Vaccination programs against COVID-19 are being scaled up. We aimed to assess the effects of vaccine characteristics on vaccine hesitancy among healthcare workers in a multi-center survey conducted within French healthcare facilities from 1 December 2020 to 26 March 2021. We invited any healthcare workers naïve of COVID-19 vaccination to complete an online self-questionnaire. They reported on their socio-demographic characteristics, as well as their perception and beliefs towards vaccination. We measured their willingness to get vaccinated in eight scenarios for candidates’ vaccines presented sequentially (1 to 4-point scale). Candidates’ vaccines varied for efficacy (25%, 50%, 100%), length of immunization (1 year or lifetime), frequency (<1/100, <1/10,000), and severity (none, moderate, severe) of adverse events. We analyzed 4349 healthcare workers’ responses with interpretable questionnaires. The crude willingness to get vaccinated was 53.2% and increased over time. We clustered the trajectories of responses using an unsupervised classification algorithm (k-means) and identified four groups of healthcare workers: those willing to get vaccinated in any scenario (18%), those not willing to get vaccinated at all (22%), and those hesitating but more likely to accept (32%) or reject (28%) the vaccination depending on the scenario. In these last two subgroups, vaccine acceptance was growing with age, educational background and was higher among men with condition. Compared to an ideal vaccine candidate, a 50% reduced efficacy resulted in an average drop in acceptance by 0.8 (SD ± 0.8, −23.5%), while it was ranging from 1.4 (SD ± 1.0, −38.4%) to 2.1 (SD ± 1.0, −58.4%) in case of severe but rare adverse event. The acceptance of a mandatory immunization program was 29.6% overall and was positively correlated to the willingness to get vaccinated, ranging from 2.4% to 60.0%. Even if healthcare workers represent a heterogeneous population, most (80%) could accept the vaccination against COVID-19. Their willingness to get the vaccine increased over time and as immunization programs became available. Among hesitant professionals, the fear of adverse events was the main concern. Targeted information campaigns reassuring about adverse events may increase vaccine coverage, in a population with a strong opinion about mandatory immunization programs.

No abstract

En France, les professionnels de santé travaillant en établissement ont un très faible taux de vaccination contre la grippe. Ce dernier atteint seulement 25%. Pourtant cette population contribue à la propagation du virus de la grippe chez les patients à risque hospitalisés sur une longue période. Chaque année, de nombreux patients décèdent de complications dues à la grippe. Plusieurs études ont été réalisées afin de déterminer les facteurs, d'étudier les modèles théoriques permettant l'adoption du comportement de vaccination chez les professionnels de santé. Ainsi, des interventions ont également été développées, mais leur efficacité reste non systématique. Il semble donc important d'aborder les interventions pouvant être prometteuses mais aussi de mettre en lumière leur limite concernant l'évaluation de leurs effets sur le comportement. Requestionner la nature du comportement de vaccination afin de permettre de nouvelles pistes de réflexion semble également nécessaire. Ce chapitre abordera dans un premier temps (a) l'hésitation vaccinale chez les professionnels de santé travaillant en établissement et notamment les facteurs favorisant le recours ou non à la vaccination. Dans un second temps (b) une stratégie de planification issue du modèle HAPA (Schwarzer, 2001) sera abordée ainsi que ses limites. Puis (c) une stratégie de planification basée sur le modèle transthéorique du changement de Prochaska et Diclemente (1983) sera discutée ainsi que différentes interventions permettant d'augmenter la motivation des soignants à adopter le comportement de vaccination. Enfin (d) une dernière partie sera consacrée à reconsidérer le comportement de vaccination comme étant un comportement prosocial et ainsi à la proposition de nouvelles pistes d'interventions.