidence-based nursing, midwifery and healthcare by disseminating high quality research and scholarship of contemporary relevance and with potential to advance knowledge for practice, education, management or policy. www.journalofadvancednursing.com

Wiley-Blackwell is the international scientific, technical, medical, and scholarly publishing business of John Wiley & Sons, with strengths in every major academic and professional field and partnerships with many of the world's leading societies. Wiley-Blackwell publishes nearly 1,500 peer-reviewed journals and 1,500+ new books annually in print and online, as well as databases, major reference works and laboratory protocols. For more information, please visit www.wileyblackwell.com/ or our new online platform, Wiley Online Library (www.wileyonlinelibrary.com/), one of the world's most extensive multidisciplinary collections of online resources, covering life, health, social and physical sciences, and humanities.

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