Behavioural determinants of COVID-19 vaccination acceptance among healthcare workers: a rapid review

J Crawshaw; K Konnyu; G Castillo; Z van Allen; J M Grimshaw; J Presseau

doi:10.1016/j.puhe.2022.06.003

Behavioural determinants of COVID-19 vaccination acceptance among healthcare workers: a rapid review

Public Health. 2022 Sep:210:123-133. doi: 10.1016/j.puhe.2022.06.003. Epub 2022 Jun 14.

Authors

J Crawshaw¹, K Konnyu², G Castillo³, Z van Allen³, J M Grimshaw⁴, J Presseau⁵

Affiliations

¹ Centre for Evidence-Based Implementation, Hamilton Health Sciences, ON, Canada; Department of Medicine, Faculty of Health Sciences, McMaster University, ON, Canada.
² Center for Evidence Synthesis in Health, Department of Health Services, Policy and Practice, School of Public Health, Brown University, RI, USA.
³ Centre for Implementation Research, Ottawa Hospital Research Institute, ON, Canada.
⁴ Centre for Implementation Research, Ottawa Hospital Research Institute, ON, Canada; Department of Medicine, University of Ottawa, ON, Canada.
⁵ Centre for Implementation Research, Ottawa Hospital Research Institute, ON, Canada; School of Epidemiology and Public Health, University of Ottawa, ON, Canada. Electronic address: jpresseau@ohri.ca.

Abstract

Objectives: Vaccinating healthcare workers (HCWs) against COVID-19 has been a public health priority since rollout began in late 2020. Promoting COVID-19 vaccination among HCWs would benefit from identifying modifiable behavioural determinants. We sought to identify and categorize studies looking at COVID-19 vaccination acceptance to identify modifiable factors to increase uptake in HCWs.

Study design: Rapid evidence review.

Methods: We searched MEDLINE and Cochrane databases until May 2021 and conducted a grey literature search to identify cross-sectional, cohort, and qualitative studies. Key barriers to, and enablers of, vaccine acceptance were categorized using the Theoretical Domains Framework (TDF), a comprehensive theoretical framework comprising 14 behavioural domains.

Results: From 19,591 records, 74 studies were included. Almost two-thirds of responding HCWs were willing to accept a COVID-19 vaccine (median = 64%, interquartile range = 50-78%). Twenty key barriers and enablers were identified and categorized into eight TDF domains. The most frequently identified barriers to COVID-19 vaccination were as follows: concerns about vaccine safety, efficacy, and speed of development (TDF domain: Beliefs about consequences); individuals in certain HCW roles (Social/professional role and identity); and mistrust in state/public health response to COVID-19 (Social influences). Routinely being vaccinated for seasonal influenza (Reinforcement), concerns about contracting COVID-19 (Beliefs about consequences) and working directly with COVID-19 patients (Social/professional role and identity) were key enablers of COVID-19 vaccination among HCWs.

Discussion: Our review identified eight (of a possible 14) behavioural determinants of COVID-19 vaccine acceptance among HCWs that, if targeted, could help design tailored vaccination messaging, policy, campaigns, and programs to support HCWs vaccination uptake.

Keywords: Barriers and enablers; COVID-19; Healthcare professionals; Healthcare workers; Rapid review; Theoretical Domains Framework; Vaccination.

Publication types

Review

MeSH terms

COVID-19 Vaccines*
COVID-19* / prevention & control
Cross-Sectional Studies
Health Personnel
Humans
Patient Acceptance of Health Care
Vaccination

Substances

COVID-19 Vaccines