Interviewer(s): Timothy Price
Interviewee(s): Participant 03

Timothy Price: Excellent. So we will go ahead and start with the informed consent. So I'm going to read you a series of statements and I'll just have you say yes, I agree, or no, I don't agree, please. I confirm that I have read the participant information sheet for this study. I've had the opportunity to consider the information asked questions and I've had these questions answered satisfactorily.

Participant 03: I agree.

Timothy Price: I understand that my participation is voluntary, and then I am free to with any time without any reason and that I can decline to answer any question during the interview.

Participant 03: I agree.

Timothy Price: I understand the information collected during my interview may be looked at by other researchers from Newcastle University who are working on or assisting with the study I give permission for these individuals to have access to this information.

Participant 03: I agree.

Timothy Price: I understand that information collected during the interview may be shared with other researchers for you some future research for teaching purposes that the data will be thoroughly anonymize first

Participant 03: I agree.

Timothy Price: I understand that the interview will be audio or video recorded according to my preference typed in that all my identifying personal details will be removed.

Participant 03: I agree

Timothy Price: I understand the direct quotations may be taken from what I say and use in research and publications, but I will not be identifiable from these quotations.

Participant 03: I agree

Timothy Price: I agree to take part in this study.

Participant 03: I agree.

Timothy Price: Excellent. And then there's just two others here. If you'd like to receive a copy of the research findings. Upon completion of the study. Please say yes now.

Participant 03: Yes, please.

Timothy Price: Yeah, absolutely. So my dissertation will be finished in August. So you'll expect to get that around. Then I'll send that address you provided. And if you'd like to receive a hard copy of the study documents. Please say yes now to receive a hard copy you will need to provide your mailing address

Participant 03: No, no need for a hard copy.

Timothy Price: All right, so that's that out of the way so thank you for that. And we can go ahead and kind of dive in here. So my first questions are just kind of helped me get to know your child, a little better and to help me sort of understand what you know about the flu. Um, so you have one child is that right?

Participant 03: Yeah, yeah.

Timothy Price: And they're three years old?

Participant 03: Yes. Yeah, she turned three, little girl called [Child], and she turned three in April.

Timothy Price: [Child]?

Participant 03: Yeah [Child].

Timothy Price: Okay. Yeah. That's awesome. Um, so can you tell me a little bit about her? Like what kind of things does she like to do? you know how, how things are being at home right now?

Participant 03: Yeah, everything. Yeah. She's really good. And yeah, she's like just any three year old little girl. She's full of energy and really um, like in terms of, like sort of health. We haven't, she doesn't have any health problems. We have been very lucky and until like about 10 months old she hadn't even like had a temperature or been unwell or anything like that. Um, so yeah, she's just a great little girl and she loves Dora the Explorer and princesses and all the kinds of things you'd expect of a of a three year old.

Timothy Price: Yeah

Participant 03: Yeah, obviously she's at home at the minute, and she's doing really well. She's a really sweet spot age where it doesn't, it doesn't really come into her, shes just happy at the moment that mum and dad are around constantly and, she wasn't a massive fan of nursery. I mean she has friends and she loves it when she gets there, but she's not she's not really into it, she doesn't run in there or anything. So she's really enjoying herself, she's living her best life!

Timothy Price: Yeah, I think, I think for a lot of children her age. It's really more about how the parents are doing because, you know, like you said, they're just happy to have everyone around and having everyone's attention all the time.

Participant 03: Totally, yeah.

Timothy Price: So can you tell me kind of what you know about the flu? Just anything that comes to mind when you think about the flu.

Participant 03: Yeah, so seasonal mainly around kind of the winter period and and that we get, we can sometimes get worst flu seasons than other flu seasons. Um, I suppose the difference, like knowing whether, you know, you've got, you've had flu or not. I don't like, I always get, like I said, people say, "Oh, I've got flu", but then other people are like, "no, I really, really had flu" and that it can absolutely floor some people, and some people can just feel a bit under the weather. And and I suppose that, like something that I've noticed over recent years, is that sort of flu can, like the strain of it, can change. So different years we have different strains of flu and that there's like lots of different flus.

Timothy Price: Yeah. Yeah, that's great. Thank you. So do you worry about your daughter, getting the flu or is it something that you know like, can you give me a sense for sort of how you feel about that when you think about your daughter potentially getting the flu?

Participant 03: Yeah, I think it's not something, I think I worried about it more, when she was younger and in probably the first one to two years because partly because of the worry of whether it was flu or something else like meningitis or anything like that. If she was to come down with symptoms would we know was flu or not? and and... Yeah, really. I mean, she's so, she's so, healthy for the most part, touch wood, that we don't. It's not something that enters my mind as something that's going to happen. Although obviously with recent, the recent pandemic proves that it can have, you know, people can get ill anytime regardless. But generally, and we've not been too worried because, we've not, as she's never had any real health complaints, we don't necessarily. It's not something that preoccupies us

Timothy Price: Yeah, that makes sense. So the worry when she was younger was sort of just general? you know, you would have worried about any illness is that—

Participant 03: Yeah. Hello, sorry.

Timothy Price: No problem. [Participant is speaking to her child]

Participant 03: Yeah, I'm sorry, could you repeat the question?

Timothy Price: Oh no, I think we just, we were just finished, just finishing, your thought. I think I was clarifying that when she was younger, you, it's like you were just worried about like any illness really, and not, you know, not knowing what she had. But as she gets a little older, it seems like you just worry a little less maybe?

Participant 03: I think a big part of that is communication. So when they're very young. They cant communicate why there are, that they're unwell and what the symptoms are. Whereas now, you know, she could communicate more and I think there's just a general, the only concern is that, that something would come on so fast that we couldn't respond to it. I suppose flu wouldn't have been in my mind or something, because flu in my mind would be something that would slowly sort of gather pace. Whereas something like meningitis or something like that. Might sort of just happen in a flash and all the sudden she goes pale or something, you know, all that kind of, you know, all the signs you're told to look out for. So as opposed, flu wasn't my main thought in my mind. My mind was probably more triggered by the kind of more immediate quick really like a ring 999 emergency sort of conditions.

Timothy Price: Yeah. Yeah, absolutely. So you almost sort of started talking about sort of my next question here. Can you tell me what you think getting sick with the flu is like for children? Like the symptoms, what do you expect them to to look like, you know, what do you expect? Can you tell me what you think about that?

Participant 03: When I think about flu, I'd expect to see her like first I suppose, more than anything, behavior. I'd expect to see her sort of be a bit more grumpy or a bit more subdued. And that followed by probably finding that she had a temperature and she'd maybe be sleeping more, not eating. And so I think I'd probably see it starting with behavior and then would probably take her temperature. We've got a little under arm thermometer. And she might get a high temperature at some point. But that might not come the first day. It might sort of gradually gather pace. I probably see, I probably see her kind of maybe having temperatures being quite subdued, maybe a bit, sort of shaky and shuddery and shivery for like a day or two and then for that... So I'll probably only ever think of the flu in like maybe a sort of three to five days, sort of thing.

Timothy Price: Sure.

Participant 03: I don't see a cough, more like just like feeling really under the weather and temperatures and sort of subduedness would be what expect to see from flu in my mind.

Timothy Price: Yeah. Yeah, absolutely. So do you know anyone whose child has gotten ill with the flu, you know, maybe any of her friends that you know you might know the parents or anything like that?

Participant 03: No, I'm sure they will have been. But it's like flu, it just feels so common place that if I heard like one of my friends kids that had flu, I'd be like "Aw that's really bad". I think the things that probably more like "Oooh", like they stick in my mind, is when children get things like hand, foot, mouth, or whatever it is. or like slap cheek? All these like really bizarre sounding things, which actually turned out to be really common. You just don't hear them as much about as flu. Like, I feel like flu would almost be like "oh yeah that's bad but loads of people get flu".

Timothy Price: Yeah, right.

Participant 03: Yeah. Like if someone had like hand, foot, mouth for those things I'd be like, "ooh, what's that?", yeah, they probably stick in my mind more.

Timothy Price: Yeah. So yeah, so it sounds like what you're saying is, like, maybe it has happened and it just doesn't you know, just didn't seem significant really at the time it was a thing that just happens to people.

Participant 03: Yeah

Timothy Price: Yeah, that's interesting. Thank you. So when you want to learn more about a sickness, like the flu for example, where would you go to get that information?

Participant 03: Ah, mainly NHS online. Um, we did get given like a little book when [Child] was born and which was an attempt, I know it was an attempt, to stop people going to 111 or calling, or go to the GP surgery. I can't remember. Was it like a red book or green book? It's sort of like seem to be the book to go to. And it's got lots of flaps for lots of child le yes

Timothy Price: Yeah, the Orange Book.

Participant 03: Ah right, thats it! But to be honest, um it wasn't intuitive to use, even though, like if there wasn't this Google and there's the NHS website and that just feels more immediate. I just I say, I type the words and so I would look at that. And I would probably look at that and I would probably pay attention when the BBC or other main news outlets were reporting on flu, I'd probably sort of listen or read an article. So if they're kind of saying "we're expecting a really bad flu season" or something like that, I'd probably pay attention to that kind of media. But mainly I would just go onto NHS online for a quick read, but quite quickly after that if I had any concerns, I'd ring 111. I definitely have done previously, Id leave the Orange Book... I just, the Orange Book just felt like let sometimes when you're flicking through it. It's like, it just felt like taking the time to flick through. It was like wasting time finding out, which almost like now I'm saying it to you, sounds insane and, you know...

Timothy Price: No, it makes sense because it sounds like what you're saying is, you know, why would you bother like to look through this book when you can get the information quickly online.

Participant 03: Yeah.

Timothy Price: Why would you bother to look for something that may or may not be in there? You can go straight to, you know, 111 and talk to someone, or go straight to the NHS website it's, you know, whatever is more convenient whatever is faster. I think makes sense to me.

Participant 03: Yeah, exactly.

Timothy Price: Have you ever talked to your daughter's GP about the flu or to like any other health care professional?

Participant 03: Not really, Hang on a second. I'm gonna-- [Participant is speaking to her child]

Timothy Price: Yeah, no, no problem at all. So the, the question we were talking about was, Have you ever talked to your daughter's GP or doing other healthcare professional about the flu?

Participant 03: No, not specifically. I don't think we've ever suspected she had flu. So that would be the only time that I would probably talk to the GP or nurse practitioner and about it.

Timothy Price: Yeah. Makes sense. Um, so my next sort of set of questions just help me learn your thoughts about the flu vaccine and whether or not something that you know, you think would be helpful for your daughter. Uh, what do you think the benefits are for your from getting the flu vaccine?

Participant 03: Um, that she was protected from whatever strains the clever people in the laboratories think were most dangerous in that winter period. Um, I don't think I ever think she's getting totally covered, but getting protected from more severe ones, strains. I suppose, because she goes to nursery as well. I felt like it gave her some. So, she just started going to nursery at 10 months and that was literally when she started becoming ill, which then in my mind makes me associate it with when she started mingling with more kids not to say that she didn't see kids, but not to the same level and intensity. And that was when she started to get like sniffles and stuff like that. And it was probably about the time we stopped breastfeeding as well. So the whole thing kind of came up when she got there. So, I think in terms of the benefits, there was being, being, I suppose, more protected when she was around more children as well. And so the more risk of catching it was limited.

Timothy Price: Yeah, now that that makes that makes a lot of sense to me. You know, I think. That that age range when they're making the transition to suddenly having all these peers around, I think it makes sense that that's a time when you start thinking about protection.

Participant 03: Yeah

Timothy Price: Do you think there are any downsides to your daughter getting the flu vaccine?

Participant 03: The only one would be the um, the kind of, any side effects, but I don't, I don't, think I, don't think she had any side effects when she had it um... but yeah, that that would be the only downside would be side effects. And also because because it was a nasal spray it was even less intrusive. I suppose that you know the other vaccines, they kind of give her sore arms, are more uncomfortable and more painful but this didn't even have that. So, and that wasn't a disadvantage of this immunization, yeah.

Timothy Price: Um, so if you want to learn more about vaccine, like, you know, side effects, benefits or even like whether your daughter should get this vaccine. Where do you go to get that information?

Participant 03: Ah NHS again, website. I stay very clear of mummy blogs and mummy websites and forums. Because yeah, they just really rial me more than I find that supportive or reassuring. So, and yeah, it would just be the NHS website and I suppose I might have, I might have talked to the nurse or GP about it. But generally, as well I think I just probably absorbed media around it and the kind of public discourse about the importance of vaccines and stuff like that. And it might have a little bit to do with the type of role I'm in. In terms of hearing about benefits of different things and health, vaccines as well might have an impact. So it's probably just absorbed the media, the positive media around the importance of the vaccine and and then yeah, I would read about the pros and cons on NHS website.

Timothy Price: Yeah. And so your daughter was vaccinated this flu season, is that corrrect?

Participant 03: Yeah.

Timothy Price: Yeah, so how important was it to you that she would be vaccinated this year? Was it something that you were, you know, "as soon as it became available, we're making an appointment" or was it something that was a little more like now "well, we'll see what happens"?

Participant 03: Yeah. Therein lies a really interesting story because and so we moved to Whitley Bay from Newcastle last year. So we were new to our doctor surgery by the time the flu jab season came around. So I rang, to kind of check, you know, "is she going to be on the list to get it?" because I was very keen for her to get it. And I got told, "yes you'll be in touch" and I didn't hear things for months and it was probably November time I started to think, "ooh definitely getting into flu season now. she's still not had it" and then it turned out there was like a lack of actual vaccines. Um and yeah, there'd been a shortage or whatever, something had happened and so it was delayed and delayed and delayed. And then I started to hear other friends, even in Whitley Bay within different GP practice areas, were getting their children vaccinated. And that started to make me more stressed, kind of thinking "I really, really want her to I definitely really wanted her to have it" and it ended up becoming, I just thought we'd walk in there, would make an appointment once the season started and the most vulnerable have been like sorted, but it ended up being like a whole kind of cat and mouse of when when was she going to be able to get it? To the point where, at one point, Ijust rang up and was like "can I book my child in?" and I think it was December. I was like, "can I put my daughter down and for the flu jab?" And then they said admin lady said yes, and then I gave her [Child]'s name and then she went, "oh, is she vulnerable person?" and she had, that she had like a session open for me to offer to go in. And then she was like "Oh no, you cant go because she's not vulnerable." And I was like, "well, hang on a second because it's like December now. If all the vulnerable people should have had, they've had communication. It's their choice if they're not getting it now. If you've got slots and you've got it. Please, can my child have it because I'm actually now trying to push for it to get it." And and then it was like "no, just hold on they'll call." And I think she got it just before Christmas in the end. So actually, I really did have to fight for it. And it felt, like it felt, like a very, this, so this was the first year that [Child] was eligible to have it because the previous year, she was still under two. So, wasn't, she was in that kind of like blank area. I kind of felt like, and I expected, to just get in there and have it. And the first thing was a concern that there was a supply, like a supply issue. And then secondly, that it felt like, it felt a little bit like bureaucracy was getting in the way a little bit. Not to say that, I absolutely am for the priority being vulnerable people, but I felt like there was a, there was like a, then, when are they going to just open up to everyone else? It was just, yeah. I felt like it got caught and bureaucracy as well. Sorry.

Timothy Price: Yeah, no, that's great. You, you spoke to one of my other questions, which is was any part of the process of getting vaccinated challenging and it sounds like most of the process was challenging. Something you said I thought was really interesting was that you needed to be very persistent

Participant 03: Yeah.

Timothy Price: it sounds like you really needed to to kind of continually advocate for your child. That it wasn't something that was just going to happen on its own.

Participant 03: Definitely, I actually almost changed GP practices and because I know, I knew that my two friends daughters got it and it's just, it's not far away, but they were like, "Oh, no, no, you can't do that" and it was like "okay fair enough", that is, you know, so I was maybe even changing. Our GP practices literally over the road to us, which I felt, you know, and I didn't really want to have to change. And there was something else. I kind of wanted to say about that as well. Just that. And I suppose. Oh yeah, there was, there was um, in during this period of November, December, there was some sort something nasty going around, which wasn't COVID, it was something something was going around. I can't remember what it was. And I think it was a sickness bug or something and then, and the public health advice, was "get the flu vaccine that's your best line of defense, any children need to get flu vaccine". And I was like, "I'm trying to get it, I can't!" And then I can't remember what it was. There was some, something going around and like a real sickness making bug and the flu vaccine was said to be a good protector for children.

Timothy Price: Now they say that, I do remember in in the fall at my uni, there is something going around a lot of a lot of, a lot of my friends were getting, you know, very ill.

Participant 03: Yeah, right.

Timothy Price: So its interesting, you know that they were recommending vaccination as well to mitigate the that.

Participant 03: Yeah, but at the same time, it just felt as a public health message, It was just like, "get the flu jab, get the flu jab." But they knew they had shortages of the nasal spray. And yeah, which is frustrating.

Timothy Price: Yeah, it sounds like you saw that there is a bit of a disconnect between the people promoting the vaccine and what was actually happening, you know, on the ground. So I guess my last few questions are just sort of more general and they helped me so learn a little bit about your thoughts surrounding vaccination as a whole. Has your daughter received any of the other like routine vaccinations?

Participant 03: Yeah, yeah, she's had everything and and so she's in the age group at the minute. And so she was she'll be coming up to getting her preschool immunizations in the next month or two and, and me and my kind of antenatal friend's, mums were all talking about it because she's the youngest a lot of them are now being asked, because I think you have it, four months after your third birthday ish. And there's been a lot of concern about going in, because of COVID, but I wouldn't, like that wouldn't concern me because generally, I kind of feel like it's, without wanting to get too, like its kind of almost a civic duty to get your child inmmunized. Because it's not about just your child. It's about all the children and I kind of get that, that the kind of herd immunity or whatever is really important. And, and, yeah, it probably I'm like so pro for it, but I find it very frustrating when people don't see the science and the logic behind it.

Timothy Price: It's interesting. Something you've, you've mentioned twice now, when you talk about the importance of having your daughter vaccinated. You're talking, you've mentioned twice the sort of collective benefit, you know that you know you wanted to protect her from getting sick at the nursery, but also you know, from spreading the flu. They're so interesting. It seems like you a big part of the benefit of vaccination, both for flu and more generally, seems to be the collective protection for you. Does that seem accurate or have I misunderstood?

Participant 03: Yeah, no, definitely. I definitely think it's that, tha,t you know. You know, once again, listening to the news headlines around measles. As an example, and how it's on the rise, and that's there's a good chance that's linked to, you know, people not taking up the immunization. It kind of goes along the same lines of that. And yeah, and my I don't know if this kind of fits with you, your question and but my parents are quite elderly as well. And so I think I was, and up until COVID, she was going round to their house, to kind of, for a night sometimes, a sleep over. So my mum's, my dad's 83, my mom's 73 and they're both, you know, fit and well. But, yeah, I think I was worrying for them specifically as well that if someone was to bring flu to them, that wouldn't be a good thing. And then conversely, they are totally anti vaccine really. So I kind of think, well, also what they're bringing to [Child], which you're not really, you know, for whatever reason, they, you know distrust and all that kind of stuff. You're not. You're not doing it. And like even, like, you know, talking to them about COVID and "are you gonna if the vaccine comes, you're going to get it?" You know, my mum is kind of going "I'm not sure" she's like sort of sitting on the fence. I'm like, "how are you sitting on the fence?" My whole approache is so, so, you've got to, we've all got to do it. And so, yeah, generally my views are that everyone should be doing that, I get a bit judgmental definitely when people don't.

Timothy Price: Yeah. Fair enough. It's, it's definitely an issue that that tends to be very important to people, I think. Not a lot of people you know, tend to be on the fence for that question. So have you personally had the flu vaccine this year?

Participant 03: No, because I'm not in a group that it needed and a lot of my my work doesn't rely on me being frontline with patients. And so I didn't get it. I did have it though. When I was pregnant, and it was during flu season I did get it then. So yeah, that's the only, that's the only time I've had it because I was obviously classes. One of the groups.

Timothy Price: Yeah, so that's almost everything. The last thing that I like to close on, is there anything else you want to say about the flu, or the flu vaccine, or vaccination in general, or anything that I didn't ask about that you'd like to speak to?

Participant 03: Ah no, I just think, I think just going back to my previous point, and I think I probably expected, socially, getting the the the flu immunization as a sort of standard and just going to happen. And it didn't end up being like that. And that made me, that's probably made me more nervous and more anxious about this coming flu season and her getting it and wanting to kind of be. Probably you know, I will do the same thing and get, you know on the phone going, "when is she going to be able to have it?" Just because probably I didn't move as quickly on it as possible, getting her signed up, we probably missed the first little ones available. So, I think, to be honest, the way that it was handled, that kind of bureaucracy around it and the issue that they had with the shortages has just made me more, kind of like, "well, this isn't a God given right to get the immunization. Actually this is this is a whole infrastructure that needs to be slick." And yeah, I think it's just made me probably more nervous about getting her immunized. It's probably made me even more, and COVID has made me even more proactive than I already was about her having it.

Timothy Price: Mm hmm. Yeah, that's, that's great to know. Thank you very much. So that is all my questions. So that concludes the interview.