RESUMEN
Health workers (HWs) have a key role in promoting vaccine acceptance. This study draws on the Behavioral and Social Drivers of Vaccination (BeSD) model and our team's investigation of vaccine hesitancy in a sample of 1197 HWs across 14 Caribbean countries in 2021. We conducted a cross-sectional Internet survey of 6718 HWs across 16 countries in Latin America in spring 2022, after the COVID-19 vaccine had recently become widely available in the region. The survey assessed HWs' attitudes regarding COVID-19 vaccines and vaccines in general. As a proxy measure of COVID-19 vaccine acceptance, we used the willingness to recommend the COVID-19 vaccine to eligible people. Ninety-seven percent of respondents were COVID-19 vaccine acceptant. Although nearly all respondents felt that the COVID-19 vaccine was safe and effective, 59% expressed concerns about potential adverse effects. Despite uniformly high acceptance of the COVID-19 vaccine overall and across Latin American subregions, acceptance differed by sex, HW profession, and COVID-19 history. Social processes, including actions and opinions of friends, family, and colleagues; actions and opinions of religious leaders; and information seen on social networks shaped many respondents' opinions of vaccines, and the magnitude of these effects differed across both demographic and geographic subgroups. Information campaigns designed for HWs should underscore the importance of vaccine safety. Messages should be tailored to specific audiences according to the information source each is most likely to consult and trust.
RESUMEN
BACKGROUND: The Caribbean has a long history of being a global leader in immunization, and one factor contributing to this success has been the commitment of healthcare workers in promoting the benefits of vaccines. Healthcare workers play a critical role in building trust between the public and the immunization program and are generally cited as the most trusted source of information on vaccination. Healthcare workers themselves, therefore, must be confident in vaccination as a public health good and able to transmit this confidence to those who trust them. However, just as with the general public, healthcare workers develop confidence at different rates and may be susceptible to misinformation about vaccines. METHODS: During April and May 2021, the Pan American Health Organization (PAHO) conducted a mixed-methods survey to assess vaccination attitudes, opinions, and reasoning of 1197 healthcare workers across 14 Caribbean countries. FINDINGS: Seventy-seven percent of respondents expressed clear intention to be vaccinated for COVID-19 as soon as possible. Intention to be vaccinated as soon as possible was expressed by lower proportions of nurses (66%) and allied health professionals (62%) than physicians (85%) and by younger respondents than older ones (64% vs. 85%, respectively; p < 0.001 for all these comparisons). Across 32 questions about attitudes and opinions, vaccine hesitancy was consistently expressed by higher proportions of nurses and allied health professionals than physicians and by younger respondents than older ones. INTERPRETATION: Insights from the survey are helping PAHO address healthcare worker concerns with informative messages and supporting countries in policy development to increase vaccine confidence and coverage among Caribbean healthcare workers. FUNDING: This work has been sponsored by the World Health Organization/Pan American Health Organization, the Government of Germany and The Gavi Alliance.
