Profiling vaccine believers and skeptics in nurses: A latent profile analysis

The second dose of COVID-19 vaccine booster hesitancy among health care workers in China: A multicenter cross-sectional study

BACKGROUND

The COVID-19 outbreak in China exposed health care workers (HCWs) to an increased risk of infection. The acquired immunity rapidly diminishes after the previous COVID-19 vaccination and the second booster vaccination has been recommended in several countries. HCWs are a priority group for vaccination because they are at increased risk of being infected, however, a certain amount of HCWs were hesitant.

METHODS

The survey was conducted among 5805 HCWs in China from January 5 to February 9, 2023. Questionnaire included sociodemographic information, COVID-19-related variables, psychological factors, and the COVID-19 vaccine hesitancy scale. Multiple logistic regression analysis was used to assess the influencing factors of the second dose of COVID-19 vaccine booster hesitancy.

RESULTS

42.2% of HCWs self-reported having the second dose of COVID-19 vaccine booster hesitancy. Occupations, years of working, COVID-19 infection status were associated with less vaccine hesitancy. HCWs who had received 3 doses of COVID-19 vaccine were less likely to be hesitant compared to those had not received. HCWs with PTSD symptoms and anxiety symptoms were more likely to be hesitant. No relation was observed between COVID-19 vaccine booster hesitancy and age, marriage, salary, and perceived an increased risk of COVID-19 infection due to work (all P > 0.05).

CONCLUSIONS

A considerable proportion of HCWs were hesitant to accept the second dose of the COVID-19 booster vaccine. Incorporating vaccine knowledge and new evidence into routine health educations and procedures to raise confidence and reduce complacency may be effective and feasible in promoting the vaccination and implementing future vaccination programs.

Quality of life and its association with predictors in lung transplant recipients: a latent profile analysis

Backgrounds

Improving quality of life (QOL) is one of the main aims of lung transplantation (LTx). There is a need to identify those who have poor quality of life early. However, research addressing inter individual quality of life variability among them is lacking. This study aims to identify group patterns in quality of life among lung transplant recipients and examine the predictors associated with quality of life subgroups.

Methods

In total, 173 lung transplant recipients were recruited from one hospital in Guangdong Province between September 2022 and August 2023. They were assessed using the Lung Transplant Quality of Life scale (LT-QOL), Mindful Attention Awareness Scale (MAAS), Life Orientation Test-Revised scale (LOT-R), and Positive and Negative Affect Scale (PANAS). Latent profile analysis was used to identify QOL subtypes, and logistic regression analysis was used to examine the associations between latent profiles and sociodemographic and psychosocial characteristics.

Results

Two distinct QOL profiles were identified: "low HRQOL" profile [N = 53 (30.94%)] and "high HRQOL" profile [N = 120 (69.06%)]. Single lung transplant recipients, and patients who reported post-transplant infection, high levels of negative emotion or low levels of mindfulness and optimism were significantly correlated with the low QOL subgroup.

Conclusion

Using the domains of the LT-QOL scale, two profiles were identified among the lung transplant recipients. Our findings highlighted that targeted intervention should be developed based on the characteristics of each latent class, and timely attention must be paid to patients who have undergone single lung transplantation, have had a hospital readmission due to infection, exhibit low levels of optimism, low levels of mindfulness or high negative emotions.

Heterogeneity of work alienation and its relationship with job embeddedness among Chinese nurses: a cross-sectional study using latent profile analysis

OBJECTIVE

To identify the distinct profiles of work alienation among Chinese nurses, examine the demographic factors associated with profile memberships, and then explore the relationship between latent categories of work alienation and job embeddedness.

METHODS

A cross-sectional survey of 523 nurses was conducted from July to August 2023. Latent profile analysis (LPA) was performed to identify distinct profiles of nurses based on three aspects: powerlessness, helplessness, and meaningfulness. A multinomial logistic regression analysis was conducted to explore the predictors of profile membership. Hierarchical regression analysis was carried out to examine the association between profile memberships and job embeddedness.

RESULTS

Three subgroups of work alienation of nurses were identified: 23.1%, 57.8%, and 19.1% in the low work alienation group (profile 1), the moderate work alienation group (profile 3), and the high work alienation group (profile 2), respectively. Nurses with college degrees were more likely to be grouped into moderate work alienation. Nurses who did not work night shifts were more likely to have low or moderate levels of work alienation. Nurses earning 2,000-3,000 and 3,001-5,000 yuan per month were likely to be in the low work alienation group. The different categories of work alienation significantly predicted job embeddedness among nurses (ΔR2 = 0.103, p < 0.001).

CONCLUSIONS

Work alienation has an important impact on clinical nurses' job embeddedness. Nursing managers should pay attention to the differences in individual work alienation status and adopt reasonable management strategies to improve the level of job embeddedness, ensure the quality of care, and reduce nursing turnover.

Temporal variations of vaccine hesitancy amid the COVID-19 outbreaks in Hong Kong

To inform the dynamic adjustments of vaccination campaigns, this study examined the transitions among vaccine hesitancy profiles over the COVID-19 pandemic progression and their predictors and outcomes. The transition patterns among hesitancy profiles over three periods were identified using a latent transition analysis with individuals from a longitudinal cohort study since the emergence of COVID-19 in Hong Kong. Four profiles (i.e., skeptics, apathetics, fence-sitters, and believers) emerged consistently over time. From Period 1 (third and fourth pandemic waves) to Period 2 (dormant period, vaccine rollout), 14.17% of believers became fence-sitters (ambivalization), and 12.11% of fence-sitters became apathetics (apathetization). From Period 2 to Period 3 (omicron surge and vaccine mandates), 20.21% of believers became fence-sitters. Lower trust in government predicted a transition to skepticism, whereas higher trust predicted the opposite. Staying as believers was associated with decreased hygienic and social distancing behavior. The stable hesitancy profiles amid the rapid vaccine uptake suggest that structural factors rather than personal agency may drive the surge. Ambivalization and apathetization may signal disengagement in preventive behaviors. Trust in the government is crucial in the pandemic response. Public health interventions may improve compliance with guidelines and prevent skepticism and apathy.

Heterogeneity in Psychological Adaptation Patterns and Its Predictive Factors Among Patients with Inflammatory Bowel Disease: A Latent Profile Analysis

Purpose

To identify the distinct profiles of psychosocial adaptation of Chinese inflammatory bowel disease (IBD) patients and the predictive factors.

Patients and Methods

A cross-sectional survey method was used to recruit 263 IBD patients who were treated in a tertiary hospital in Shandong Province from July 2022 to April 2023. The general information questionnaire, Inflammatory Bowel Disease Psychosocial Adaptation Questionnaire, Resilience Scale for Inflammatory Bowel Disease, Chinese Benefit Finding Scale, and Stigma Scale for Chronic Illnesses, Medical Coping Modes Questionnaire and Inflammatory Bowel Disease-Disk were used as the instruments for investigation. Latent profile analysis was conducted with the six dimensions of the IBD Psychosocial Adaptation Questionnaire as the explicit indicators. The predictors of profile membership were analyzed by multinomial logistic regressions.

Results

Four profiles of psychosocial adaptation in IBD patients were identified: Low level psychosocial adaptation (14.1%), Medium level psychosocial adaptation - High body image distress (25.5%), Medium level psychosocial adaptation - Low body image distress (30.0%) and High level psychosocial adaptation (30.4%). Compared with Low level psychosocial adaptation group, High level psychosocial adaptation group had a higher level of positive cognition (OR=2.930, 95%IC 0.017-0.305, p< 0.001) and overall psychological resilience (OR=1.832, 95%IC 0.000-0.016, p < 0.001), more health behaviors (OR= 2.520, 95%IC 0.191-1.358, p=0.001), a lower level of internal stigma (OR=0.135, 95%IC 0.043-0.420, p < 0.001) and overall stigma (OR=0.010, 95%IC 0.003-0.118, p=0.001), less acceptance-resignation coping style (OR=0.055, 95%IC 0.209-3.200, p < 0.001) and lower disease burden (OR=0.407, 95%IC 0.298-0.698, p=0.006).

Conclusion

About a half of IBD patients had a medium level of psychosocial adaptation. Psychological resilience, benefit finding, stigma, medical coping styles and disease burden predicted psychosocial adaptation profiles. Healthcare providers need to focus on the heterogeneity of psychosocial adaptation of IBD patients and formulate personalized intervention programs for patients with different profiles to improve their psychosocial adaptation.

Attitudes of healthcare workers toward the COVID-19 vaccine and related factors: A systematic review

AIM AND OBJECTIVES

This systematic review aims to examine healthcare professionals' attitudes toward the COVID-19 vaccine and related factors.

BACKGROUND

Healthcare workers have priority among risky groups accepted as candidates for early vaccination. Therefore, it is important to consider health professionals' attitudes toward COVID-19 vaccination to better address barriers to widespread vaccination.

MATERIALS AND METHODS

Six databases were searched for articles published between January 01, 2020, and February 31, 2022, and 1161 studies were reached. As a result of the evaluations, 10 studies were included in the systematic review. Nine studies are cross-sectional, and one is a descriptive study. A 9-item Critical Appraisal Checklist for Analytical Cross Sectional Studies from the Joanna Briggs Institute MAStARI Critical Assessment Tools (JBI-MAStARI) was used for quality assessment. High-quality studies with an average or higher methodological quality score were included in the systematic review. The PRISMA guideline was followed while selecting studies.

RESULTS

Positive attitudes of healthcare professionals toward the COVID-19 vaccine ranged from 10% to 93.7%, and negative attitudes varied between 6.3% and 41.0%. Factors such as the male gender, being a physician, advanced age, previous influenza vaccination history, and presence of chronic disease were found to be associated with vaccine acceptance. Factors such as doubt about the efficacy of the COVID-19 vaccine, safety concerns, and fear of unknown side effects of the vaccine were associated with COVID-19 vaccine hesitancy.

CONCLUSION

There is a need for confidence-building interventions and tailored communication strategies, including personalized training to change the ambiguous attitudes of healthcare professionals, increase vaccine uptake, and cope with the multifaceted impact of infection.

PROSPERO REGISTRATION NUMBER

CRD42021290482.

Revisiting Vaccine Hesitancy in Residential Care Homes for the Elderly for Pandemic Preparedness: A Lesson from COVID-19

Residents in residential care homes for the elderly (RCHEs) are at high risk of severe illnesses and mortality, while staff have high exposure to intimate care activities. Addressing vaccine hesitancy is crucial to safeguard vaccine uptake in this vulnerable setting, especially amid a pandemic. In response to this, we conducted a cross-sectional survey to measure the level of vaccine hesitancy and to examine its associated factors among residents and staff in RCHEs in Hong Kong. We recruited residents and staff from 31 RCHEs in July-November 2022. Of 204 residents, 9.8% had a higher level of vaccine hesitancy (scored ≥ 4 out of 7, mean = 2.44). Around 7% of the staff (n = 168) showed higher vaccine hesitancy (mean = 2.45). From multi-level regression analyses, higher social loneliness, higher anxiety, poorer cognitive ability, being vaccinated with fewer doses, and lower institutional vaccination rates predicted residents' vaccine hesitancy. Similarly, higher emotional loneliness, higher anxiety, being vaccinated with fewer doses, and working in larger RCHEs predicted staff's vaccine hesitancy. Although the reliance on self-report data and convenience sampling may hamper the generalizability of the results, this study highlighted the importance of addressing the loneliness of residents and staff in RCHEs to combat vaccine hesitancy. Innovative and technology-aided interventions are needed to build social support and ensure social interactions among the residents and staff, especially amid outbreaks.

Integrating the person-centered approach with the study of vaccine hesitancy: Applying latent profile analysis to identify vaccine hesitancy subpopulations and assess their relations with correlates and vaccination outcomes

In scholarly and popular discussions of vaccine hesitancy, authors have repeatedly referred to different "types" of vaccine hesitant individuals; however, almost all modern research on vaccine hesitancy utilizes variable-centered approaches to identify the relation of variables rather than a person-centered approach to identify subpopulations, which suggests that a discrepancy exists between conceptual discussions and empirical research on vaccine hesitancy. For this reason, the current article conducts a latent profile analysis (LPA) on the dimensions of a well-supported vaccine hesitancy measure, which assess hesitancy towards vaccines in general. We also assess the relations of the resultant profiles (e.g., subpopulations) with relevant self-reported outcomes and correlates, wherein most of our outcomes are associated with COVID-19 and flu vaccines. Our LPA results support the existence of eight vaccine hesitancy profiles. The profile with the most unfavorable vaccination outcomes (e.g., willingness, receipt, and word-of-mouth) was associated with greater perceptions that vaccines cause health risks and unneeded when healthy; the profile with the most favorable vaccination outcomes was associated with low levels of all vaccine hesitancy dimensions. The other profiles produced a clear gradient between these two extremes. The profiles also differed regarding their standing on correlates, but the clearest difference was their relation with political orientation. Profiles with more unfavorable vaccination outcomes were associated with conservatism, whereas profiles with more favorable vaccinations outcomes were associated with liberalism. These results provide a new perspective for current understandings of vaccine hesitancy and open several avenues for future research.

Individual and Work-Related Characteristics Associated with COVID-19 Vaccination Status among Ohio Nurses

Uptake of the COVID-19 vaccine by nurses lags behind that of other health care professionals with minimal empirical evidence to understand this phenomenon. In this secondary analysis, we examined nurses' individual and work-related characteristics and their association with COVID-19 vaccination status. Alumni of three Ohio nursing colleges and members of a professional organization were invited to complete questionnaires from June through August 2021. Logistic regression models were used to evaluate associations between nurse characteristics and vaccination status. Among 844 respondents, 754 (80.30%) had received at least one dose of the vaccine. Older age, having a bachelor's degree or higher, and working in critical care were associated with vaccination. Providing direct care for COVID-19 patients in the last 7 days and a higher perception of one's work being affected by COVID-19 were significantly associated with being vaccinated, whereas prior COVID-19 infection was inversely associated with vaccination status. Our findings suggest that COVID-19 vaccine uptake among nurses is influenced by a host of factors related to virus knowledge, beliefs, and risk perceptions. Awareness of these factors can aid the development of interventions to increase nurses' acceptance of vaccines.

Towards a sense of urgency for innovation realization: a case study on complacency asymmetries in interorganizational relations

This paper seeks to explore the concept of complacency as a barrier to the sense of urgency within product innovation, by investigating the concept on behalf of interfirm project partners. More specifically, the study aims to understand complacency within the context of an industrial research project in Norway subject to material substitution of an energy transmission tower. As such, the study seeks to give a contextual understanding of complacency for innovation realization (e.g., innovation speed) from a single case study. The study identified different complacency mechanism asymmetries on behalf of the actors, as well as the varying reasons (drivers) to why urgency gaps may occur among actors. The urgency gaps were found to impact a sense of urgency and thus innovation speed negatively. The asymmetries are presented from the drivers: role understanding, competence, project intent, risk and trust. Moreover, the urgency gaps' implications for interorganizational project collaboration, and how they contribute to theory on industrial product innovation, are explained. The findings contribute with new insights on important mechanisms for how a sense of urgency may be enhanced in research projects subject to interorganizational innovation. Theoretical contributions thus relate to enhanced understanding of complacency asymmetry in product innovation collaboration, and how trust is an important dimension for urgency creation.

Determinants of Acceptance of COVID-19 Vaccination in Healthcare and Public Health Professionals: A Review

Vaccinations of healthcare workers (HCWs) aim to directly protect them from occupational diseases, and indirectly protect their patients and communities. However, studies increasingly highlight that HCWs can be vaccine hesitant. This review aims to analyze HCWs' and public health professionals' sentiments toward COVID-19 (Coronavirus Disease 2019) vaccination and determinants across different countries. A search strategy was conducted in PubMed using keywords such as "COVID-19", "sentiment/acceptance", "healthcare workers", "vaccine hesitancy", and "influenza". A total of 56 articles were selected for in-depth analyses. The highest COVID-19 vaccination uptake was found in an Italian study (98.9%), and the lowest in Cyprus (30%). Older age, male gender, the medical profession, higher education level, presence of comorbidities, and previous influenza vaccination were associated with vaccine acceptance. Factors for low acceptance were perceived side effects of the vaccine, perceived lack of effectiveness and efficacy, and lack of information and knowledge. Factors for acceptance were knowledge, confidence in the vaccine, government, and health authorities, and increased perception of fear and susceptibility. All studies focused on healthcare providers; no studies focusing on public health professionals' sentiments could be found, indicating a gap in research that needs to be addressed. Interventions must be implemented with vaccination campaigns to improve COVID-19 vaccine acceptance.

COVID-19 Vaccine Hesitancy among Italian Healthcare Workers: Latent Profiles and Their Relationships to Predictors and Outcome

Vaccine hesitancy and conspiracy beliefs among healthcare workers (HCWs) represent operational priorities that require urgent attention. Identifying and classifying specific subpopulation of hesitancy is crucial to customize educational and intervention strategies to enhance the acceptance and uptake rate of vaccination. Thus, the main purpose of our study was to empirically identify latent profiles of vaccine hesitancy among Italian HCWs adopting a person-centered approach and investigating their relationships with antecedents and intention to get a fourth dose of COVID-19 vaccine. We conducted latent profile analyses (LPA) to identify different configurations of vaccine hesitancy based on five antecedents of vaccination: confidence, complacency, constraints, calculation, and collective responsibility among a sample of Italian HCWs (n = 573). LPA revealed four distinct profiles: believer (61.5%), middler (24.7%), hesitant (9.00%), and rejecter (4.7%). Having conspiracy beliefs was associated with a greater likelihood of membership in all but believer. Finally, the likelihood of intention to get a fourth dose of COVID-19 vaccine was lowest in the rejector and hesitant profiles. Theoretical contributions and implications for practice are discussed.

Strategies to Increase Willingness to Receive a COVID-19 Vaccine among Nursing Home Staff

BACKGROUND

Nursing home (NH) staff and residents have been prioritized to receive COVID-19 vaccinations. However, NH staff have been hesitant. This study explored what strategies were used to overcome this hesitancy and which of these were found to be important by NH staff to increase their willingness to take a COVID-19 vaccine.

METHODS

This study employed a sequential exploratory qualitative design. The COVID-19 MINUTES study aimed to describe the challenges presented by, responses to, and impact of the COVID-19 pandemic in NHs. The minutes of COVID-19 outbreak teams (COTs) in Dutch long-term care organizations (n = 41) were collected and coded using content analysis. Textual units from December 2020 to April 2021 that regarded strategies to increase staff's vaccination willingness (n = 67) were selected. Subsequently, to validate these data, two panels of NH healthcare workers (HCWs) and policy workers (PWs) (n = 8) selected, discussed, and ranked the strategies that they found to be important using a modified nominal group technique.

RESULTS

The strategies described in the minutes included financial reimbursements, personal contact, story sharing, logistics support, role models, visual information, and written information. Except for financial reimbursement, all these strategies were considered important or very important by the panel participants. Some organizations combined multiple strategies.

CONCLUSION

The strategies that were found important in combination may be used more broadly and should be developed further with the involvement of HCWs.

A systematic literature review to clarify the concept of vaccine hesitancy

Vaccine hesitancy (VH) is considered a top-10 global health threat. The concept of VH has been described and applied inconsistently. This systematic review aims to clarify VH by analysing how it is operationalized. We searched PubMed, Embase and PsycINFO databases on 14 January 2022. We selected 422 studies containing operationalizations of VH for inclusion. One limitation is that studies of lower quality were not excluded. Our qualitative analysis reveals that VH is conceptualized as involving (1) cognitions or affect, (2) behaviour and (3) decision making. A wide variety of methods have been used to measure VH. Our findings indicate the varied and confusing use of the term VH, leading to an impracticable concept. We propose that VH should be defined as a state of indecisiveness regarding a vaccination decision.

Models of determinants of COVID-19 vaccine hesitancy in non-pregnant and pregnant population: Review of current literature"

Vaccination has proven to be the most effective tool in controlling the COVID-19 pandemic. While pregnant individuals are considered to be a high-risk population and are more likely to experience adverse effects from COVID-19, vaccination rates among pregnant individuals are significantly lower than in the general population. The Health Belief Model (HBM), Theory of Planned Behavior (TPB), 3C model, 5C model, and 5A model have been used to assess vaccination hesitancy behaviors. In this paper, we review the use of each of these models to address vaccine hesitancy, with a focus on the pregnant population and the COVID-19 vaccine. The HBM, TPB, 3C model, and 5C model have demonstrated great versatility in their ability to evaluate, explain, and modify vaccine hesitancy and behavior. Up to date, the HBM and 3C models appear to be the most effective models to study and address vaccination hesitancy within the pregnant persons.

The way forward to achieve high COVID-19 vaccination and revaccination coverage in a city amid a period of tranquility

Background

Amid the current COVID-19 pandemic, there is an urgent need for both vaccination and revaccination ("boosting"). This study aims to identify factors associated with the intention to receive a booster dose of the coronavirus (COVID-19) vaccine among individuals vaccinated with two doses and characterize their profiles in Hong Kong, a city with a low COVID-19 incidence in the initial epidemic waves. Among the unvaccinated, vaccination intention is also explored and their profiles are investigated.

Methods

From December 2021 - January 2022, an online survey was employed to recruit 856 Hong Kong residents aged 18 years or over from an established population-based cohort. Latent class analysis and multivariate logistic regression modeling approaches were used to characterize boosting intentions.

Results

Of 638 (74.5%) vaccinated among 856 eligible subjects, 42.2% intended to receive the booster dose. Four distinct profiles emerged with believers having the highest intention, followed by apathetics, fence-sitters and skeptics. Believers were older and more likely to have been vaccinated against influenza. Older age, smoking, experiencing no adverse effects from a previous COVID-19 vaccination, greater confidence in vaccines and collective responsibility, and fewer barriers in accessing vaccination services were associated with higher intentions to receive the booster dose. Of 218 unvaccinated, most were fence-sitters followed by apathetics, skeptics, and believers.

Conclusion

This study foretells the booster intended uptake lagging initial vaccination across different age groups and can help refine the current or future booster vaccination campaign. Given the fourth COVID-19 vaccine dose may be offered to all adults, strategies for improving boosting uptake include policies targeting young adults, individuals who experienced adverse effects from previous doses, fence-sitters, apathetics, and the general public with low trust in the health authorities.

Targeting COVID-19 vaccine hesitancy among nurses in Shanghai: A latent profile analysis

Objectives

This study aims to clarify the profiles of the psychological antecedents of vaccine hesitancy among Shanghai nurses with a person-centered approach.

Methods

A population-based cross-sectional online survey was conducted on Shanghai nurses from July to August 2021 (N = 1,928). In the online survey, participants were asked to report their sociodemographic, the 5C vaccine hesitancy components, their knowledge level of COVID-19 vaccine and vaccination, and the COVID-19 vaccination uptake intention and attention to vaccine news. Latent profile analysis was used to reveal distinct profiles of vaccine hesitancy.

Results

The results revealed four profiles, including "believers" (68.9%; high confidence and collective responsibility), "free riders" (12.7%; similar characteristics to believers, except for a low collective responsibility), "middlemen" (14.6%; middle in all 5C constructs), and "contradictors" (3.7%; high in all 5C constructs). Compared to believers, middlemen were younger, more likely to be female, childless, less educated, held lower professional titles, had fewer years of nursing service, sometimes or never complied with recommended vaccinations, had satisfactory or poor self-assessed health status, had no work experience during the COVID-19 epidemic, and possessed greater levels of knowledge. Free riders were more likely to work in community health centers and have a lower degree than believers. Contradictors were more likely to work in community health centers, had junior college degrees or lower, and had no work experience during the COVID-19 epidemic than believers. From the highest to the lowest on vaccination intention and attention to vaccine news were believers, then free riders, contradictors, and finally middlemen.

Conclusion

This study could aid in the development of personalized vaccination strategies based on nurses' vaccine hesitancy profiles and predictors. In addition to vaccine believers, we identified other three profiles based on their 5C psychological antecedents, emphasizing the significance of establishing tailored vaccination campaigns. Further research into the prevalence of profile structure in other groups of healthcare workers is required.

Distrustful, Dissatisfied, and Conspiratorial: A Latent Profile Analysis of COVID-19 Vaccination Rejection

Trust in science and scientists, satisfaction with the national government, and endorsement of conspiracy theories are important factors in the decision to be vaccinated. In this study, we investigated whether there are different profiles of individuals depending on the above factors and whether they differ in their sociodemographic composition. We used data from Round 10 of the European Social Survey for Slovenia, employing a nationally representative sample of 1252 participants. Based on latent profile analysis, three distinct profiles emerged: Profile 1 expressed moderate trust in science, satisfaction with government, and high endorsement of conspiracies; Profile 2 expressed low trust and satisfaction and moderate endorsement of conspiracies; Profile 3 expressed high trust and satisfaction and low beliefs in conspiracy theories. In addition, Profile 3 expressed the strongest support for vaccination and Profile 2 the lowest. Our results suggest that distrust, dissatisfaction, and the presence of conspiracy theories are the "perfect storm" for vaccination rejection. In contrast, despite conspiracy theories, a certain level of trust and satisfaction may reduce vaccination rejection.

Confidence in a Vaccine against COVID-19 among Registered Nurses in Barcelona, Spain across Two Time Periods

OBJECTIVE

To report the vaccine hesitancy (VH) for a vaccine against COVID-19 in registered nurses in Barcelona, with measurements taken at two stages, prior to the vaccination campaign and once 75% vaccination coverage had been reached.

METHODS

A self-completed online survey was administered in December 2020 and again in July 2021 through the College of Nurses of Barcelona. It measured the prevalence of VH against a government-approved vaccine recommended by their employer, their intention to be vaccinated, perceptions of disease risk and vaccine protection, attitudes and beliefs to vaccination and social norm. Bivariate analysis according to VH and application time are presented.

RESULTS

2430 valid responses were obtained in the first measurement and 2027 in the second. At both times, 86% were women and 69% worked mainly in the public sector. Prior to the vaccine availability, VH was 34.2%, decreasing to 17.9%. Risk perceptions were significantly lower in those with VH compared to non-VH, in all groups studied and at both times, while safety and efficacy perceptions increased in all groups, significantly less in VH. The greatest benefit of the COVID-19 vaccine is perceived by pharmaceutical companies. VH nurses perceived a more hesitant social environment.

CONCLUSION

As the vaccination was rolled out, VH in nurses declined, with time improving the confidence in the safety and efficacy of the vaccines. Risk perceptions also decreased over time, except for the perception of severity in HCW where it increased. Trust in institutions impacts trust in vaccines.