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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is the causative agent of the ongoing coronavirus disease 2019 (COVID-19) pandemic, is a highly infectious and virulent virus. Several vaccines against COVID-19 have received emergency use authorization (EUA) from global regulatory authorities, after which vaccination programs have been launched in many countries around the world.
Vaccines against COVID-19 have been shown to protect people from severe infection and reduce human-to-human transmission. Thus, global vaccination campaigns have to some extent alleviated some of the enormous pressure on health facilities while reducing the adverse social and economic impacts of COVID-19.
study: Determinants of intention to vaccinate against COVID-19 among healthcare workers in France: A qualitative study. Image credit: David Pereiras / Shutterstock.com
Background
In France, healthcare workers (HCWs) are prioritized for vaccination against COVID-19, as they are more likely to be infected due to their professional activities. Despite this strategy, about 34% of nosocomial SARS-COV-2 infections were reported in February 2021. This report highlights the importance of vaccination against COVID-19 among healthcare workers to protect them, their patients, their families and anyone else, whom you interact with.
People’s adherence to vaccination depends on their personal opinion, available advice and immunization status. One of the main obstacles to vaccination against COVID-19 is vaccine hesitancy, which has been quite significant in France since the approval of these vaccines.
One of the factors that contributed to the vaccine hesitancy among French health workers includes the rapid development of vaccines against COVID-19 compared to all other vaccines. In addition, several vaccines have been developed using innovative approaches, most of which have been provided with EUAs by world authorities.
Understanding the determinants of people’s intention to receive vaccines against COVID-19 is essential to determine appropriate public health policies. Recently Vaccines study describes the results of semi-structured qualitative interviews of healthcare workers to determine the factors associated with their vaccine hesitancy.
About the research
The present qualitative study was conducted from January 2021 to April 2021, which was at the beginning of the national vaccination program against COVID-19 in France. Healthcare workers were interviewed individually in a semi-structured manner to determine their perception of vaccination against COVID-19.
The researchers used a theoretical framework related to a comprehensive behavioral model of vaccination against COVID-19. The key feature of the vaccine hesitancy model was that it helped to understand vaccination behavior based on different strategies that could be developed to overcome this challenge.
A comprehensive behavioral model was developed to examine the behavioral determinants that are associated with vaccination. This model is based on meta-analyses and systematic reviews of non-compulsory vaccination intention (eg influenza vaccination), a cross-sectional analysis of the results of the CoVaPred study and behavioral theories related to preventive measures. This theory-based model aimed to help uncover key factors leading to vaccine hesitancy as well as strategies that could be formulated to promote vaccination uptake.
Survey results
Intention to vaccinate against COVID-19 among French healthcare workers primarily depends on their level of trust in the proposed vaccines. In addition, their personal or proxy experiences with the disease and vaccination also contributed to their hesitancy about vaccination.
The perception of information provided by the media about vaccination against COVID-19 also affected health care workers. The opinion and vaccination status of others in the health workers’ environment were also determinants of the intention to be vaccinated.
Interestingly, recently identified determinants of HCWs’ intention to vaccinate are consistent with factors identified by the overall behavioral pattern of vaccination against COVID-19 in the general population. It should be noted that HCWs’ vaccination intentions are influenced by the level of knowledge, trust in health and political authorities, personal habits and the perceived norm of vaccination.
Like the general population, healthcare workers needed to be reassured about the safety and efficacy of the vaccine.
In October 2021, France introduced a mandatory vaccination policy for medical workers, raising questions. This coercive measure also increased vaccine hesitancy among medical professionals.
Confidence in the COVID-19 vaccines was based on high efficacy and information about their short- and long-term side effects. In France, confidence in COVID-19 vaccines has been weakened by several scandals and controversies surrounding AstraZeneca’s Vaxzevria vaccine. It is therefore imperative to promote positive experiences of vaccinated individuals and to ensure transparency about possible side effects.
In line with many countries around the world, France has also implemented restrictive measures to manage the pandemic. However, these measures provoked opposition and turned vaccination into a political issue.
In the interviews, some medical workers expressed that they were no longer afraid of COVID-19 because they had already been exposed to the virus on a daily basis without getting sick. A low perception of risk influenced the lack of intention to vaccinate.
Interestingly, physicians shared a high level of confidence in the COVID-19 vaccines, which may be due to their easier access to valid information. This observation suggests that the easy availability of valid information can encourage vaccination.
Conclusions
The study cohort consisted of healthcare workers from a specific geographic location, thus limiting the generalizability of the findings. Moreover, the interviews were conducted in a rapidly changing context, as the French government very frequently changed policies related to the priority groups for vaccination against COVID-19.
Nevertheless, the current study reported several factors that influenced vaccine hesitancy that could be addressed to improve the current situation.
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