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

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.

This study aims to assess the factors associated with vaccine hesitancy (VH) among health professionals (physicians, nurses, pharmacists and dentists).

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.

Complacency, communications, confidence and convenience were strongly associated with VH probability. Concerns about vaccines' efficacy (OR_Physicians  = 8.33, 95% CI: 4.51-15.36) and safety (OR_Nurses  = 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/OR_Nurses  = 2.76, 95% CI: 1.52-5.02) and suffering complications (1/OR_Nurses  = 33.72, 95% CI: 8.48-134.13), higher confidence in the effectiveness of COVID-19 vaccines (1/OR_Dentists  = 12.29, 95% CI: 2.91-51.89), risk perception of getting infected if vaccinated (1/OR_Physicians  = 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/OR_Dentists  = 17.76, 95% CI: 3.83-82.22).

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.