THE COVID-19 VACCINATION ACCEPTANCE/HESITANCY RATE AND ITS DETERMINANTS AMONG HEALTHCARE WORKERS OF 91 COUNTRIES: A MULTICENTER CROSS-SECTIONAL STUDY

Askarian M. Semenov A. Llopis F. Rubulotta F. Dragovac G. Pshenichnaya N. Assadian O. Ruch Y. Shayan Z. Fortunatti C.P. Lucey D. Almohaizeie A. Kamal A.H.M. Ogunshe A. Konkayev A. Beg A. Primerano E. Amer F. Pilli H.P.K. Hung I. Ayoade F. Lefrant J.Y. Zajkowska J. Rello J. Kazi M. Taghrir M.H. Blot S. Leib S. Hosseinpour P. Hosseinpour H. Erfani A. Borazjani R. Akbarialiabad H. Najafi M. Askarian A. Erdem H.
3 January 2022 Leibniz Research Centre for Working Environment and Human Factors

EXCLI Journal
2022 #21 93 - 103 pp.

The aim of this study was to investigate the COVID-19 vaccination acceptance rate and its determinants among healthcare workers in a multicenter study. This was a cross-sectional multi-center survey conducted from February 5 to April 29, 2021. The questionnaire consisted of 26 items in 6 subscales. The English version of the question-naire was translated into seven languages and distributed through Google Forms using snowball sampling; a col-league in each country was responsible for the forward and backward translation, and also the distribution of the questionnaire. A forward stepwise logistic regression was utilized to explore the variables and questionnaire fac-tors tied to the intention to COVID-19 vaccination. 4630 participants from 91 countries completed the question-naire. According to the United Nations Development Program 2020, 43.6 % of participants were from low Human Development Index (HDI) regions, 48.3 % high and very high, and 8.1 % from medium. The overall vaccination hesitancy rate was 37 %. Three out of six factors of the questionnaire were significantly related to intention to the vaccination. While ‘Perceived benefits of the COVID-19 vaccination’ (OR: 3.82, p-value<0.001) and ‘Prosocial norms’ (OR: 5.18, p-value<0.001) were associated with vaccination acceptance, ‘The vaccine safety/cost con-cerns’ with OR: 3.52, p-value<0.001 was tied to vaccination hesitancy. Medical doctors and pharmacists were more willing to take the vaccine in comparison to others. Importantly, HDI with OR: 12.28, 95 % CI: 6.10-24.72 was a strong positive determinant of COVID-19 vaccination acceptance. This study highlighted the vaccination hesitancy rate of 37 % in our sample among HCWs. Increasing awareness regarding vaccination benefits, con-fronting the misinformation, and strengthening the prosocial norms would be the primary domains for maximizing the vaccination coverage. The study also showed that the HDI is strongly associated with the vaccination ac-ceptance/hesitancy, in a way that those living in low HDI contexts are more hesitant to receive the vaccine.

COVID-19 , COVID-19 vaccines , HDI , Health personnel , Human Development Index , Vaccination coverage

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Department of Community Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
Health Behavior Science Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
Ekaterinburg Research Institute of Viral Infections SRC VB Vector, Ekaterinburg, Russian Federation
Emergency Department, Bellvitge University Hospital, l’Hospitalet de Llobregat, Barcelona, Spain
Department of Intensive Care Medicine, Charing Cross Hospital, Imperial College, NHS Trust London, United Kingdom
Department of Epidemiology, University of Novi Sad, Serbia
Center of Disease Prevention and Control, Institute of Public Health of Vojvodina, Novi Sad, Serbia
Clinical Department of Infectious Pathology, Central Research Institute of Epidemiology, Moscow, Russian Federation
Regional Hospital Wiener Neustadt, Austria
Institute of Skin Integrity and Infection Prevention, University of Huddersfield, United Kingdom
Department of Infectious Diseases, Strasbourg University Hospital, Strasbourg, France
Trauma Research Center, Department of Biostatistics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
School of Nursing, Pontificia Universidad Catolica de Chile, Santiago, Chile
Department of Infectious Diseases, Georgetown University Medical Center, Washington, 20057, DC, United States
King Faisal Specialist Hospital and Research Center, Riyadh, Alfaisal University Riyadh, Saudi Arabia
Department of Anaesthesiology and ICU, Rajshahi Medical College Hospital, Rajshahi, Bangladesh
Applied Microbiology and Infectious Diseases, Department of Microbiology, University of Ibadan, Oyo State, Nigeria
Department of Anesthesiology and Intensive Care, Astana Medical University, Nur-Sultan, Kazakhstan
National Centre of Traumatology and Orthopedia named by Batpenov, Nur-Sultan, Kazakhstan
Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
Department of Anesthesia and Intensive Care, Polyclinic of Monza, Monza, Italy
Department of Medical Microbiology and Immunology, School of Medicine, Zagazig University, Zagazig, Egypt
Department of Microbiology, GITAM Institute of Medical Sciences and Research, GITAM, Deemed to be University, Visakhapatnam, India
Department of Infectious Diseases; Gastroenterology and Hepatology, The University of Hong Kong, Hong Kong
Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, 33136, FL, United States
Department of Anaesthesia, Critical Care Emergency and Pain Medicine, University Hospital of Nimes, Montpellier University, Nimes, France
Department of Infectious Diseases and Neuroinfections, Medical University, Biaøystok, Poland
CRIPS, Vall Hebron Institute of Research (VHIR) and CHRU Nimes, Nimes, France
Research Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan
Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium
Institute for Infectious Diseases, University of Bern, Bern, Switzerland
School of Medicine, Islamic Azad University, Kazeroun branch, Kazeroun, Iran
Department of Surgery, Shiraz Laparoscopic Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
Shiraz University of Medical Sciences, Shiraz, Iran
College of Arts and Science, University of Saskatchewan, Saskatoon, Canada
Ankara, Turkey

Department of Community Medicine
Health Behavior Science Research Center
Ekaterinburg Research Institute of Viral Infections SRC VB Vector
Emergency Department
Department of Intensive Care Medicine
Department of Epidemiology
Center of Disease Prevention and Control
Clinical Department of Infectious Pathology
Regional Hospital Wiener Neustadt
Institute of Skin Integrity and Infection Prevention
Department of Infectious Diseases
Trauma Research Center
School of Nursing
Department of Infectious Diseases
King Faisal Specialist Hospital and Research Center
Department of Anaesthesiology and ICU
Applied Microbiology and Infectious Diseases
Department of Anesthesiology and Intensive Care
National Centre of Traumatology and Orthopedia named by Batpenov
Department of Pathology and Laboratory Medicine
Department of Anesthesia and Intensive Care
Department of Medical Microbiology and Immunology
Department of Microbiology
Department of Infectious Diseases; Gastroenterology and Hepatology
Division of Infectious Diseases
Department of Anaesthesia
Department of Infectious Diseases and Neuroinfections
CRIPS
Research Department of Paediatrics and Child Health
Trauma Research Center
Department of Internal Medicine and Pediatrics
Institute for Infectious Diseases
School of Medicine
Department of Surgery
Thoracic and Vascular Surgery Research Center
Shiraz University of Medical Sciences
College of Arts and Science
Ankara

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