Eva Mac Lachlan - nurse

WHO/Malin Bring

“Making sure that as many of our elderly patients as possible are vaccinated against influenza is a high priority for us. We work hard to remind them to have their annual shot, and to give them a good experience when they come here,” says Eva Mac Lachlan, district nurse in the Swedish county of Jönköping.

For a number of years Jönköping has positioned itself as the county with the highest coverage of vaccination of 65-year olds and older in the country.

The annual outbreak of influenza is one of the major causes of morbidity and mortality among older people around the world, Sweden included. At the same time, the elderly population is growing rapidly.

“Every year another thousand pensioners are added to the county’s total population of around 350 000. It means we have to vaccinate more people every year to reach the same coverage as the year before,” says Eva Mac Lachlan.

Rosenhälsan health centre, where she has worked since 1999, has a relatively high percentage of patients 65 years or older. Thanks to many years of dedicated efforts, Rosenhälsan has become one of the best-performing centres in the county when it comes to vaccination of the elderly.

“At the start of the influenza season we have a drop-in clinic, and we make sure always to have enough stock of vaccines, so nobody has to wait for their shot. We have a slideshow about vaccination running in the waiting room, and always encourage people 65 years or older to seize the opportunity to get vaccinated if they visit us on some other business,” says Eva Mac Lachlan.

With diabetes and fibrillations, 72-year old Per-Erik Åbom belongs to one of the risk groups, and started taking influenza shots even before he turned 65.

“I’m an old hand at this,” he laughs as he rolls up his shirt sleeve to have his injection in one of the treatment rooms at Rosenhälsan.

“You can’t avoid getting the message that vaccination is important when you come here. The local newspaper usually covers the vaccination campaign as well, and every autumn people talk about it,” he says.

At the county hospital’s infection control unit, the efforts to increase the coverage of influenza vaccination of the elderly have been going on for a long time. In 2002 a vaccination register was set up, offering highly reliable statistics of the number of doses given and of the different risk groups among the recipients. Yearly meetings with the county’s nurses were introduced, encouraging and informing the medical staff about the upcoming influenza season. Vaccination was made free of charge for the elderly, pregnant women and other risk groups, and at the same time a hard-nosed figurehead known as “nurse Gladis” made her appearance in the vaccination campaign.

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

As part of this work the infection control unit monitors the vaccination register closely, and reports back how the individual health centres are performing.“We encourage the centres to keep generous hours and maintain a friendly approach to the visitors, because we know it’s effective. The commitment and attitude of the staff makes all the difference,” says Ing-Marie Einemo, infection control nurse at Ryhov county hospital in Jönköping.

District nurse Eva Mac Lachlan agrees: “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.”