Vaccine hesitancy among hospital staff physicians: A cross-sectional survey in France in 2019

BackgroundHealthcare professionals, because they recommend vaccines to their patients, answer their questions, and vaccinate them, are the cornerstone of vaccination in France. They can nonetheless be affected by vaccine hesitancy (VH). Aims. We sought to study the opinions, practices, and perceptions of French hospital staff physicians (HSPs) toward vaccination and the prevalence and correlates of VH among them. Methods. We conducted a cross-sectional survey in 14 public hospitals in France from September 2018 to October 2019. HSPs completed a standardized questionnaire –most of the time face-to-face — about their vaccine-related attitudes and practices. Data were weighted for age and sex. An agglomerative hierarchical cluster analysis of the HSPs’ perceptions and opinions toward vaccination allowed us to identify vaccine-hesitant HSPs, and multiple Poisson regression with robust standard errors let us study the factors associated with VH. Results. The study included 1,795 HSPs (participation rate: 86%). Almost all (93.7%) were strongly favorable to vaccination, even though 42.2% (95CI = 39.8–44.6) showed moderate VH. VH prevalence was lowest among infectious disease specialists (12.3%; 95CI = 6.7–21.3) and pediatricians (27.7%; 95CI = 21.4–35.2). Hesitant HSPs were less trustful of vaccination information sources and doubted the safety of vaccines more often than HSPs with almost no VH. Compared with non-hesitant HSPs, those with higher VH had less often taken a medical course about vaccination and were less likely to be vaccinated against seasonal influenza, to recommend vaccines to their patients and to try to convince vaccine-hesitant patients to be vaccinated. Conclusions. Strong favorability to vaccination does not prevent VH, which was observed in most specialties. Interventions are required to help hesitant HSPs to adopt more proactive vaccination practices.