What determines health professionals' COVID-19 vaccine hesitancy? A nationwide study.

ABSTRACT

INTRODUCTION: To contain the COVID-19 pandemic, higher vaccination rates are essential. However, as vaccine hesitancy is a reality, it is important to understand what drives health professionals to refuse getting vaccinated against COVID-19, who have been in the frontline of this pandemic since its beginning and may be key actors to improve vaccine coverage among their patients. PURPOSE: This study aims to assess the factors associated with vaccine hesitancy (VH) among health professionals (physicians, nurses, pharmacists and dentists). METHODS: A nationwide cross-sectional study was conducted through an online survey, with 890 Portuguese health professionals. A logistic regression analysis was used to determine the adjusted odds ratio (OR) of the independent variables (perceptions, knowledge and attitudes) per 1-point increase in the Likert scale and VH. RESULTS: Complacency, communications, confidence and convenience were strongly associated with VH probability. Concerns about vaccines' efficacy (ORPhysicians  = 8.33, 95% CI 4.51-15.36) and safety (ORNurses  = 11.07, 95% CI 4.12-29.77) increase the risk of VH on all health professional groups. A reduction of VH probability is associated with higher risk perceptions of getting infected (1/ORNurses  = 2.76, 95% CI 1.52-5.02) and suffering complications (1/ORNurses  = 33.72, 95% CI 8.48-134.13), higher confidence in the effectiveness of COVID-19 vaccines (1/ORDentists  = 12.29, 95% CI 2.91-51.89), risk perception of getting infected if vaccinated (1/ORPhysicians  = 14.92, 95% CI 6.85-32.50), risk of suffering from complications after getting vaccinated, and higher trust levels on the information transmitted by competent authorities (1/ORDentists  = 17.76, 95% CI 3.83-82.22). CONCLUSIONS: To reduce COVID-19 VH, which appears to be highly influenced by perceptions, knowledge and attitudes, it is essential to promote interventions directed to transforming these potentially modifiable determinants.