The Role of Perceived Susceptibility, Perceived Severity, Perceived Barriers and Benefits in COVID-19 Vaccine Hesitancy and Uptake Among Outpatient Surgery Nurses in the United States: A Qualitative Study

Abstract

Background and Objective: This qualitative study explores outpatient nurses’ perceptions of coronavirus disease 2019 (COVID-19) and the COVID-19 vaccine, aiming to inform future research and health education strategies for reducing vaccination hesitancy among healthcare workers, particularly nurses. The nurses recruited for this study were all registered nurses (RNs). Studies have shown that registered professional nurses consistently display higher vaccination hesitancy versus other healthcare groups, specifically doctors. Little is known about the vaccine acceptance disparities that exist among healthcare workers, or why nurses appear to consistently display higher rates of vaccine hesitancy, versus other healthcare groups, especially doctors. Methods: Semi-structured interviews guided by the health belief model were conducted with 8 outpatient nurses, and a focus group guided by the health belief model was conducted with 5 outpatient nurses, for a total of 13 nurses (N=13). The data were triangulated through interviews, a focus group, and a literature review. In addition, an independent external secondary analyst confirmed the findings. Results: Three key themes appeared: (1) sources of information (trusted sources of information), (2) experience (belief about personal risk and personal responsibility), and (3) logistics (COVID-19 testing requirements, booster frequency, and mandate versus choice). Conclusion and Implications for Translation: We advise public health professionals to adopt a grassroots approach to vaccine hesitancy interventions, engaging and training doctors and nurses. We also recommend consistency in prevention approaches, as that produces trust. We also recommend further research into the booster requirement, as requiring an unknown number of boosters appears to lower trust among nurses.