Coronavirus

Nursing researchers on vaccination: jumble of regulations leads to resignation

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The discussion about compulsory vaccination is stirring. After many representatives of the medical profession opted for a vaccination against Covid-19, the Bavarian Prime Minister Markus Söder brought a possible vaccination requirement for nursing staff into play. The allegedly low willingness to vaccinate in this professional group is the reason for this. So far, there are no reliable figures for whether that many nurses are really against the vaccination.

The COSMO project (COVID-19 Snapshot Monitoring) has just published a special evaluation of its population study on the subject of vaccination skepticism among medical staff. It determines the confidence in the safety of the vaccination as the most important influencing factor on the willingness to vaccinate.

The study suggests that compulsory vaccination for caregivers could adversely affect citizens’ behavior. Laboratory studies from a different context would indicate that even the theoretical discussion of compulsory vaccination creates a resistant attitude in test subjects. With regard to the pandemic, this could be expressed, for example, in a lower acceptance of other measures, such as wearing masks, or other voluntary vaccinations.

Health Minister Jens Spahn assured that there would be no compulsory vaccination, as he had always said before when the first discussions about a new passage in the Infection Protection Act broke out in November. Prime Minister Söder called on the German Ethics Council to examine the compulsory vaccination for nursing staff.

Stefan Görres, Head of the Department for Interdisciplinary Aging and Nursing Research at the Institute for Public Health and Nursing Research at the University of Bremen, gave an extensive statement to the renowned Science Media Center (SMC). NewsABC.net documents Görres’ assessment:

“We need vaccination solidarity and you cannot commit to solidarity. There is no clear legal basis for mandatory vaccination against SARS-CoV-2. Almost all parties are – so last week on the occasion of the government statement by Health Minister Jens Spahn – therefore also agree that it – initially ?! – Can not and will not be subject to an imprint.

But everyone also knows that without a high vaccination rate – at least 60 percent according to the World Health Organization – the pandemic cannot be controlled and certainly not contain it. In a democratic state structure – however difficult it may be in view of the high incidence and number of deceased – the only way left is to appeal to the people’s understanding and willingness.

This requires an absolute masterpiece in terms of communication strategy on the part of politics, possibly even target group-specific – older / younger people, people with / without a migration background, medical and nursing staff. In order for this to be successful, on the one hand a high level of political responsibility towards the population is required through confidence-building measures. These primarily consist of information and the making of clear, comprehensible and consensual decisions. This seems to have only partially succeeded over the months, because until today it is still not possible for many people to understand the jumble of different, constantly changing regulations – even in the living room. The discussion about school openings is just one example.

From a psychological point of view, this not only leads to a decline in acceptance, but also to resignation in a not small part of the population. But that is exactly what we least need in view of the long road ahead with the pandemic. In addition, a successful vaccination strategy requires a high level of reliability in management and operational processes.

At this point, however, there are a large number of critical voices in all conceivable political and non-political camps – especially on site, in the municipalities, hospitals and nursing homes as well as vaccination centers. From the late ordering of vaccine doses to their lack of availability to a mess when scheduling appointments, the complaints are received without a break by the Minister of Health, who cannot be envied for his job. So when we talk about mandatory vaccination that supposedly no politician wants, but many – albeit unspoken – would like to have, then we actually mean vaccination solidarity. And you cannot commit to solidarity, but you can promote it through trust.

There is in fact no data on the allegedly low willingness to vaccinate among health workers. In this respect, his skepticism towards the claim that his willingness to vaccinate is low is great and so is the horror of corresponding reports in the daily press. But one cannot fail to recognize the now numerous examples from institutions and more or less reliable small study results from the own ranks of individual sponsors, which at least paint a heterogeneous picture. Starting with an extremely low willingness to vaccinate of around 30 percent to almost 100 percent. We do not yet have sufficient evidence, but nonetheless a visible phenomenon that stimulates the viewer to interpret in the desired direction.

Even in the short period of time there can be no large-scale studies, let alone correspondingly valid results. And of course it is assured everywhere that one can confidently assume that willingness will increase even more if only the large group of nursing and nursing professionals – around 1.3 million – is provided with the means of providing information about what is to be expected or not sufficiently informed or at least calmly discussed with them. One is slightly inclined to assume that it is precisely this group, at least medically informed, that should know about the need for vaccination in view of the sick and those in need of care entrusted to them.

Because it is precisely she who cares for people under the most difficult circumstances or who sees them dying in their own hands in too large numbers. But perhaps it is precisely this enlightenment that explains their reluctance, at least in part. They can imagine possible uncertainties and risks more easily than ‘average’ fellow citizens, because they have the appropriate training and corresponding specialist knowledge.

Whatever the case: I cannot understand the assumption, among others on the part of the German Professional Association for Nursing Professions (DBfK), that politicians in the search for explanations for the announced ‘jerkiness’ around their vaccination strategy have finally found the scapegoats in the nursing staff and seems to have a red herring from one’s own (political) inability to do so.

In case of doubt, like everyone else, caregivers make use of their personal right to physical integrity. No more and no less. They should be admitted that they are absolutely certain of their ethical and professional responsibility. In any case, they are not to be envied for the emotional pressure and it is currently being built up around them.

Sometimes politicians in particular draw a comparison with the measles vaccination requirement in daycare centers when it comes to finding a quickly conjured up reason for the controversial vaccination requirement for Corona. The Bavarian Prime Minister Söder recently pointed out, saying: ‘The effects of Corona are at least as bad as those of measles.’

Now the ethics council should deal with it, which it does with noticeable reluctance: On the one hand, in its view, at least knowledge should be available about whether a vaccination actually avoids the risk of continuing to infect other people, and on the other hand no long-term consequences are to be feared. This knowledge is not available so far and in the foreseeable future. Söder’s comparison is initially obvious, but it is not shared and, on closer inspection, it is at least imprecise: Unlike the COVID-19 vaccination, the measles vaccination is assumed to lead to lifelong immunity, the former may last for two to three years, but that’s not clear yet.

And with the COVID-19 vaccination, herd immunity of around 60 to 70 percent is sufficient, with the measles vaccination a quota of at least 95 percent must be achieved. These two aspects alone show that the comparison, although trying hard, cannot be transferred one to one to the measles vaccination requirement. However, it cannot be ruled out that Söders’s initiative, which initially started as an argumentative ‘test balloon’, will catch up with us one day. May the course of the pandemic prevent it. “

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