Influenza and Covid-19 uptake in NHS employees

Influenza and Covid-19 uptake in NHS employees

We developed five theory-informed interventions that address a range of specific barriers to vaccine uptake in NHS employees.

National Health Service staff are offered an annual seasonal influenza vaccine to protect themselves and others; however, uptake can be low. In 2017 – 2018, the Welsh Government set a target of 60% uptake of the seasonal influenza vaccine, but despite several campaigns to encourage flu vaccination, fewer than 55% of NHS Wales healthcare workers received their vaccination in 2018 – 2019. All NHS staff were offered the COVID-19 vaccine from December 2020.

There is a strong need to identify the barriers and facilitators for influenza and COVID-19 vaccination uptake so that interventions can be put in place to support vaccination uptake among NHS employees in Wales and therefore the success of the vaccination programme.

Researchers from the Centre for Behavioural Science and Applied Psychology (CeBSAP) carried out a study on behalf of Public Health Wales and Cwm Taf Morgannwg University Health Board (CTMUHB) to co-design new interventions to support vaccination uptake that meet the needs and priorities of NHS healthcare workers.

Informed by the Behaviour Change Wheel, researchers conducted interviews with 35 NHS healthcare workers at CTMUHB to explore the barriers and facilitators for influenza and COVID-19 vaccine uptake. They then carried out co-production workshops with employees to jointly design new theory-informed interventions that are likely to address those identified needs.

The interventions were new behavioural-science informed messaging and communications, training staff to become ‘staff champions’ to have supportive and non-judgemental conversations with their peers and, changes to local practice to make vaccination easy and flexible.

Dr Rachael Thorneloe, Senior Research Fellow in the Centre for Behavioural Science and Applied Psychology, led the study.

Dr Thorneloe said: “We know that vaccinations programmes for flu and COVID-19 are vital to protect NHS staff and their patients, but the success of the programme relies on uptake. 

This project has enabled us to identify key barriers and facilitators for uptake of flu and COVID-19 vaccinations among a group of NHS employees.

“By working together with NHS healthcare workers, we were able to design new theory-informed interventions that address those identified needs, whilst also ensuring that the interventions are likely to be acceptable, practical, and equitable for employees”

We have worked with Nifty Fox ( to produce a range of infographics (in Welsh and English) that provide practical recommendations for implementing these findings into practice. They are of interest to anyone who is currently developing strategies to support vaccination uptake within their health board or trust.

You can access the infographics here:

  • What do we need to consider when developing strategies to increase vaccination uptake? What factors help or hinder vaccination uptake?  EnglishWelsh

  • What do we need to consider when developing messages and communications about vaccinations for NHS healthcare staff?  English / Welsh

  • What do we need to consider if implementing a ‘staff champion’ intervention to support vaccination uptake for NHS healthcare staff?  English / Welsh

You can read the full report here:

You can also access a recording of our webinar here:

If you would like to find out more about this project, please email