Nurses' Covid-19 Vaccine Hesitancy: A Qualitative Study

Aslıhan Çatıker; Kamuran Özdil; Gizem Deniz Bulucu Büyüksoy; Gülhan Küçük Öztürk

doi:10.19127/mbsjohs.1210520

Research Article

Nurses' Covid-19 Vaccine Hesitancy: A Qualitative Study

Year 2023, Volume: 9 Issue: 1, 111 - 124, 28.02.2023

Aslıhan Çatıker Kamuran Özdil Gizem Deniz Bulucu Büyüksoy Gülhan Küçük Öztürk

https://doi.org/10.19127/mbsjohs.1210520

Abstract

Objectives: This qualitative study aimed to conduct an in-depth analysis of the opinions of nurses who did not receive the COVID-19 vaccine during the pandemic regarding the issue.

Methods: This research was designed as a qualitative research in the case study design and based on the guidelines proposed by the COREQ checklist. It was conducted in nurses working in various healthcare institutions and units providing preventive and therapeutic services. In the study, 10 nurses who did not receive the COVID-19 vaccine were interviewed. The data of the study were collected through an introductory “Information form” and “Semi-structured interview form” by conducting in-depth interviews. The data were analyzed by the content analysis method.

Results: In the study, 3 main themes and 8 sub-themes were determined after the thematic analysis. Themes were determined as follows: (1) Extreme skepticism (a. mistrust, b. rumor, c. anxiety), (2) Perceived risk (a. low risk perception, b. experiences), and (3) Self-others (a. individual freedom, b. inconsistency, c. perception of social benefit).

Conclusion: It was found that nurses refused to receive the COVID-19 vaccine, which is an important strategy in the fight against the pandemic, based on various reasons and inferences. Developing a standard recommendation for all nurses in the world on vaccine hesitancy can be difficult. But the strategic efforts to increase confidence in vaccines should focus on the invisible barriers to vaccine hesitancy.

Keywords

COVID-19 vaccines, nurses, qualitative study, vaccine hesitancy.

References

1. World Health Organization (WHO). Summary WHO SAGE conclusions and recommendations on vaccine hesitancy, 2015, www.who.int/immunization/programmes_systems/summary_of_sage_vaccinehesitancy_2pager.pdf?ua=1 (accessed 15 June 2020).
2. Anderson P, Bryson J. Confronting vaccine hesitancy: What nurses need to know. Nursing 2021 2020; 50(8): 43–46. https://doi.org/10.1097/01.NURSE.0000668436.83267.29
3. Taylor S, Landry CA, Paluszek MM. A proactive approach for managing COVID-19: The importance of understanding the motivational roots of vaccination hesitancy for SARS-CoV2. Frontiers in Psychology 2020;11. https://doi.org/10.3389/fpsyg.2020.575950
4. Kuter BJ, Browne S, Momplaisir FM, Feemster KA, Shen AK, Green-McKenzie J, et al. Perspectives on the receipt of a COVID-19 vaccine: A survey of employees in two large hospitals in Philadelphia. Vaccine 2021;39(12):1693–1700. https://doi.org/10.1016/j.vaccine.2021.02.029
5. Rabi R, Maraqa B, Nazzal Z, Zink T. Factors affecting nurses' intention to accept the COVID-19 vaccine: A cross-sectional study. Public Health Nursing 2021; 00:1-8. https://doi.org/10.1111/phn.12907.
6. Kwok KO, Li KK, Wei WI, Tang A, Wong SYS, Lee SS. Influenza vaccine uptake, COVID-19 vaccination intention and vaccine hesitancy among nurses: A survey. Int J Nurs Stud 2020;(5) 114:1-9. https://doi.org/10.1016/j.ijnurstu.2020.103854.
7. Özceylan G, Toprak D, Esen ES. Vaccine rejection and hesitation in Turkey. Human Vaccines & Immunotherapeutics 2020;16(5):1034–1039. https://doi.org/10.1080/21645515.2020.1717182.
8. Manby L, Dowrick A, Karia A, Maio L, Buck C, Singleton G, et al. Healthcare workers' perceptions and attitudes towards the UK's COVID-19 vaccination programme: A rapid qualitative appraisal. BMJ Open 2022, Feb 15;12(2):1-8. doi: 10.1136/bmjopen-2021-051775.
9. Moniz MH, Townsel C, Wagner AL, Zikmund-Fisher BJ, Hawley S, Jiang C, et al. COVID-19 vaccine acceptance among healthcare workers in a United States medical center. Journal of Perinatology 2021; 41:2549-2551. https://doi.org/10.1101/2021.04.29.21256186 https://doi.org/10.1101/2021.04.29.21256186
10. Biswas N, Mustapha T, Khubchandani J, Price JH. The nature and extent of COVID-19 vaccination hesitancy in healthcare workers. Journal of Community Health 2021;1–8. https://doi.org/10.1007/s10900-021-00984-3.
11. European Centre for Disease Prevention and Control (ECDC). Vaccine hesitancy among healthcare workers and their patients in Europe: A qualitative study 2015;5-17, https://www.ecdc.europa.eu/sites/default/files/media/en/publications/Publications/vaccine-hesitancy-among-healthcare-workers.pdf (accessed 16 June 2020).
12. Agyekum MW, Afrifa-Anane GF, Kyei-Arthur F, Addo B. Acceptability of COVID-19 vaccination among health care workers in Ghana. Advances in Public Health 2021, https://doi.org/10.1155/2021/9998176.
13. Kurtuluş Ş, Can R. What do health care professionals think about COVID-19 vaccine applications: A university example. Journal of Harran University Medical Faculty 2021;18(1):29-34. https://doi.org/10.35440/hutfd.908043
14. Crawshaw J, Konnyu K, Castillo G, van Allen Z, Grimshaw JM, Presseau J. Behavioural determinants of COVID-19 vaccination acceptance among healthcare workers: A rapid review. Public Health 2022;210, 123–133. https://doi.org/10.1016/j.puhe.2022.06.003
15. Nzaji MK, Ngombe LK, Mwamba GN, Ndala DBB, Miema JM, Lungoyo CL, et al. Acceptability of vaccination against COVID-19 among healthcare workers in the Democratic Republic of the Congo'', Pragmatic and observational research, 2020;11:103.
16. World Health Organization (WHO). The role of community health workers in COVID-19 vaccination, implementation support guide, https://apps.who.int/iris/bitstream/handle/10665/340986/WHO-2019-nCoV-NDVP-CHWs-role-2021.1-eng.pdf Son erişim tarihi: 03 Eylül 2021.
17. Bajnok I, Catton H, Hons E, Skinner T, Shamian J. The Role of Nurses in Immunisation A Snapshot from OECD Countries, 2018:10-18. https://www.icn.ch/sites/default/files/inline-files/IMMUNISATION_Report_vFinal.pdf (accessed 15 June 2020).
18. Wilson R, Zaytseva A, Bocquier A, Nokri A, Fressard L, Chamboredon P, et al. Vaccine hesitancy and self-vaccination behaviors among nurses in southeastern France. Vaccine 2020;38(5), 1144–1151. https://doi.org/10.1016/j.vaccine.2019.11.018
19. Çatıker A, Kaya A, and Kılıç M. Hemşirelerde COVID-19 aşısının kabulü ve kararsızlığı (COVID-19 Vaccine Acceptance and Hesitancy Among Nurses). Turkiye Klinikleri Journal of Nursing Sciences 2022;14(1):52-60. https://doi.org/10.5336/nurses.2021-82273.
20. Pless A, McLennan SR, Nicca D, Shaw DM, Elger BS. Reasons why nurses decline influenza vaccination: A qualitative study. BMC Nursing 2017;16:20. https://doi.org/10.1186/s12912-017-0215-5.
21. Aloweidi A, Bsisu I, Suleiman A, Abu-Halaweh S, Almustafa M, Aqel M, et al. Hesitancy towards COVID-19 vaccines: An analytical cross–sectional study. International Journal of Environmental Research and Public Health 2021;18(10):5111, doi: 10.3390/ijerph18105111.
22. Thaivalappil A, Young I, MacKay M, Pearl DL, Papadopoulos A. A qualitative study exploring healthcare providers’ and trainees’ barriers to COVID-19 and influenza vaccine uptake. Health Psychology and Behavioral Medicine 2022;10(1), 695-712. https://doi.org/10.1080/21642850.2022.2106231.
23. Whitehead AL, and Perry SL. How culture wars delay herd immunity: Christian nationalism and anti-vaccine attitudes. Socius 2020; 6:2378023120977727.
24. Shekhar R, Sheikh AB, Upadhyay S, Singh M, Kottewar S, Mir H, et al. COVID-19 vaccine acceptance among health care workers in the United States. Vaccines 2021;9(2):119. https://doi.org/10.3390/vaccines9020119
25. Burki TK. Herd immunity for COVID-19. The Lancet. Respiratory Medicine 2021;9(2):135–136. https://doi.org/10.1016/S2213-2600(20)30555-5.
26. Buss LF, Prete Jr CA., Abrahim C, Mendrone A, Jr Salomon T, de Almeida-Neto C, et al. Three-quarters attack rate of SARS-CoV-2 in the Brazilian amazon during a largely unmitigated epidemic. Science 2021;371(6526):288–292. https://doi.org/10.1126/science.abe9728
27. World Health Organization (WHO). Coronavirus disease (COVID-19): Herd immunity, lockdowns and COVID-19, 2020, https://www.who.int/news-room/q-a-detail/herd-immunity-lockdowns-and-covid-19? gclid=CjwKCAjwiLGGBhAqEiwAgq3q_s7OUDIXvA0tzAurvuQqADG-H2QXkFLgoyfyYixoUUGFEu05dwrtcRoCOOEQAvD_BwE# (accessed 15 June 2020).
28. Doroftei B, Ciobica A, Ilie O-D, Maftei R, Ilea C. Mini-review discussing the reliability and efficiency of COVID-19 vaccines. Diagnostics 2021;11(4):579, 10.3390/diagnostics11040579. https://doi.org/10.3390/diagnostics11040579
29. MacIntyre CR, Costantino V, Trent M. Modelling of COVID-19 vaccination strategies and herd immunity, in scenarios of limited and full vaccine supply in NSW, Australia. Vaccine 2021:S0264-410X(21)00501-6. https://doi.org/10.1016/j.vaccine.2021.04.042
30. Chandok RS, Madar P, Majeed A. A qualitative study of factors influencing COVID-19 vaccine hesitancy among South Asians in London. JRSM Open, 2022;13(10):20542704221123430. https://doi.org/10.1177/20542704221123430
31. Öztürk R. Exploring healthcare professionals’ views and approaches regarding COVID-19 vaccines. J Health Sci Med 2021;4(5):692-697. https://doi.org/10.32322/jhsm.952354
32. Giubilini, A, and Savulescu J. Vaccination, Risks, and Freedom: The Seat Belt Analogy. Public Health Ethics 2019;12(3):237–249. https://doi.org/10.1093/phe/phz014
33. Garcia ÉM, Nery Teixeira Palombo C, Waldman EA, Sato A. Factors associated with the completeness of the vaccination schedule of children at 12 and 24 months of age in a Brazilian medium-size municipality. Journal of Pediatric Nursing 2021; S0882-5963(21)00070-1. https://doi.org/10.1016/j.pedn.2021.02.028
34. Pattison KH. An historical view of nursing and polio. OJIN: The Online Journal of Issues in Nursing 2021;26(1):1-5. https://doi.org/10.3912/OJIN.Vol26No01PPT05

Year 2023, Volume: 9 Issue: 1, 111 - 124, 28.02.2023

Aslıhan Çatıker Kamuran Özdil Gizem Deniz Bulucu Büyüksoy Gülhan Küçük Öztürk

https://doi.org/10.19127/mbsjohs.1210520

Abstract

Keywords

COVID-19 vaccines, nurses, qualitative study, vaccine hesitancy.

References

1. World Health Organization (WHO). Summary WHO SAGE conclusions and recommendations on vaccine hesitancy, 2015, www.who.int/immunization/programmes_systems/summary_of_sage_vaccinehesitancy_2pager.pdf?ua=1 (accessed 15 June 2020).
2. Anderson P, Bryson J. Confronting vaccine hesitancy: What nurses need to know. Nursing 2021 2020; 50(8): 43–46. https://doi.org/10.1097/01.NURSE.0000668436.83267.29
3. Taylor S, Landry CA, Paluszek MM. A proactive approach for managing COVID-19: The importance of understanding the motivational roots of vaccination hesitancy for SARS-CoV2. Frontiers in Psychology 2020;11. https://doi.org/10.3389/fpsyg.2020.575950
4. Kuter BJ, Browne S, Momplaisir FM, Feemster KA, Shen AK, Green-McKenzie J, et al. Perspectives on the receipt of a COVID-19 vaccine: A survey of employees in two large hospitals in Philadelphia. Vaccine 2021;39(12):1693–1700. https://doi.org/10.1016/j.vaccine.2021.02.029
5. Rabi R, Maraqa B, Nazzal Z, Zink T. Factors affecting nurses' intention to accept the COVID-19 vaccine: A cross-sectional study. Public Health Nursing 2021; 00:1-8. https://doi.org/10.1111/phn.12907.
6. Kwok KO, Li KK, Wei WI, Tang A, Wong SYS, Lee SS. Influenza vaccine uptake, COVID-19 vaccination intention and vaccine hesitancy among nurses: A survey. Int J Nurs Stud 2020;(5) 114:1-9. https://doi.org/10.1016/j.ijnurstu.2020.103854.
7. Özceylan G, Toprak D, Esen ES. Vaccine rejection and hesitation in Turkey. Human Vaccines & Immunotherapeutics 2020;16(5):1034–1039. https://doi.org/10.1080/21645515.2020.1717182.
8. Manby L, Dowrick A, Karia A, Maio L, Buck C, Singleton G, et al. Healthcare workers' perceptions and attitudes towards the UK's COVID-19 vaccination programme: A rapid qualitative appraisal. BMJ Open 2022, Feb 15;12(2):1-8. doi: 10.1136/bmjopen-2021-051775.
9. Moniz MH, Townsel C, Wagner AL, Zikmund-Fisher BJ, Hawley S, Jiang C, et al. COVID-19 vaccine acceptance among healthcare workers in a United States medical center. Journal of Perinatology 2021; 41:2549-2551. https://doi.org/10.1101/2021.04.29.21256186 https://doi.org/10.1101/2021.04.29.21256186
10. Biswas N, Mustapha T, Khubchandani J, Price JH. The nature and extent of COVID-19 vaccination hesitancy in healthcare workers. Journal of Community Health 2021;1–8. https://doi.org/10.1007/s10900-021-00984-3.
11. European Centre for Disease Prevention and Control (ECDC). Vaccine hesitancy among healthcare workers and their patients in Europe: A qualitative study 2015;5-17, https://www.ecdc.europa.eu/sites/default/files/media/en/publications/Publications/vaccine-hesitancy-among-healthcare-workers.pdf (accessed 16 June 2020).
12. Agyekum MW, Afrifa-Anane GF, Kyei-Arthur F, Addo B. Acceptability of COVID-19 vaccination among health care workers in Ghana. Advances in Public Health 2021, https://doi.org/10.1155/2021/9998176.
13. Kurtuluş Ş, Can R. What do health care professionals think about COVID-19 vaccine applications: A university example. Journal of Harran University Medical Faculty 2021;18(1):29-34. https://doi.org/10.35440/hutfd.908043
14. Crawshaw J, Konnyu K, Castillo G, van Allen Z, Grimshaw JM, Presseau J. Behavioural determinants of COVID-19 vaccination acceptance among healthcare workers: A rapid review. Public Health 2022;210, 123–133. https://doi.org/10.1016/j.puhe.2022.06.003
15. Nzaji MK, Ngombe LK, Mwamba GN, Ndala DBB, Miema JM, Lungoyo CL, et al. Acceptability of vaccination against COVID-19 among healthcare workers in the Democratic Republic of the Congo'', Pragmatic and observational research, 2020;11:103.
16. World Health Organization (WHO). The role of community health workers in COVID-19 vaccination, implementation support guide, https://apps.who.int/iris/bitstream/handle/10665/340986/WHO-2019-nCoV-NDVP-CHWs-role-2021.1-eng.pdf Son erişim tarihi: 03 Eylül 2021.
17. Bajnok I, Catton H, Hons E, Skinner T, Shamian J. The Role of Nurses in Immunisation A Snapshot from OECD Countries, 2018:10-18. https://www.icn.ch/sites/default/files/inline-files/IMMUNISATION_Report_vFinal.pdf (accessed 15 June 2020).
18. Wilson R, Zaytseva A, Bocquier A, Nokri A, Fressard L, Chamboredon P, et al. Vaccine hesitancy and self-vaccination behaviors among nurses in southeastern France. Vaccine 2020;38(5), 1144–1151. https://doi.org/10.1016/j.vaccine.2019.11.018
19. Çatıker A, Kaya A, and Kılıç M. Hemşirelerde COVID-19 aşısının kabulü ve kararsızlığı (COVID-19 Vaccine Acceptance and Hesitancy Among Nurses). Turkiye Klinikleri Journal of Nursing Sciences 2022;14(1):52-60. https://doi.org/10.5336/nurses.2021-82273.
20. Pless A, McLennan SR, Nicca D, Shaw DM, Elger BS. Reasons why nurses decline influenza vaccination: A qualitative study. BMC Nursing 2017;16:20. https://doi.org/10.1186/s12912-017-0215-5.
21. Aloweidi A, Bsisu I, Suleiman A, Abu-Halaweh S, Almustafa M, Aqel M, et al. Hesitancy towards COVID-19 vaccines: An analytical cross–sectional study. International Journal of Environmental Research and Public Health 2021;18(10):5111, doi: 10.3390/ijerph18105111.
22. Thaivalappil A, Young I, MacKay M, Pearl DL, Papadopoulos A. A qualitative study exploring healthcare providers’ and trainees’ barriers to COVID-19 and influenza vaccine uptake. Health Psychology and Behavioral Medicine 2022;10(1), 695-712. https://doi.org/10.1080/21642850.2022.2106231.
23. Whitehead AL, and Perry SL. How culture wars delay herd immunity: Christian nationalism and anti-vaccine attitudes. Socius 2020; 6:2378023120977727.
24. Shekhar R, Sheikh AB, Upadhyay S, Singh M, Kottewar S, Mir H, et al. COVID-19 vaccine acceptance among health care workers in the United States. Vaccines 2021;9(2):119. https://doi.org/10.3390/vaccines9020119
25. Burki TK. Herd immunity for COVID-19. The Lancet. Respiratory Medicine 2021;9(2):135–136. https://doi.org/10.1016/S2213-2600(20)30555-5.
26. Buss LF, Prete Jr CA., Abrahim C, Mendrone A, Jr Salomon T, de Almeida-Neto C, et al. Three-quarters attack rate of SARS-CoV-2 in the Brazilian amazon during a largely unmitigated epidemic. Science 2021;371(6526):288–292. https://doi.org/10.1126/science.abe9728
27. World Health Organization (WHO). Coronavirus disease (COVID-19): Herd immunity, lockdowns and COVID-19, 2020, https://www.who.int/news-room/q-a-detail/herd-immunity-lockdowns-and-covid-19? gclid=CjwKCAjwiLGGBhAqEiwAgq3q_s7OUDIXvA0tzAurvuQqADG-H2QXkFLgoyfyYixoUUGFEu05dwrtcRoCOOEQAvD_BwE# (accessed 15 June 2020).
28. Doroftei B, Ciobica A, Ilie O-D, Maftei R, Ilea C. Mini-review discussing the reliability and efficiency of COVID-19 vaccines. Diagnostics 2021;11(4):579, 10.3390/diagnostics11040579. https://doi.org/10.3390/diagnostics11040579
29. MacIntyre CR, Costantino V, Trent M. Modelling of COVID-19 vaccination strategies and herd immunity, in scenarios of limited and full vaccine supply in NSW, Australia. Vaccine 2021:S0264-410X(21)00501-6. https://doi.org/10.1016/j.vaccine.2021.04.042
30. Chandok RS, Madar P, Majeed A. A qualitative study of factors influencing COVID-19 vaccine hesitancy among South Asians in London. JRSM Open, 2022;13(10):20542704221123430. https://doi.org/10.1177/20542704221123430
31. Öztürk R. Exploring healthcare professionals’ views and approaches regarding COVID-19 vaccines. J Health Sci Med 2021;4(5):692-697. https://doi.org/10.32322/jhsm.952354
32. Giubilini, A, and Savulescu J. Vaccination, Risks, and Freedom: The Seat Belt Analogy. Public Health Ethics 2019;12(3):237–249. https://doi.org/10.1093/phe/phz014
33. Garcia ÉM, Nery Teixeira Palombo C, Waldman EA, Sato A. Factors associated with the completeness of the vaccination schedule of children at 12 and 24 months of age in a Brazilian medium-size municipality. Journal of Pediatric Nursing 2021; S0882-5963(21)00070-1. https://doi.org/10.1016/j.pedn.2021.02.028
34. Pattison KH. An historical view of nursing and polio. OJIN: The Online Journal of Issues in Nursing 2021;26(1):1-5. https://doi.org/10.3912/OJIN.Vol26No01PPT05

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Details

Primary Language	English
Subjects	Health Care Administration
Journal Section	Research articles
Authors	Aslıhan Çatıker 0000-0001-8102-6795 Kamuran Özdil 0000-0003-0852-7854 Gizem Deniz Bulucu Büyüksoy 0000-0003-2957-2451 Gülhan Küçük Öztürk 0000-0002-9220-6051
Publication Date	February 28, 2023
Published in Issue	Year 2023 Volume: 9 Issue: 1

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Vancouver	Çatıker A, Özdil K, Bulucu Büyüksoy GD, Küçük Öztürk G. Nurses’ Covid-19 Vaccine Hesitancy: A Qualitative Study. Mid Blac Sea J Health Sci. 2023;9(1):111-24.

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