Vaccine hesitancy among healthcare professionals at a university hospital

Fidelis, Renata Verissimo; Paula, Weslla Karla Albuquerque Silva de; Bezerra, Joana Lidyanne de Oliveira; Coriolano-Marinus, Maria Wanderleya de Lavor

doi:10.37689/acta-ape/2024AO00001394

Brasil

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Original Article • Acta Paul Enferm 37 • 2024 • https://doi.org/10.37689/acta-ape/2024AO000013944 linkcopy

Vaccine hesitancy among healthcare professionals at a university hospital

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective To analyze the factors associated with vaccine hesitancy among healthcare professionals at a university hospital.

Methods This is a cross-sectional, descriptive and analytical study, developed at a federal university hospital in Pernambuco, between June and November 2022, with institution healthcare workers with high school and higher education. The predictor variables socioeconomic and occupational aspects, history of vaccine reactions, fears related to vaccines and aspects of 3Cs model (confidence, compliance, convenience) dimensions with the outcome vaccine hesitancy, defined as delay or refusal of vaccination, despite the availability of this service, were analyzed. Binary logistic regression was used, according to the stepwise backward method, to verify associations (p < 0.05).

Results A total of 283 healthcare workers participated, with vaccine hesitancy being statistically associated with fear of Events Supposedly Attributable to Vaccination or Immunization (OR: 2.047; CI: 1.165-3.595; p = 0.013), having something happen that made them disbelieve in vaccine effectiveness (OR: 2.964; CI: 1.265-6.944; p = 0.012) and immunobiological agent availability in the health unit to update the card (OR: 0.314; CI: 0.136-0.723; p = 0.006).

Conclusion It was observed that: fear of Events Supposedly Attributable to Vaccination or Immunization increases the chance of vaccine hesitancy by two times; the fact that something happened that led to disbelief in vaccine effectiveness increases it by almost three times; and immunobiological agent availability in the health unit to update the card reduces the occurrence of this phenomenon.

Vacination; Health personnel; Vaccination hesitancy; Hospitals university

Variables	Vaccine hesitancy		Total n(%)	p-value(X²)
Variables	Yes n(%)	No n(%)	Total n(%)	p-value(X²)
Age (years)				0.356^*
20 - 29	9(30)	21(70)	30(10.6)
30 - 39	28(32.6)	58(67.4)	86(30.5)
40 - 49	32(33.7)	63(66.3)	95(33.7)
50 - 59	18(34.6)	34(65.4)	52(18.4)
60 and older	2(2.2)	17(8.8)	19(6.7)
			282(99.6)^≈
Sex				0.723
Female	75(33.7)	164(66.3)	239(84.5)
Male	15(34.1)	29(65.9)	44(15.5)
			283(100)
Education				0.449
Vocational training	18(33.3)	36(66.7)	54(19.1)
Graduation	27(37.5)	45(62.5)	72(25.4)
Lato sensu graduate education	32(31.1)	71(68.9)	103(36.4)
Stricto sensu graduate education	13(24.1)	41(75.9)	54(19.1)
			283(100)
Race				0.254^*
Black	13(43.3)	17(56.7)	30(10.6)
White	35(34.3)	67(65.7)	102(36)
Yellow	3(50)	3(50)	6(2.1)
Brown	39(27.3)	104(72.7)	143(50.5)
Indigenous	-(-)	2(100)	2(0.7)
			283(100)
Income (in MW)				0.664^*
1 - < 2	3(27.3)	8(72.7)	11(4)
2 – 4	39(34.2)	75(65.8)	114(41.9)
5 and more	43(29.3)	104(70.7)	147(54)
			272(96.1)^≈
Professional category				0.678
Nursing professionals	56(30.9)	125(69.1)	181(64)
Other professionals	34(33.3)	68(66.7)	102(36)
			283(100)
Job tenure (years)				0.409
< 5	30(35.3)	55(64.7)	85(30)
≥5	60(30.3)	138(69.7)	198(70)
			283(100)
Employment relationship
Permanent (SLR)**	26(27.1)	70(72.9)	96(35.4)	0.372
Permanent (company)#	49(34)	95(66)	144(53.1)
Temporary (company) #	12(38.7)	19(61.3)	31(11.4)
			271(95.7)^≈

Variables	Vaccine hesitancy		Total n(%)	p-value(X²)
Variables	Yes n(%)	No n(%)	Total n(%)	p-value(X²)
History of vaccine reaction				0.936
Yes	27(32.1)	57(67.9)	84(29.7)
No	63(31.7)	136(68.3)	199(70.3)
Fear of applying the vaccine				0.157
Yes	20(40)	30(60)	50(17.7)
No	69	163	232(82.3)
Fear of ESAVI				0.006
Yes	41(42.3)	56(57.7)	97(34.3)
No	49(26.3)	137(73.7)	186(65.7)
Welcomed by vaccinators on their last visit to the health unit				1.000*
Yes	88(31.9)	188(68.1)	276(97.5)
No	2(28.6)	5(71.4)	7(2.5)
Confidence
Something happened that made me stop believing in vaccine effectiveness				0.001
Yes	17(58.6)	12(41.4)	29(10.3)
No	73(29)	179(71)	252(89.7)
Believe that the government offers the best vaccines on the market				0.790
Yes	73(32.4)	152(67.6)	225(83)
No	14(30.4)	32(69.6)	46(17)
Trust the information that professionals give about vaccines				0.315
Yes	82(31.1)	182(68.9)	264(96)
No	5(45.5)	6(54.5)	11(4)
Feel safe receiving new vaccines				0.116
Yes	72(30)	168(70)	240(85.7)
No	12(42.5)	27(57.5)	40(14.3)
Trust the professionals who take care of the vaccination process				0.611
Yes	85(31.7)	163(68.3)	268(95.4)
No	5(38.5)	8(61.5)	13(4.6)
Convenience
Consider that have enough information about vaccines to decide whether to be vaccinated				0.108
Yes	73(30)	170(70)	243(86.8)
No	16(43.2)	21(56.8)	37(13.2)
Feel sufficiently informed about the risks/benefits of vaccines				0.036
Yes	66(28.9)	162(71.1)	228(80.6)
No	24(43.6)	31(56.4)	55(19.4)
Updated the vaccination card because a vaccination campaign was carried out at the workplace				0.484
Yes	51(29.7)	121(70.3)	172(61.6)
No	36(33.6)	71(66.4)	107(38.4)
Updated the vaccination card after hearing information about the benefits of vaccines in the media				0.653
Yes	35(30.2)	81(69.8)	116(41.7)
No	53(32.7)	109(67.3)	162(58.3)
Vaccine availability the last time that went to the health unit to update the vaccination card				0.004
Yes	72(28.6)	180(71.4)	252(90.3)
No	15(55.6)	12(44.4)	27(9.7)
Having a vaccination room at the workplace makes it easier to receive vaccines				0.384*
Yes	86(31.2)	190(68.8)	276(97.9)
No	3(50)	3(50)	6(2.1)
Complacency
Working at a hospital increases the risk of vaccine-preventable diseases				0.226
Yes	78(30.7)	176(69.3)	254(90.7)
No	11(42.3)	15(57.7)	26(9.3)
Think that have something to gain by being vaccinated				1.000*
Yes	89(31.9)	190(68.1)	279(98.9)
No	1(33.3)	2(66.7)	3(1.1)
Would give up conceptions about vaccination usefulness, benefits and risk to decide to be vaccinated				0.161
Yes	15(41.7)	21(58.3)	36(12.9)
No	73(30)	170(70)	243(87.1)

Variables	Unadjusted model		Adjusted model
Variables	OR (95% CI)	p-value	OR (95% CI)	p-value
Fear of applying the vaccine		0.157		0.411
Yes	1.575(0.837-2.963)		1.350(0.660-2.759)
No	1		1
Fear of ESAVI		0.006		0.013
Yes	2.047(1.219-3.438)		2.047(1.165-3.595)
No	1		1
Confidence
Something happened that made me stop believing in vaccine effectiveness		0.001		0.012
Yes	3.474(1.580-7.635)		2.964(1.265-6.944)
No	1		1
Feel safe receiving new vaccines		0.116		0.634
Yes	0.580(0.292-1.150)		1.238(0.515-2.997)
No	1		1
Convenience
Consider that have enough information about vaccines to decide whether to be vaccinated		0.108		0.665
Yes	0.564(0.278-1.142)		0.821(0.335-2.008)
No	1		1
Feel sufficiently informed about the risks/benefits of vaccines		0.036		0.156
Yes	0.526(0.287-0.964)		0.614(0.313-1.206)
No	1		1
Vaccine availability the last time that went to the health unit to update the vaccination card		0.004		0.006
Yes	0.320(0.143-0.717)		0.314(0.136-0.723)
No	1		1
Complacency
Give up conceptions about vaccination usefulness, benefits and risk to decide to be vaccinated		0.161		0.785
Yes	1.663(0.812-3.407)		1.140(0.445-2.923)
No	1		1

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Escola Paulista de Enfermagem, Universidade Federal de São Paulo R. Napoleão de Barros, 754, 04024-002 São Paulo - SP/Brasil, Tel./Fax: (55 11) 5576 4430 - São Paulo - SP - Brazil
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[TFN1001] * Fisher’s exact test; **SLR: Single Legal Regime; MW: minimum wage; # Company providing hospital services; ≈ The total for some variables may be lower than n=283 (100%) due to lack of information from participants.