Influenza Vaccine hesitancy in European health care workers: a qualitative literature review

Abstract

Background: Influenza, commonly known as the flu, is a very common viral illness that resulted in almost 650,000 deaths in 2018. Its easy transmissibility, rapid spread, and the insurmountable burden caused by this virus highlight the importance of influenza vaccination. In general, the vaccination process is often heralded as one of the greatest public health achievements of the previous century as it consists the most effective way to prevent the development of infectious and contagious diseases, while at the same time ensuring the well-being and safety of the global population. However, the effectiveness and continuity of this process can be compromised by individual reluctance or refusal to be vaccinated, a phenomenon defined as vaccination hesitancy. Aim: The aim of this dissertation was to identify the current trends, attitudes, and causes that facilitate and establish influenza vaccine hesitancy in European HCPs, and also provide distinct recommendations that could mitigate this phenomenon. Methodology: The methodology followed was based on a qualitative assessment of research studies (qualitative literature review) that were in turn identified and collected from current literature using distinct eligibility criteria and research strategy. In addition, the Caldwell’s mixed methods critical appraisal tool was implemented so as to evaluate the validity, effectiveness, and significance of each study included. Results: A total of nine studies were included in this review and which highlighted the prevalence of five themes with respect to the reasons propelling influenza vaccine hesitancy: scepticism over the potential vaccination side-effects, the fact that HCPs exhibit decreased perceived necessity to be vaccinated, low levels of trust to the care system also as a result of the economic benefits of pharmaceutical companies,

individual freedom of choice, and academic and professional status. In addition, parameters such as inadequate information, corruption, organisational inefficiency, low job satisfaction levels, low levels of trust towards the care system in general, have all identified as being very significant determinants for HCPs decision to abstain from this vaccination process. Furthermore, the most common recommendations provided included educational interventions to inform healthcare professionals regarding the safety of these vaccines, to motivate and inspire HCPs to trust healthcare systems, and that international/national agencies should organise vaccination programs that are consistent, specific, and transparent to each country. Conclusions: Influenza vaccine hesitancy is a significant issue within the healthcare community in Europe. While in the midst of the COVID-19 pandemic, health care authorities and organisations now have a golden opportunity to instil trust in their processes, and thus motivate and enable healthcare workers to willingly participate in the influenza vaccination campaign.