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School vaccinations: nurses should never be subject to threats and abuse

Being involved in the COVID-19 vaccination drive is a big challenge for school nurses

Being involved in the COVID-19 vaccination drive is challenging the school nursing workforce and some have experienced threats and abuse

School nurses are at the forefront of the drive to vaccinate children aged 12-15 against COVID
Picture: Alamy

Many school nursing services are no longer being commissioned to provide immunisations to schoolchildren, which are instead being provided by dedicated teams.

The situation changed as a result of the government imperative to vaccinate all those aged 12-15 against COVID-19, part of its push to get the country back to normal.

School nurses are being asked to support this emergency call to arms by helping to vaccinate eligible children, and are doing so with grace, grit and determination.

Some school nurses are burnt out after COVID-19 redeployment and long working hours

But what this means in practice is school nurses spending the weekends and evenings catching up on their ‘day job’, while delivering COVID-19 vaccinations and some other missed childhood immunisations during the ‘working week’.

This is far from ideal for their own health and well-being, with many nurses already experiencing burnout after redeployment following the first wave of COVID 19.

However, as school nurses, we all recognise this as a public health emergency for which we are best placed to tackle.

‘While school nurses acknowledge and respect parental views on children’s healthcare, they should never be subject to personal threats and abuse’

Sadly, the school nursing and other immunisation providers’ workforce is being challenged by adult ‘anti-vaxxers’. This is taking up invaluable time and resources in responding and working to resolve conflict.

On occasions, nurses and their teams receive physical or emotional threats via correspondence or even face-to-face, with some anti-vaxxers martialling and blockading venues, as well as hurling aggressive abuse and threats.

Many parents have valid concerns about COVID-19 vaccination

While school nurses acknowledge and respect parental views on children’s healthcare, they should never be subject to personal threats and abuse. That is wholly unacceptable.

On the other hand, school nurses and other immunisation providers also encounter parents and young people with valid concerns who are conflicted by the official advice received and genuinely confused.

Making time to have conversations with them is difficult, but so important.

Young people are, for the most part highly influenced by their peers and likely to follow those who take up the COVID-19 vaccination offer.

Therefore, if we facilitate and enable informed consent, uptake will improve.

In September 2021 in London, anti-vaccine protesters marched for the World Wide Rally For Freedom against children's vaccinations and vaccine passports
In September 2021 in London, anti-vaccine protesters marched for the World Wide Rally For Freedom against children's vaccinations and vaccine passports Picture: Alamy

A professionally challenging situation

On occasion, school nurses and immunisation teams will use Gillick competence and Fraser guidelines to allow young people to self-consent to healthcare, including immunisations.

However, in an effort to diffuse public unrest in some areas, it has been decided by directors of public health and local authorities, not to use this for COVID-19 vaccinations. This makes the situation professionally challenging.

‘School nurses are experts at working with parents and carers who object to, or do not comply with, childhood immunisations. This lack of compliance is often due to genuine fear or misunderstanding’

It is often with young people most in need where the Gillick competence and Fraser guidelines could be usefully used, for example in looked-after children, or those whose parents have poor health literacy.

However, when considering the unique nature of the pandemic, the valid fears from many parents and young people, and the need to work in partnership, we accept those decisions have been taken with the best interests of all at heart.

Evidenced-based solution-focused approach can achieve positive outcomes

School nurses are experts at working with parents and carers who object to, or do not comply with, childhood immunisations. This lack of compliance is often due to genuine fear or misunderstanding.

By adopting an evidenced-based solution-focused approach involving motivational interviews and brief interventions, nurses can achieve positive outcomes.

But in trying to achieve maximum uptake with too few resources, we have little time to take this approach. This situation is far from ideal and goes against the grain, but we must accept the limitations and understand what is being asked of us.

We have, of course, insisted on the accurate recording of those who have missed their COVID-19 immunisations.

Keeping schools open and offering vaccines has been a vital response to the pandemic

In partnership with a range of stakeholders, including young people, parent groups, schools, primary and secondary care, community services, voluntary sector, faith groups, we will aim to offer these immunisations again, but in a more tailored way.

There is much yet to learn from the global pandemic.

In the UK, there has been significant collateral damage as a result of lost schooling, unimaginable abuse and neglect, poverty and an ongoing exponential rise in mental health issues. Many personal stories from the pandemic remain untold.

But we have learned that keeping schools open and offering COVID-19 vaccines for children aged over 11 should be a key aspect of our response to pandemics in the future.


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