Health care workers (HCW) can address vaccine hesitancy (VH) in the community on the basis that their advice will be sought by the public. Before that can happen, we need to understand why many HCWs are themselves vaccine-hesitant.
The information is updated on a regular basis*
WHY FOCUS ON HCWs
The WHO defined vaccine hesitancy (VH) very broadly as a “complex behavioural phenomenon specific to vaccines, context, time, and place influenced by factors of complacency, convenience and confidence” i.e. a definition of VH which is also pragmatically highly variable depending on the vaccine, context, time and geographical location.
Subsequently, in 2019, the WHO described VH as one of the major threats to global health. Increases in the incidence, and frequency of outbreaks of measles and other vaccine-preventable diseases reflects an increasing failure to achieve herd or collective immunity in populations and VH has been identified as the key reason for this.
The COVID-19 pandemic emphasized the problem of VH as novel vaccines were being developed rapidly. Even amongst health care workers there can be significant VH. VH in HCW is an important metric to track and understand as it has major health, social, cultural and economic implications with the potential to increase public doubt and jeopardise healthcare provision.
One potential difficulty in comparing studies is that VH can be conceptualized in different ways. One of the main-stream approaches to conceptualize VH is using the “Three Cs”: confidence, complacency and convenience.
“Confidence” is defined as the trust that people have in vaccine, the healthcare system itself, and the process leading to decisions on licensing. “Complacency” is the individual evaluation of the risks and benefits of vaccines where in relation to VH there is a tendency to over-estimate vaccination risks whilst under-estimating the risks of the vaccine-preventable disease. “Convenience” concerns availability, accessibility of vaccines, user-friendliness and delivery of vaccines.
Study Design and Objectives
International multicenter study to analyse the degree of VH, in HCWs, with a focus on COVID-19 and influenza vaccination, including acceptance of mandatory vaccination for HCWs.
Using the Three Cs approach, we aimed to identify factors associated with vaccine uptake (and vaccine hesitancy) which can inform development of policies and interventions to increase vaccine confidence, and which are generalisable, to improve pandemic and wider public health planning.
A total of 2079 healthcare workers (HCWs) responded to an anonymous survey on vaccine hesitancy conducted between December 2022 and October 2023 at centers in Lithuania, Portugal, Poland, Germany, and Brazil.
RESULTS AND NEXT STEPS
55.7% were confident about the long-term safety of the COVID-19 vaccine
10% believed the risk of having COVID-19 vaccines was greater than the risk of COVID-19 itself
54.2% believed that COVID-19 vaccination should be compulsory for all staff working in healthcare settings (unless medically exempt), for all patient-facing HCW (59.0%), and for all medical, nursing, and midwifery students (56.7%); fewer supported compulsory influenza vaccination, i.e., 38.0%, 41.5% and 39.7% for equivalent groups.
Under half had been vaccinated for influenza in recent years.
Respondents were supportive of childhood vaccinations. Level of education, specific HCW occupation and geography were associated with the degree of vaccination hesitancy. The majority trusted advice from health professionals or scientists/doctors and distrusted statements from politicians.
Key factors that HCWs thought would encourage vaccination included: vaccine availability at their workplace, vaccination of professional colleagues, sufficient opportunity to ask about vaccine safety and efficacy, supportive information from international bodies, and HCW plans to visit vulnerable family/friends.
Our EuCARE study demonstrated that generic vaccine promotion activities, whilst valuable, require nuanced modification for different HCW subgroups, vaccines, education levels, and geography.
Investigators
Francis Drobniewski
Marcia Ashmi
Dian Kusuma
Raheelah Ahmad
Daniel Naumovas
Dovilė Juozapaitė
Cristina Toscano
Elvira Perea
Ana B. Abecasis
Miguel Viveiros
Joana P. V. Pereira
Björn-Erik Ole Jensen
Nils Bardeck
Julia Fonseca de Morais Caporali
Jorge Andrade Pinto
Francesca Incardona
Milosz Parczewski
Karol Serwin