Marital conflict of a nurse family following COVID-19 vaccinations: A case studying

Abstract

Vaccination is one of the best strategies to control a pandemic. Although there is much research evidence of its effectiveness, a small percentage of people would not incubate the vaccine. After starting vaccination of healthcare workers as the first group in Iran, there were many debates and concerns regarding the effectiveness of the COVID-19 vaccine and its long-term side effects among them. In this investigation, the impact of these disagreements on the relationship of a nurse couple has been presented. The wife believed that people should incubate the COVID-19 vaccine as soon as possible and the man was anti-vaxxer and he believed that COVID-19 vaccines are not safe and it should be refused. After that, the wife got the COVID-19 vaccine, and their difference in views led to marital conflicts and disturbance in the function of the family. This case study was approved by the Research Council and Ethics Committee of Semnan University of Medical Science. Vaccine refusing could have complicated effects on a community and family. There should be a plan to assess families’ function and apply it in the case of disturbance in families’ function. Moreover, several strategies should be implemented to persuade anti-vaxxers.

Introduction

The COVID-19 disease originated in Wuhan, China and quickly spread throughout the world[1] and became a pandemic.[2,3] In order to control this pandemic, in addition to physical distancing, using face masks, vaccination is introduced as the best strategy to control this pandemic.[2,3] Following that, several companies were started working on COVID-19 vaccine production.[4] Surprisingly, as research and development projects on the COVID-19 vaccine were progressed, the results of several polls in different societies revealed a large number of people who would not get a COVID-19 vaccine.

Although similar debates regarding accepting vaccination against the communicable disease were reported previously,[5,6,7] public access to the new generation of social media such as Instagram, YouTube had caused a huge amount of data regarding probable side effects and negative features of the COVID-19 vaccine were distributed on such media.

This information raises many concerns about societal endorsement, and workplace peer support and trust to health leaders.[8,9] This case study shed new light on one of the socio-familial concerns raised following conflicting views regarding the COVID-19 vaccine between young nurse couples in I.R. Iran.

Case History

On the 9 of February of 2021, the COVID-19 vaccination was started in Iran. Healthcare workers were prioritized as the first group to receive vaccines. There were many debates and concerns regarding COVID-19 effectiveness of the COVID-19 vaccine and its long-term side effects among healthcare workers and public people. These issues have caused a lot of controversial opinions among experts and laypeople.

In this case study, the effect of these disagreements on the relationship of a nurse couple was explored. The family husband is a friend of one of the authors who talked with him about his situation. After two sessions of friendly speaking, the author decided presented this issue as a case study. The author shared his idea with the man. The man permitted the author to present their concern as a case while preserving his confidentiality. Data were collected through interviews with both of the couple.

The wife believed that people should incubate the COVID-19 vaccine and furthermore encourages people to get a vaccine. She mentioned that vaccination help communities come back to their normal situation. In contrast to the woman’s opinion, the man was believed that the COVID-19 vaccines are not safe and refused to get vaccines.

At first, he mentions that all of the COVID-19 vaccines have only emergency used licenses, and their long-term side effects are unknown and may be detected in the future. Therefore, they will not be traceable and pharmaceutical companies are not accountable regarding these side effects. He also stated that the COVID-19 vaccine may be the result of conspiracy theory beliefs. He mentioned a huge information that can be founded on social media and scientific websites. This difference in views has led to several familial conflicts between men and women because of their safety and children. Their marital relationship was hardly affected, following wife incubation with COVID vaccine. These conflicts have caused their emotional separation and their avoidance of intimate partnership. Moreover, their children were affected by these disputes of this couple and have suffered psychological challenges in the family. Finally, they need family counselling intervention to solve the problem.

This study was approved by the Research Council and Ethics Committee of Semnan University of Medical Science (IR.SEMUMS.REC.1401.028). Written informed consent was obtained from the case study participant, keeping the anonymity and the confidentiality of participant information.

Discussion

Vaccination has been introduced as one of the most crucial tools in public health for disease prevention and harms mitigation.[10] This fact has been reinforced in the COVID-19 pandemic era. In spite of the huge scientific body about the effectiveness of vaccination, suspicion regarding vaccination especially COVID-19 vaccines is increasing.[5,10]

Vaccine hesitancy and resistance to vaccination could be important obstacles towards responding to the COVID-19 pandemic.[5] This hesitancy among public people and health care workers raises due to wrong news and rumors such as increasing the risk of diseases like cancer, infertility, and depopulation about the COVID-19 vaccine.[10]

These contradictions and oppositions by creating opposing and favoring fractions in a family or the public or a workplace could severely disrupt their performance[5] as in this case different views about vaccination impair the family function.

A family’s defective function is characterized by showing disorganization in family roles, high rates of inter-family member conflict, and poor affective relationships among family members. Research evidence also indicated that various aspects of the COVID-19 pandemic have resulted in a significant deterioration in parents’ mental and behavioral health,[11] as potential family conflicts and intra-family disagreements about immunization are more prevalent among hesitant families.[12] Consequently, these health effects and marital conflicts of the pandemic were also related to heightened antisocial behavior, depression, and decreased well-being.[13]

Therefore, assisting families to resolve these pandemic effects is important. These assistances included assessing family functions and proper informed support and intervention by a multidimensional and interdisciplinary approach, including social work professionals, mental health clinicians, counsellors, family service agencies, and sports organizations.[11]

As the family husband of this case introduced himself as an anti-vaxxer, their activities could raise significant skepticism about children immunization in this pandemic and after that.[5] Moreover, it should emphasize that anti-vaccine movement action may cause to shape some informal groups in great organizations and companies, and they act as controversially to security and health goals.[14] It is necessary to develop several strategies like understanding its causes and leading factors, health education, and effective communication through the social mobilization team for solving the vaccine hesitancy and refusal problem,[10,15] as the case itself is a healthcare worker and consulted with another health staff. In order to enhance the health literacy of community members about vaccination pros and cons, healthcare workers must be supported in their role as health educators with information from confident scientific resources.[16]

Conclusion

Although vaccination has been accepted as the main tool for controlling the pandemic, a small percent of community members is hesitating or refused to be vaccinated. ‎Hesitancy in or refusal of vaccination could have social and familial impacts. Adopting a more mindful and coordinated approach is necessary to overcome these complex socio-familial issues. To properly assist families and resolve anti-vaxxer effects a multidimensional and interdisciplinary approach is required.

Ethical statement

This study was approved by the Research Council and Ethics Committee of Semnan University of Medical Sciences. Written informed consent was obtained from the case study participant, keeping the anonymity, the confidentiality of participant information, and also the right to withdraw from the study were also considered. The time and place of the interview were arranged to the participant request.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.