Knowledge, attitudes, and behaviors toward COVID-19 vaccination in a sample of Italian healthcare workers

ABSTRACT

Vaccine hesitancy in healthcare workers (HCWs) has been studied for various contagious diseases, but there is still insufficient knowledge about this phenomenon for COVID-19. We developed and validated a knowledge, attitude, and practice survey of 39 questions to assess Italian HCWs’ hesitancy toward vaccination in general (general hesitancy), COVID-19 vaccination (COVID-19 hesitancy), and public health injunctive measures (refusal of obligations). The survey was administered through a web platform between July and November 2021. Three multivariable logistic regressions were performed to evaluate the association between the explored dimensions of hesitancy and the potential determinants investigated. Out of 2,132 respondents with complete answers, 17.0% showed to be generally hesitancy toward vaccination, 32.3% were hesitant on COVID-19 vaccination, while 18.8% were categorized as refusing obligations. A significant protective effect against all three dimensions of hesitancy was found for increasing fear of COVID-19, advising COVID-19 vaccination to relatives and patients, having received flu vaccination in the previous year and having higher levels of education. Better self-rated knowledge about COVID-19 vaccines and reading up institutional sources were significantly protective against general and COVID-19 hesitancy, while being a physician rather than another healthcare professional was protective only against COVID-19 hesitancy. Conversely, increasing age and referring to colleagues to expand knowledge about COVID-19 were positively associated with COVID-19 hesitancy. The determinants of general hesitancy, COVID-19 hesitancy and the refusal of obligations are mostly overlapping. Given the great influence they exert on patients and communities, it is pivotal to limit HCWs vaccine hesitancy through appropriate training activities.

KEYWORDS:

• COVID-19
• Covid-19 vaccines
• vaccination hesitancy
• vaccination
• health knowledge and attitudes
• health personnel
• physicians
• surveys and questionnaires
• Italy

Acknowledgment

The authors would like to thank Dr. Gianfranco Damiani, Dr. Azzurra Massimi and Dr. Fidelia Cascini for their precious support in the dissemination of the survey.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethical approval and consent to participate

The study was approved by the Ethics Committee of the “Fondazione Policlinico Universitario A. Gemelli – IRCCS” (Prot. No. 0021609/21, study ID 4104). Informed consent was obtained from all subjects involved in the study.

Additional information

Funding

This study was funded by the National Center for Disease Prevention and Control (CCM) of the Ministero della Salute as part of the project “Survey of attitudes toward anti-SARS-CoV2 vaccination in the general population and among healthcare workers in the Italian territory”.