Covid-19 vaccine hesitancy: the role of nurses and other health and social care employees in vaccine hesitancy

This week’s blog was written by Dr Carol Gray Brunton from Napier University in Edinburgh, UK, and highlights the important thing role that nurses and healthcare professionals play in clarifying beliefs about vaccines.

Vaccination is one of the crucial effective public health interventions in developing countries by eliminating infectious diseases. Achieving high vaccination rates is very important for “herd” immunity, which protects the final population from disease [1]. Global Immunization Week 24-30 April 2023 The Great Catch-Up goals to support countries to fulfill pre-2019 vaccination rate targets which were missed or negatively impacted by the worldwide pandemic [2].

The Covid-19 pandemic has highlighted the worldwide importance of vaccination. She also highlighted the numerous role of nurses and other health and social care employees in vaccination campaigns: as priority groups to receive Covid-10 vaccines attributable to their work on the front line, as vaccination advocates, and as trusted sources of knowledge for the general public [for example 3]. However, the very concept that nurses and other health and social care employees could refuse or delay receiving their very own Covid-19 vaccine could possibly be seen as a controversial issue, given their skilled role and commitment to evidence-based practice. Vaccine hesitancy, defined as delays or refusals, is taken into account a serious public health problem worldwide for complex and context-dependent reasons. [4-5].

In our recent online mixed-method survey, we considered the subject of Covid-19 vaccine hesitancy amongst nurses and other health and social care professionals/training. We have adapted the web survey [6] and online focus group discussions for one large university School of Health and Social Care in a small pilot trial. The results showed that the vast majority of participants had positive views in regards to the Covid-19 vaccine and vaccines typically and reported having received no less than two doses of a Covid-19 vaccine on the time of the study (June–September 2022). However, about 10% of participants had not yet received any Covid-19 vaccine and had strongly negative views in regards to the vaccine. This small group of vaccine hesitators is paying homage to previously reported large studies of the final population [6].

In online qualitative discussions, professionals expressed mainly positive views in regards to the Covid-19 vaccine, but mentioned cases where the vaccine could be perceived as problematic of their skilled or personal interactions with the general public. Common concerns about vaccines were noted, including avoiding “overloading” the immune system with multiple vaccines; protecting vulnerable groups by avoiding risk of harm or ‘negligent bias’ [7]; and that some vaccines were considered less vital, comparable to flu vaccines.

Given the abundant and ever-changing flow of vaccine information through the pandemic, it’s difficult but necessary for professionals to stay awake thus far with the newest evidence. Nurses and other professionals remain an integral a part of the vaccination campaign, given their trusted and leading role in society, and might address common vaccine concerns in skilled and private settings. Evidence-based research and training during vaccine campaigns could address widespread public concerns about vaccines which will permeate the general public and a few professionals, in order that professionals have the boldness to handle these concerns. This will not be consistent with the data deficit model of providing more scientific information [8] but somewhat within the context of managing emotions and skilled relationships to enhance informed decision-making [9].

Dr Carol Gray Brunton PhD, MSc, BSc (Hons) CPsychol AFBPsS FHEA (@GrayBrunton)

[1] How vaccines work, World Health Organization. [Accessed 25/04/2023] How do vaccines work? (who.int)
[2]. World Immunization Week April 24-30, 2023, “The big catch-up: World Health Organization. [Accessed 25/04/2023] World Immunization Week 2023 (who.int)
[3] Petrova D, Gray Brunton C, Jaeger M, Lenneis A, Munoz R, Garcia-Retamero R, Todorova I. Young women’s views on HPV vaccine communication in four European countries. Curr HIV Res. 2015;13(5):347-58. doi: 10.2174/1570162×13666150511124743. PMID: 26149158.
[4] Ten threats to global health in 2019. World Health Organization. [Accessed 25/04/2023 ] https://www.who.int/news-room/spotlight/ten-threats-to-global-health-in-2019
[5] MacDonald NE. Vaccine hesitancy: definition, scope and determinants. Vaccine. 2015 Aug 14;33(34):4161-4.
[6] Freeman D, Loe BS, Chadwick A, Vaccari C, Waite F, Rosebrock L, Jenner L, Petit A, Lewandowsky S, Vanderslott S, Innocenti S, Larkin M, Giubilini A, Yu LM, McShane H, Pollard AJ, Lambe S Covid-19 vaccine hesitancy in the UK: explanations, attitudes and narratives around the Oxford (Oceans) II virus. Psychological Medicine. Cambridge University Press; 2022;52(14):3127–41.
[7] Ritov I, Baron J. Vaccine hesitancy: error of omission and ambiguity. Journal of behavioral decision making. 1990 October; 3(4):263-77.
[8] Lehner, L., Gribi, J., Hoffmann, K. et al. Beyond the “information deficit model” – understanding the attitudes of midwives in Austria regarding vaccine hesitancy: a qualitative study. BMC Public Health 21, 1671 (2021). https://doi.org/10.1186/s12889-021-11710-y
[9] Kennedy, C., Gray Brunton, C. and Hogg, R. ‘Just that little little bit of doubt’: the views of Scottish parents, teenage girls and health professionals on MMR, H1N1 and HPV vaccines. Int.J. Behave yourself. Med. 21, 3–10 (2014). https://doi.org/10.1007/s12529-013-9356-4

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