Nurse Gladis leads the way on influenza vaccination in Jönköping, Sweden

For a number of years, Jönköping, Sweden has worked to become the county with the highest influenza vaccination coverage in the country for those aged 65 and older. Every year another 1000 pensioners are added to Jönköping’s total population of around 350 000, meaning that health workers must vaccinate more people each year to reach the same coverage level as in the previous year. Nevertheless, it appears they are succeeding in reaching their target group.

“You can’t avoid getting the message that vaccination is important when you come here,” said 72-year-old Per-Erik Åbom during a visit to Rosenhälsan health centre, one of the best-performing centres in the county when it comes to vaccination of the elderly. “The local newspaper usually covers the vaccination campaign as well, and every autumn people talk about it.”

With diabetes and fibrillations, Åbom started receiving influenza vaccination even before he turned 65. “I’m an old hand at this,” he said, laughing and rolling up his shirt sleeve to have his injection.

At the Jönköping county hospital’s infection control unit, efforts to increase the coverage of influenza vaccination of the elderly have been underway for a long time. In 2002, a vaccination register was set up, offering highly reliable statistics on the number of doses given and the different risk groups among the recipients. Yearly meetings with the county’s nurses were introduced, informing the medical staff about the upcoming influenza season and encouraging them to talk about vaccination with their patients. Vaccination was made free of charge for the elderly, pregnant women and other risk groups. But perhaps the most memorable tactic employed in Jönköping has been the introduction of a hard-nosed, no-nonsense character known as “Nurse Gladis”.

“You are first-rate at getting yourselves vaccinated! Make sure you are number one again this year!” has been Gladis’ blunt message in past seasons, delivered via magazines, posters, television commercials and in cinemas across Jönköping county. Despite her gruffness, Gladis has become a popular and well-known centrepiece of the vaccination campaign. Moreover, she has brought results. In 2005–2006, Jönköping county reached the WHO goal of vaccinating 75% of people 65 years and older.

“Making sure that as many of our elderly patients as possible are vaccinated against influenza is a high priority for us,” says Eva Mac Lachlan. Unlike the fictional Gladis, she is a real nurse at Rosenhälsan.

She continues, “I really enjoy this part of my work. I meet a lot of people, many of them the same persons year after year. We almost have a bit of a party here when the vaccination season starts, and the elderly really enjoy coming here”.