Barriers and drivers of positive COVID-19 vaccination behaviours among healthcare workers in Europe and Central Asia: a qualitative cross-country synthesis

Cath Jackson (), Sian Smith, Anastas Aghasaryan, Diana Andreasyan, Aron Kassahun Aregay, Katrine Bach Habersaat, Lusine Hovhannisyan, Ignat V. Bogdan, Darya P. Chistyakova, Šeila Cilović-Lagarija, Silviu Colonescu, Jeyhun Hajiyev, Anna Ilves, Anna Isahakyan, Shushanik Isahakyan, Nursultan Jusupov, Iago Kachkachishvili, Elisa Kender, Elena Kjosevska, Siff Malue Nielsen, Alyona Mazhnaia, Marje Oona, Bogdan Păunescu, Haris Šabanović, Anca-Irina Săndulescu, Ana Vasilevska, Sahil Warsi, Elvin Yusifli, Raisa-Gabriela Zamfirescu and Brett Craig
Additional contact information
Cath Jackson: World Health Organization Regional Office for Europe
Sian Smith: World Health Organization Regional Office for Europe
Anastas Aghasaryan: National Institute of Health
Diana Andreasyan: National Institute of Health
Aron Kassahun Aregay: World Health Organization Country Office in Ukraine
Katrine Bach Habersaat: World Health Organization Regional Office for Europe
Lusine Hovhannisyan: National Institute of Health
Ignat V. Bogdan: Research Institute for Healthcare and Medical Management of Moscow Healthcare Department
Darya P. Chistyakova: Research Institute for Healthcare and Medical Management of Moscow Healthcare Department
Šeila Cilović-Lagarija: Institute for Public Health Federation of Bosnia and Herzegovina
Silviu Colonescu: The Romanian Association for Health Promotion
Jeyhun Hajiyev: Sustainera Research and Consulting Services
Anna Ilves: Medicolm OÜ
Anna Isahakyan: National Institute of Health
Shushanik Isahakyan: National Institute of Health
Nursultan Jusupov: Department of Sociological Research
Iago Kachkachishvili: Tbilisi State University
Elisa Kender: The National Institute for Health Development
Elena Kjosevska: Institute of Public Health
Siff Malue Nielsen: World Health Organization Regional Office for Europe
Alyona Mazhnaia: World Health Organization Country Office in Ukraine
Marje Oona: University of Tartu
Bogdan Păunescu: The Romanian Association for Health Promotion
Haris Šabanović: Valicon, Federation of Bosnia and Herzegovina
Anca-Irina Săndulescu: The Romanian Association for Health Promotion
Ana Vasilevska: TIM Institute
Sahil Warsi: World Health Organization Regional Office for Europe
Elvin Yusifli: Sustainera Research and Consulting Services
Raisa-Gabriela Zamfirescu: University of Bucharest
Brett Craig: World Health Organization Regional Office for Europe

Palgrave Communications, 2023, vol. 10, issue 1, 1-15

Abstract: Abstract Vaccination uptake is essential to controlling the ongoing COVID-19 pandemic. Healthcare workers (HCWs) play a critical role in receiving, recommending and delivering COVID-19 vaccination. Understanding the specific influences on each behaviour enables the development of targeted and tailored interventions to improve vaccination uptake. This paper presents a qualitative synthesis of HCWs’ individual and context barriers and drivers to these three vaccination behaviours across 10 countries in Europe and Central Asia. Qualitative data from interviews and focus group discussions with 378 HCWs between December 2020 and March 2022 were synthesised and organised by four COM (capability, physical and social opportunity, motivation) factors. Differences by stage of COVID-19 vaccine roll-out (in preparation, early and late delivery) were explored. Receiving vaccination related to all four factors. Recommending vaccination mostly related to capability and motivation. HCWs were generally well-informed by official sources and viewed vaccination as the way to end the pandemic, acknowledging their important role in this. Colleagues, family and friends were positive influences on personal vaccination decisions. However, knowledge gaps were evident, particularly amongst nurses who relied on (social) media. Concerns about safety and effectiveness, often connected to knowledge gaps, were heightened by the accelerated timeline for COVID-19 vaccine development and approval. This impeded some HCWs’ motivation to receive and recommend vaccination even in the later roll-out countries. Delivering vaccination was facilitated by support from public health organisations, teamwork and service re-organisation, more evident amongst later roll-out countries. Ongoing high workloads, stress and burnout hindered delivery. Complex and inter-related factors affecting HCWs’ vaccination behaviours were identified. These insights should inform the design of multifaceted interventions (e.g., communication skills training, management support for HCWs’ mental health, and engaging them in decision-making for service redesign); not only for COVID-19 vaccination as it is integrated into routine services but for routine immunization as a whole.

Date: 2023
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DOI: 10.1057/s41599-023-02443-x

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