Older people's experience of COVID-19 restrictions on vaccine hesitancy: A longitudinal phenomenological study to support nurse-patient vaccination conversations

Aims To explore how older people's experiences of COVID-19 restrictions influenced their decision to receive a vaccine and to support nurse-patient vaccination conversations. Design A longitudinal hermeneutic phenomenological study. The application of the COREQ checklist informed the reporting of this study. Methods Data were collected through semi-structured telephone interviews with older people (age >= 70) during two national restrictions implemented in England due to COVID-19. Phase one of interviews occurred between April and July 2020 (six interviews), and phase two of interviews between January and April 2021 (four interviews). Data analysis was performed through content analysis. Results Thirteen older people (mean age 78) worked through six stages about their thoughts and beliefs about receiving a vaccine, which encompassed four of the five elements of the 5C model of vaccine hesitancy, confidence, convenience, calculation, collective, but not complacency. Stages included 'our only hope is a vaccine'; 'understanding and acceptance of an effective vaccine'; 'social responsibility to protect others'; 'organized but left with unanswered questions'; 'need to feel secure' and finally 'vaccination alone is not enough'. Conclusion The experience of COVID-19 restrictions by older people informed their approach of engaging with scientific information to inform their decisions to be vaccinated but also developed their sense of collective responsibility to younger generations and those at risk, which informed their adherence to restrictions and the vaccination programme. Impact Nurses are optimally placed to support older people to implement and adhere to national government restrictions as appropriate and prevent obsessive routines, and support discussions and the provision of scientific information on COVID-19 vaccinations, whilst being inclusive of older peoples' sense of collective responsibility.