Health care institutions and their physicians are the greatest promoters of COVID-19 vaccine acceptance among health care workers

Abstract

Background: ESPERES, a prospective e-cohort study is designed to assess attitudes and perceptions of the COVID-19 pandemic among French health care workers.

Objectives: We aimed to document (i) their confidence in the information directly transmitted by their health care institutions; (ii) the role of physicians in the development of normative beliefs about vaccines against COVID-19 among them; (iii) their view of issues related to governmental health institution communication; and (iv) the impact of this communication on their posture to promote vaccine adherence among patients.

Methods: We conducted semistructured interviews with health care workers from the ESPERES cohort (n = 50). We based our maximal variation strategy mainly on the social gradient. We proceeded to a thematic analysis following an inductive approach.

Results: Vaccine programs should rely on health care workers' high level of confidence in the information provided directly by their health care institutions. Moreover, our results indicated that in health care institutions, the behavior of physicians influences the normative beliefs and the personal motivation to get vaccinated through a trickle-down effect (from physicians to allied health professionals), as well as a trickle-around effect (between physicians). Additionally, it appeared that physicians' eagerness to be vaccinated against COVID-19 was a major determinant in promoting the reassurance of other health care workers. However, they all reported a lack of reliability of the information provided by governmental health institutions, which contributed to patients' vaccine hesitancy. In this context, in contrast to clinicians, nurses and assistant nurses did not promote vaccination against COVID-19 in order to preserve their relationship with hesitant patients, which highlights the need of future vaccine programs to better involve these professionals who work closely with patients.

Conclusion: Our results are very informative for sustaining the implementation of vaccine programs among health care workers in the case of future pandemics.

Trial registration: ClinicalTrials.gov NCT04870086.

Keywords: COVID-19; Health care workers; Implementation of vaccine programs; Qualitative study; Vaccine adherence.