COVID-19 Vaccines; Humans; Trust; Vaccination; Health Personnel; Vaccination Hesitancy; COVID-19/prevention & control; COVID-19; Molecular Medicine; Immunology and Microbiology (all); Veterinary (all); Public Health, Environmental and Occupational Health; Infectious Diseases; General Veterinary; General Immunology and Microbiology
Abstract :
[en] [en] BACKGROUND: Polarized debates about Covid-19 vaccination and vaccine mandates for healthcare workers (HCWs) challenge Belgian HCWs ability to discuss Covid-19 vaccine sentiments with peers and patients.Although studies have identified drivers of HCWs vaccine hesitancy, they do not include effects of workplace interactions and have not addressed consequences beyond vaccine coverage.
METHODS: Interviews and focus group discussions with 74 HCWs practicing in Belgium addressed Covid-19 vaccine sentiments and experiences of discussing vaccination with peers and patients.
RESULTS: Most participating HCWs reported difficulties discussing Covid-19 vaccination with peers and patients. Unvaccinated HCWs often feared that expressing their vaccine sentiments might upset patients or peers and that they would be suspended. Consequently, they used social cues to evaluate others' openness to vaccine-skeptical discourses and avoided discussing vaccines. Surprisingly, some vaccine-confident HCWs hid their vaccine sentiments to avoid peer and patient conflicts. Both vaccinated and unvaccinated HCWs observed that unvaccinated patients occasionally received suboptimal care. Suboptimal care was central in unvaccinated HCW unwillingness to express their vaccine sentiments to peers. Both vaccinated and unvaccinated HCWs described loss of trust and ruptured social relations with peers and patients holding divergent vaccine sentiments.
DISCUSSION: Belgian HCW perceived Covid-19 vaccines as a risky discussion topic and engaged in "strategic silences" around vaccination to maintain functional work relationships and employment in health institutions. Loss of trust between HCW and peers or patients, along with suboptimal patient care based on vaccination status, threaten to weaken Belgium's, and by implication, other health systems, and to catalyze preventable disease outbreaks.
Disciplines :
Public health, health care sciences & services
Author, co-author :
Heyerdahl, Leonardo W; Department of Global Health, Anthropology and Ecology of Disease Emergence Unit, Institut Pasteur, Paris, France. Electronic address: leonard.heyerdahl@pasteur.fr
Dielen, Stef; Socio-Ecological Health Research Unit, Institute of Tropical Medicine, Antwerp, Belgium
Dodion, Hélène ; Université de Liège - ULiège > Département de science politique > Méthodologie, analyse et évaluation des politiques publiques ; Socio-Ecological Health Research Unit, Institute of Tropical Medicine, Antwerp, Belgium
Van Riet, Carla; Access-To-Medicines Research Centre, KU Leuven, Belgium
Nguyen, ToTran; Socio-Ecological Health Research Unit, Institute of Tropical Medicine, Antwerp, Belgium
Simas, Clarissa; Vaccine Confidence Project and London School of Hygiene and Tropical Medicine, United Kingdom
Boey, Lise; Access-To-Medicines Research Centre, KU Leuven, Belgium
Kattumana, Tarun; Access-To-Medicines Research Centre, KU Leuven, Belgium, Husserl Archives, Research Center for Phenomenology and Continental Philosophy, Institute of Philosophy, KU Leuven, Belgium
Vandaele, Nico; Access-To-Medicines Research Centre, KU Leuven, Belgium
Larson, Heidi J; Vaccine Confidence Project and London School of Hygiene and Tropical Medicine, United Kingdom
Grietens, Koen Peeters; Socio-Ecological Health Research Unit, Institute of Tropical Medicine, Antwerp, Belgium, School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
Giles-Vernick, Tamara; Department of Global Health, Anthropology and Ecology of Disease Emergence Unit, Institut Pasteur, Paris, France
Gryseels, Charlotte; Socio-Ecological Health Research Unit, Institute of Tropical Medicine, Antwerp, Belgium
Strategic silences, eroded trust: The impact of divergent COVID-19 vaccine sentiments on healthcare workers' relations with peers and patients.
Alternative titles :
[fr] Silences stratégiques, confiance érodée : L'impact des sentiments divergents à l'égard du vaccin COVID-19 sur les relations des travailleurs de la santé avec leurs pairs et les patients.
Original title :
[en] Strategic silences, eroded trust: The impact of divergent COVID-19 vaccine sentiments on healthcare workers' relations with peers and patients.
Addressing vaccine hesitancy, however, requires a public health capacity to understand and dialogue about individual and group vaccine concerns [16,17] . During the implementation of a prior study of vaccine sentiments in the Belgian population (Project “Transvaxx”, funded by the Fund for Scientific Research of Flanders, Belgium), unvaccinated HCWs were often unwilling to participate in group discussions out of fear of being recognized as vaccine hesitant among their peers. HCWs’ ability to share their concerns with others may be limited by the tense epidemiological and political contexts of successive Covid-19 waves and legislation mandating vaccines. We conceptualized this phenomenon as unspoken vaccine hesitancy, as we reported in previously published correspondence [18] . From November 2021 to February 2022, we studied unspoken vaccine hesitancy among HCWs by analyzing their vaccine sentiments, vaccine uptake decisions, their experiences of interacting with peers and patients regarding Covid-19 vaccinations and the consequences for their social relations.
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