Vaccine hesitancy among healthcare workers in Europe: A qualitative study
Introduction
Healthcare workers (HCWs) are considered the most trusted source of vaccine-related information [1]. However, studies are showing that HCWs are losing confidence in vaccination for their children, themselves, or their patients [2], [3], [4], [5]. Public health experts refer to this loss of confidence as “vaccine hesitancy”, which has recently been defined by the SAGE Working Group on Vaccine Hesitancy as “a behaviour, influenced by a number of factors including issues of confidence, complacency, and convenience” [6]. Vaccine hesitant HCWs can have a powerful influence on vaccination decisions, as they might recommend vaccines less frequently to their patients, and/or otherwise undermine confidence and contribute to vaccine hesitancy among the general population [2].
The little available research on HCWs’ attitudes is primarily related to seasonal and/or pandemic influenza vaccines. Most found that HCWs had not taken the influenza vaccine because of lack of time [7], [8], not feeling at risk of influenza [9], [10], because they considered they had no medical indication for the vaccine [4], [5], or due to concerns about safety and efficacy [3], [11].
This research aims to better understand vaccine hesitancy among vaccine providers in Europe, and explore the nature of their concerns, their perceptions of vaccine-related information, and their perceived role in responding to vaccine hesitancy.
Section snippets
Methods
The study was conducted in Croatia, France, Greece and Romania, as these countries responded to ECDC’s call for interest in participating in the project entitled “Comprehensive expert opinion on motivating hesitant population groups to vaccinate”. These countries have very different socio-economic and political backgrounds, allowing a more comprehensive overview of vaccine hesitancy in various contexts. Semi-structured interviews were conducted with healthcare providers who advise on
Results
Sixty-five semi-structured interviews were conducted across Croatia (17/65), France (16/65), Greece (15/65) and Romania (17/65). Most participants were female (66%) and between 25 and 44 years old (58%). The majority were GPs (72%), with gynaecologists (9%), epidemiologists (6%), paediatricians (6%) and internal medicine specialists (6%) also participating (Table 1).
The coding themes identified across all countries included: perceived benefits of vaccination (mentioned 227 times across all
Discussion
The results from the qualitative interviews with HCWs from Croatia, France, Greece and Romania confirm the study’s initial assumption of existence of vaccine hesitancy among HCWs and provide an insight into the reasons behind these doubts. Although the reports from the interviews were overall positive and showed generally high levels of trust and confidence in vaccination, there were also concerns about safety, questions about the need for vaccines, and/or mistrust of pharmaceutical companies
Conflict of interests
None
Funding
This study was commissioned by the European Centre for Disease Prevention and Control (ECDC), under the Framework Service Contract ECDC/2014/013, coordinated by Irina Dinca at ECDC, produced by World Health Communication Associates (WHCA) and sub-contracted to the London School of Hygiene and Tropical Medicine (LSHTM).
The LSHTM research group “The Vaccine Confidence Project” has received funding from the Bill & Melinda Gates Foundation, the Center for Strategic and International Studies, EU
Acknowledgements
We would like to show our gratitude to our colleagues from the four studied countries who provided insight and expertise that greatly assisted the research: Eleni Antoniadou and Agoritsa Baka at the Hellenic Centre for Disease Control, Greece; Adriana Baban at the Babes-Bolyai University, Romania; Patrick Pereti-Watel and Pierre Verger at the Institut national de la santé et de la recherche médicale (INSERM), France and Vesna Visěkruna Vučina at the Croatian National Institute of Public Health,
References (24)
- et al.
Likely uptake of swine and seasonal flu vaccines among healthcare workers. A cross-sectional analysis of UK telephone survey data
Vaccine
(2011) - et al.
Understanding vaccine hesitancy around vaccines and vaccination from a global perspective: A systematic review of published literature, 2007–2012
Vaccine
(2014) - et al.
Analysis of motivations for antiflu vaccination of the Clermont-Ferrand University Hospital staff
Medecine et Maladies Infectieuses
(2008) - et al.
Acceptance of the 2009 A(H1N1) influenza vaccine among hospital workers in two French cancer centers
Vaccine
(2010) - et al.
Influenza vaccination of health care workers in hospitals–a review of studies on attitudes and predictors
Vaccine
(2009) - et al.
Acceptance of seasonal and pandemic a (H1N1) 2009 influenza vaccination by healthcare workers in a French Teaching Hospital
Vaccine
(2011) - et al.
Human papillomavirus (HPV) vaccination: Perception and practice among French general practitioners in the year since licensing
Vaccine
(2011) - et al.
Pandemic A(H1N1)2009 influenza vaccination in Lyon University Hospitals, France: perception and attitudes of hospital workers
Vaccine
(2013) Anti-vaccine activists, Web 2.0, and the postmodern paradigm–an overview of tactics and tropes used online by the anti-vaccination movement
Vaccine
(2012)- et al.
Opportunities and challenges of Web 2.0 for vaccination decisions
Vaccine
(2012)
An analysis of the human papilloma virus vaccine debate on MySpace blogs
Vaccine
Vaccine-criticism on the internet: new insights based on French-speaking websites
Vaccine
Cited by (296)
Addressing vaccine concerns through the spectrum of vaccine acceptance
2023, Social Science and MedicineKnowledge, attitude, practices regarding COVID-19 vaccination among health care professionals in southern Tunisia
2023, Journal of Interprofessional Education and PracticeAttitudes toward COVID-19 vaccination of healthcare workers in Israel and vaccination rates during vaccine rollout
2023, Epidemiology and Infection