Abstract
A total of 2079 healthcare workers (HCWs) responded to an anonymous survey on vaccine hesitancy conducted between December 2022 and October 2023 at centers in Lithuania, Portugal, Poland, Germany, and Brazil. Only 55.7% were confident about the long-term safety of the COVID-19 vaccine; 10% believed the risk of having COVID-19 vaccines was greater than the risk of COVID-19 itself. 54.2% believed that COVID-19 vaccination should be compulsory for all staff working in healthcare settings (unless medically exempt), for all patient-facing HCW (59.0%), and for all medical, nursing, and midwifery students (56.7%); fewer supported compulsory influenza vaccination, i.e., 38.0%, 41.5% and 39.7% for equivalent groups. Under half had been vaccinated for influenza in recent years. Respondents were supportive of childhood vaccinations. Level of education, specific HCW occupation and geography were associated with the degree of vaccination hesitancy. The majority trusted advice from health professionals or scientists/doctors and distrusted statements from politicians. Key factors that HCWs thought would encourage vaccination included: vaccine availability at their workplace, vaccination of professional colleagues, sufficient opportunity to ask about vaccine safety and efficacy, supportive information from international bodies, and HCW plans to visit vulnerable family/friends. Generic vaccine promotion activities, whilst valuable, require nuanced modification for different HCW subgroups, vaccines, education levels, and geography.