Covid-19 vaccine acceptance, hesitancy, and refusal among Canadian healthcare workers: A multicenter survey

Abstract

Background : Determinants of COVID-19 vaccine acceptance among healthcare workers (HCW) remains poorly understood. We assessed HCWs’ willingness to be vaccinated and reasons underlying hesitancy. Methods : Cross-sectional survey across 17 healthcare institutions. HCWs eligible for vaccination (Pfizer-BioNTech mRNA) in December 2020 were invited to receive immunization. Multivariate logistic regression was performed to identify predictors of acceptance. Reasons for refusal among those who never intended to be vaccinated (i.e. firm refusers) and those who preferred delaying vaccination (i.e. vaccine hesitants) were assessed. Results : Among 2761 respondents (72% female, average age, 44), 2233 (80.9%) accepted the vaccine. Physicians, environmental services workers and healthcare managers were more likely to accept vaccination compared to nurses. Male sex, age over 50, rehabilitation center workers, and occupational COVID-19 exposure were independently associated with vaccine acceptance by multivariate analysis. Factors for refusal included vaccine novelty, wanting others to receive it first, and insufficient time for decision-making. Among those who declined, 74% reported they may accept future vaccination. Vaccine firm refusers were more likely than vaccine hesitants to distrust pharmaceutical companies and to prefer developing a natural immunity by getting COVID-19. Conclusions : Vaccine hesitancy exists among HCWs. Our findings provide useful information to plan future interventions and improve acceptance.

Mandate or Not Mandate: Knowledge, Attitudes, and Practices of Italian Occupational Physicians towards SARS-CoV-2 Immunization at the Beginning of Vaccination Campaign

“…On the one hand, such results are clearly consistent with the health belief model, i.e., an individual’s belief in a health threat, as well as belief in the effectiveness of the recommended health behavior or action are the main predictors for the likelihood that the person will adopt the behavior [ 46 ]. On the other hand, we failed to identify, as a predictive for acceptance of the mandatory status, a series of factors that previous studies strongly associated with the acceptance of SARS-CoV-2/COVID-19 vaccines, i.e., gender, history of personal uptake of SIV, knowledge status, previous interactions with the pathogen [ 47 , 48 , 49 ]. However, it should be stressed that the willingness to pay for a vaccine may be considered a summary index for perceived ease of access, awareness of the vaccine (including a trade-off of perceived pros and cons), but also the ability to pay for the vaccine [ 50 ].…”

“…For example, in the study by Janssen et al, the willingness to get vaccinated against COVID-19 was 53.2%, but 19.8% and 14.1% were either not likely or not willing to get vaccinated at all [ 59 ], while a report by Gharpure et al showed that a median of 37.5% of participating long-term care staff from the United States had accepted the first shot of a COVID-19 vaccine at the time of the study, demonstrating a low response to the vaccination campaign [ 60 ]. Moreover, even in the aforementioned study from Verger et al a more accurate analysis of reported data identified some degree of vaccine hesitancy in 28.4% of respondents [ 47 , 48 ]. As HCWs represent a model for the general public, they may either be instrumental in overcoming vaccine hesitancy [ 61 ], or improperly spread false beliefs and misconceptions that may be eventually detrimental to global efforts to achieve high vaccination rates as soon as possible [ 12 , 13 , 32 , 34 ].…”

“…Wide acceptance of SARS-CoV-2/COVID-19 vaccines was similarly reported by Szmyd et al [ 58 ] (i.e., 94.4% among 252 Polish medical doctors), particularly by Verger et al in a very large study involving 2768 HCWs from French speaking countries (i.e., France, Belgium, Canada): of them, 79.6% would either certainly or probably recommend a future COVID-19 vaccine to their patients; and 72.4% would certainly or probably agree to be vaccinated with it. Moreover, a subsequent study from Dzieciolowska et al involving Canadian HCWs [ 47 ] confirmed a very high acceptance (80.9%), particularly when compared to other adult-administered vaccines [ 47 ]. On the other hand, numerous studies indicate that vaccine hesitancy exists among HCWs [ 48 ], and OPs are not exempt [ 12 , 13 , 32 , 34 ].…”

Acceptance of COVID-19 Vaccines Among Physicians in Mid Delta Region of Egypt: A Cross-Sectional Study

“…In contrary to our ndings, Dzieciolowska et al found that the level of COVID-19 vaccine was higher among Canadian physicians aged more than 50 years, while they agreed with ours regarding the gender of physicians with high vaccine acceptance (Dzieciolowska et al 2021). Also, Shekhar et al 2021 in the United States reported gures that contradict our age group of physicians with high vaccine acceptance.They found that the acceptance of vaccination against COVID-19 increased with increasing age as 47% aged more than 70 years old.…”

“…A lower percent of vaccine refusal was reported in the United States, as Shekhar et al, in their study reported that only 8% of HCWs refused to be vaccinated, with a higher percentage of them accepted to take the vaccine (36%) while the greatest percent was the HCW who waited for a review before being vaccinated (56%) (Shekhar et Also, in Canada and Belgium, the level of COVID-19 vaccine acceptance was high in 48.6% of the physicians, 23 % showed moderate acceptance while only 28.4% showed hesitancy towards vaccination (Verger P et al2021). A much higher rate of physicians' acceptance was recorded by an Canadian study, as Dzieciolowska et al, found that 80.9% accepted to take the vaccine while only 19.1% refused (Dzieciolowska et al 2021).…”