RESUMO

A decisão vacinal de profissionais de saúde tem sido observada em diferentes países, devido ao seu comportamento de hesitação frente à vacinação contra a Covid-19, que pode interferir no controle da pandemia. Pretendeu-se identificar os fatores associados à decisão vacinal de profissionais de saúde contra a Covid-19 em publicações de julho de 2020 a julho de 2022. Foi realizada uma revisão integrativa da literatura nas bases de dados PubMed, Scopus, Web of Science e Cinahl. Das 439 publicações, foram escolhidos 35 artigos para análise. As características sociodemográficas da decisão vacinal revelaram que profissionais não médicos, principalmente enfermeiros, apresentaram maior hesitação. O estudo revelou fatores associados à hesitação vacinal, tais como: dúvidas sobre a eficácia das vacinas e o processo de produção, insegurança pela escassez de estudos, medo dos efeitos colaterais e informações veiculadas em mídias sociais. Em relação à aceitação e à recomendação vacinal, ressaltam-se a vacinação prévia contra a influenza, a confiança na eficácia das vacinas e o receio pelo risco de contágio por Covid-19. A identificação dos fatores associados à decisão vacinal de profissionais de saúde contra a Covid-19 foi estratégica em relação à ampliação da cobertura vacinal, tanto para a proteção da saúde dos profissionais quanto para a da população.

PALAVRAS-CHAVES
Vacinação; Covid-19; Hesitação vacinal; Recusa de vacinação; Pessoal de saúde

ABSTRACT

The vaccine decision of health professionals has been observed in different countries, due to their hesitation behavior in the face of vaccination against COVID-19, which can interfere with the control of the pandemic. It was intended to identify the factors associated with the vaccination decision of health professionals against COVID-19 in publications from July 2020 to July 2022. An Integrative Literature Review was carried out in PubMed, Scopus, Web of Science and CINAHL databases. Of the 439 publications, 35 articles were chosen for analysis. The sociodemographic characteristics of the vaccine decision revealed that non-medical professionals, mainly nurses, had greater vaccine hesitancy. The study revealed factors associated with vaccine hesitancy, such as: doubts about the effectiveness of vaccines and the production process, insecurity due to lack of studies, fear of side effects and information conveyed on social media. Regarding vaccine acceptance and recommendation, prior vaccination against influenza, confidence in the effectiveness of vaccines and fear of the risk of contagion by COVID-19 stand out. Identifying the factors associated with the vaccination decision of health professionals against COVID-19 was strategic in relation to expanding vaccination coverage, both to protect the health of professionals and the population.

KEYWORDS
Vaccination; COVID-19; Vaccination hesitancy; Vaccination refusal; Health staff

Introdução

Historicamente, a imunização vem sendo identificada como uma estratégia assertiva e eficaz no combate às doenças infecciosas ¹1 Tizard IR. Vaccination against coronaviruses in domestic animals. Vaccine. 2020 [acesso em 2022 nov 20]; 38(33):5123-30. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7284272/pdf/main.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... . Neste sentido, o desenvolvimento de vacinas tem tomado um porte expressivo no âmbito mundial, por serem consideradas como ferramentas potentes no enfrentamento da pandemia e no controle da Covid-19 ²2 Ashok N, Krishnamurthy K, Singh K, et al. High COVID-19 Vaccine hesitancy among healthcare workers: should such a trend require closer attention by policymakers? Cureus. 2021 [acesso em 2022 nov 20]; 13(9):e17990. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8519358/pdf/cureus-0013-00000017990.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,³3 Sharma O, Sultan AA, Ding H, et al. A review of the progress and challenges of developing a vaccine for COVID-19. Front Immunol. 2020 [acesso em 2022 nov 20]; (11):585354. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7591699/pdf/fimmu-11-585354.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... . Neste contexto, o fortalecimento dos programas de imunização tem se tornado essencial para a prevenção e a promoção da saúde, incentivando a população à utilização das vacinas, contando com os profissionais de saúde na linha de frente desse processo ⁴4 Anderson RM, Vegvari C, Truscott J, et al. Challenges in creating herd immunity to SARS-CoV-2 infection by mass vaccination. Lancet. 2020 [acesso em 2022 nov 20]; (396):1614-6. Disponível em: https://www.thelancet.com/action/showPdf?pii=S0140-6736%2820%2932318-7.
https://www.thelancet.com/action/showPdf... .

Concomitantemente, um movimento antivacina, de extrema resistência, tem tomado o mundo inteiro, se apresentando como grande desafio no controle de agravos infectocontagiosos, especialmente no enfrentamento à pandemia da Covid-19 ⁵5 Briko NI, Korshunov VA, Mindlina AY, et al. Healthcare workers’ acceptance of COVID-19 vaccination in Russia. Int J Environ Res Public Health. 2022 [acesso em 2022 nov 20]; 19(7):4136. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8998926/pdf/ijerph-19-04136.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,⁶6 Kashif M, Fatima I, Ahmed AM, et al. Perception, Willingness, Barriers, and Hesitancy towards COVID-19 Vaccine in Pakistan: comparison between healthcare workers and general population. Cureus. 2021 [acesso em 2022 nov 20]; 13(10):e19106. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8627421/.
https://www.ncbi.nlm.nih.gov/pmc/article... . Surpreendentemente, este comportamento não vem acontecendo distantemente dos profissionais de saúde, mesmo diante de um maior risco de contágio pela exposição ao Covid-19 no ambiente do trabalho ou da eminente ameaça de transmitirem a doença aos seus contatos domiciliares. Dessa forma, a hesitação desses profissionais de saúde frente à vacinação contra a Covid-19 vem se manifestando como um comportamento nocivo à sua saúde e à saúde coletiva ¹1 Tizard IR. Vaccination against coronaviruses in domestic animals. Vaccine. 2020 [acesso em 2022 nov 20]; 38(33):5123-30. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7284272/pdf/main.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,⁷7 Al-Sanafi M, Sallam M. Psychological determinants of COVID-19 vaccine acceptance among healthcare workers in kuwait: a cross-sectional study using the 5c and vaccine conspiracy beliefs scales. Vaccines (Basel). 2021 [acesso em 2022 nov 20]; 9(7):701. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8310287/pdf/vaccines-09-00701.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,⁸8 Amuzie CI, Odini F, Kalu KU, et al. COVID-19 vaccine hesitancy among healthcare workers and its socio-demographic determinants in Abia State, Southeastern Nigeria: a cross-sectional study. Pan Afr Med J. 2021 [acesso em 2022 nov 20]; (40):10. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8490164/pdf/PAMJ-40-10.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,⁹9 Fakonti G, Kyprianidou M, Toumbis G, et al. Attitudes and acceptance of COVID-19 vaccination among nurses and midwives in cyprus: a cross-sectional survey. Front Public Health. 2021 [acesso em 2022 nov 20]; (9):656138. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8244901/pdf/fpubh-09-656138.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,¹⁰10 Janssen C, Maillard A, Bodelet C, et al. Hesitancy towards COVID-19 vaccination among healthcare workers: a multi-centric survey in france. Vaccines (Basel). 2021 [acesso em 2022 nov 20]; 9(6):547. Disponível em: https://www.mdpi.com/2076-393X/9/6/547.
https://www.mdpi.com/2076-393X/9/6/547... ,¹¹11 Kara EB, Can G, Pirdal BZ, et al. COVID-19 vaccine hesitancy in healthcare personnel: a university hospital experience. Vaccines (Basel). 2021 [acesso em 2022 nov 20]; 9(11):1343. Disponível em: https://www.mdpi.com/2076-393X/9/11/1343.
https://www.mdpi.com/2076-393X/9/11/1343... .

Os profissionais de saúde lidam diretamente com o cuidado ao público, mediante ações de assistência e acompanhamento de pessoas contaminadas pelo coronavírus. E, significativamente, se implicam no cenário da testagem e da vacinação contra a Covid-19, desenvolvendo um papel decisivo na orientação da população em relação à vacinação, de modo geral. Por esta razão, a sua tomada de decisão vacinal torna-se alvo de pesquisas para a obtenção de maiores conhecimentos e aprofundamentos ²2 Ashok N, Krishnamurthy K, Singh K, et al. High COVID-19 Vaccine hesitancy among healthcare workers: should such a trend require closer attention by policymakers? Cureus. 2021 [acesso em 2022 nov 20]; 13(9):e17990. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8519358/pdf/cureus-0013-00000017990.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,⁹9 Fakonti G, Kyprianidou M, Toumbis G, et al. Attitudes and acceptance of COVID-19 vaccination among nurses and midwives in cyprus: a cross-sectional survey. Front Public Health. 2021 [acesso em 2022 nov 20]; (9):656138. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8244901/pdf/fpubh-09-656138.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,¹⁰10 Janssen C, Maillard A, Bodelet C, et al. Hesitancy towards COVID-19 vaccination among healthcare workers: a multi-centric survey in france. Vaccines (Basel). 2021 [acesso em 2022 nov 20]; 9(6):547. Disponível em: https://www.mdpi.com/2076-393X/9/6/547.
https://www.mdpi.com/2076-393X/9/6/547... ,¹²12 Tuong VC, Thota KS, Reep M, et al. COVID-19 vaccine acceptance among rural appalachian healthcare workers (Eastern Kentucky/West Virginia): a cross-sectional study. Cureus. 2021 [acesso em 2022 nov 20]; 13(8):e16842. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8410864/pdf/cureus-0013-00000016842.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... .

Desse modo, esta revisão torna-se importante no sentido de conhecer os fatores associados que interferem tanto na resistência quanto na predisposição de profissionais de saúde em relação às vacinas, principalmente no período da pandemia da Covid-19. Isto com vistas à ampliação da cobertura vacinal, tanto para a proteção da saúde dos profissionais quanto para a da população.

Pretende-se identificar os fatores associados à decisão vacinal de profissionais de saúde contra a Covid-19 em publicações de julho de 2020 a julho de 2022.

Material e métodos

Trata o presente estudo de uma Revisão Integrativa da Literatura (RIL) ¹³13 Botelho LLR, Cunha CCA, Macedo M. O método da revisão integrativa nos estudos organizacionais. Gest. Soc. 2011 [acesso em 2023 abr 14]; 11(5):121-36. Disponível em: https://www.gestaoesociedade.org/gestaoesociedade/article/view/1220.
https://www.gestaoesociedade.org/gestaoe... sobre a aceitação e a hesitação de profissionais de saúde em relação à vacinação contra a Covid-19, tendo sido desenvolvido com base nas recomendações do guia internacional PRISMA-ScR26 ¹⁴14 Tricco AC, Lillie E, Zarin W, et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and explanation. Ann Intern Med. 2018 [acesso em 2023 abr 14]; 169(7):467-73. Disponível em: https://www.acpjournals.org/doi/full/10.7326/M18-0850?rfr_dat=cr_pub++0pubmed&url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org.
https://www.acpjournals.org/doi/full/10.... .

Para iniciar, foi descrita a questão de pesquisa: ‘Quais os fatores identificados em artigos publicados entre julho de 2020 e julho de 2022 que interferem na hesitação e na aceitação de profissionais de saúde, em relação à vacinação contra a Covid-19?’. Essa questão foi definida a partir da estratégia PICo: Participantes (profissionais de saúde), Interesse (fatores associados à hesitação e à aceitação) e Contexto (vacinação contra a Covid-19).

Em seguida, foram estabelecidos os descritores do estudo, obedecendo à terminologia padronizada cientificamente, que auxilia na identificação das publicações por assuntos, e confirmados nos Descritores em Ciências da Saúde (DeCS) e na Medical Subjects Headings (MeSH). Os descritores limitados no DeCS foram: “Vacinação”, “Covid-19”, “Hesitação”, “Aceitação pelo Paciente de Cuidados de Saúde”, “Profissionais de Saúde”. No MeSH: “Vaccination”, “Covid-19”, “Vaccination Hesitancy”, “Patient Acceptance of Health Care”, “Health Personnel”. Como estratégias de investigação dos descritores, foi utilizada a busca avançada com o operador booleano AND nas seguintes articulações: “Vaccination” AND “COVID-19” AND “Healthcare Worker” AND “Hesitancy” AND “Health Personnel”.

A busca foi realizada entre os dias 02 e 03 de agosto de 2022, nas seguintes bases de dados: PubMed, Scopus, Web of Science e Cinahl.

Os critérios de inclusão foram: estudos originais, gratuitos, completos e disponíveis eletronicamente, nos idiomas português, espanhol e inglês, publicados entre julho de 2020 e julho de 2022, tendo como marco temporal o desenvolvimento da vacina contra a Covid-19, além da temática para a aceitação e a hesitação vacinal pelos profissionais de saúde. Os critérios de exclusão foram: artigos duplicados, editoriais, relatos de experiência, resumos, estudos realizados com a população em geral ou com uma categoria profissional específica, e publicações que não incluíam hesitação ou aceitação em relação à vacinação contra a Covid-19.

Houve a busca inicial das publicações nas bases de dados e, em seguida, foram excluídos os registros duplicados. Foi realizada a leitura de todos os títulos dos artigos, seguida dos resumos por pares, independentemente. Utilizou-se o método triplo cego, a fim de que o revisor pudesse identificar estudos potencialmente elegíveis, de acordo com os critérios estabelecidos. Posteriormente, houve a leitura integral do texto, além da exclusão das publicações que não estavam relacionadas à temática, resultando nos achados pertinentes.

Em relação à inclusão ou à exclusão dos artigos nos momentos de dúvidas e/ou divergências entre os revisores, quanto à sua elegibilidade, as questões foram resolvidas em consenso.

Os artigos foram classificados, segundo os níveis de evidência reconhecidos nos estudos, da seguinte forma: 1) evidências resultantes da meta-análise de múltiplos estudos clínicos controlados e randomizados; 2) evidências obtidas em estudos individuais com delineamento experimental; 3) evidências de estudos quase-experimentais; 4) evidências de estudos descritivos ou com abordagem qualitativa; 5) evidências provenientes de relatos de caso ou de experiência; e 6) evidências baseadas em opiniões de especialistas ¹⁵15 Souza MT, Silva MD, Carvalho R. Integrative review: what is it? How to do it? Einstein (São Paulo). 2010 [acesso em 2022 nov 20]; 8(1):102-6. Disponível em: https://www.scielo.br/j/eins/a/ZQTBkVJZqcWrTT34cXLjtBx/?lang=en.
https://www.scielo.br/j/eins/a/ZQTBkVJZq... .

A análise dos dados referente à tomada de decisão dos profissionais de saúde em relação à vacinação contra a Covid-19 foi realizada sob influência de Bardin, seguindo as etapas preconizadas para análise temática ¹⁶16 Bardin L. 2016. Análise de Conteúdo. São Paulo: Edições 70; 2016. . As categorias analíticas foram assim preestabelecidas: fatores associados à hesitação vacinal e fatores que favorecem a aceitação dos profissionais de saúde, em relação à vacinação contra a Covid-19.

Resultados

Na primeira fase de buscas, foram identificadas 439 publicações indexadas em periódicos científicos, assim divididas entre as seguintes bases de dados: 102 artigos na PubMed, 133 na Scopus, 133 na Web of Science e 71 na Cinahl. Foram excluídos 174 registros duplicados, mantendo-se 265 publicações. Após leitura de todos os títulos e realização de resumos por pares, independentemente, foram excluídas 176 e mantidas 89 publicações. Posteriormente à leitura integral do texto, foram retiradas 54 publicações, por não responderem à questão de pesquisa. Finalizando, obteve-se o total de 35 artigos para análise. O processo de seleção encontra-se apresentado na figura 1 a seguir, referente ao fluxograma PRISMA ¹⁴14 Tricco AC, Lillie E, Zarin W, et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and explanation. Ann Intern Med. 2018 [acesso em 2023 abr 14]; 169(7):467-73. Disponível em: https://www.acpjournals.org/doi/full/10.7326/M18-0850?rfr_dat=cr_pub++0pubmed&url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org.
https://www.acpjournals.org/doi/full/10.... .

Questões relacionadas ao ano de publicação, local de origem da pesquisa, campo de estudo e à coleta de dados foram quantificadas, possibilitando um resumo analítico dos artigos, como pode ser observado na tabela 1.

No que se refere ao período de publicação, verificou-se que o maior quantitativo de publicações se deu no ano de 2022 (54,28%), que foi seguido de forma equitativa pelo ano de 2021 (45,71%).

Quanto à origem das pesquisas, pôde-se observar um predomínio de artigos publicados nas seguintes regiões: Ásia (37,14%), América do Norte (20%), África (14,28%), Europa (14,28%) e Eurásia (14,28%), tendo a PubMed como a principal base de dados para a indexação dos artigos científicos identificados.

Os campos dos estudos, em sua maior parte, foram as áreas hospitalares (37,14%), tendo 8,57% das pesquisas sido desenvolvidas na Atenção Primária à Saúde (APS) e 54,28% realizadas em áreas denominadas como diversas, por abrangerem diferentes campos de atuação dos profissionais de saúde.

No que concerne à classificação do nível de evidência, 100% dos artigos foram considerados como nível 3, dando visibilidade aos estudos observacionais nesse período – 100% de estudos transversais. Destes, 97,14% são estudos quantitativos. Apenas um estudo é considerado misto.

Quanto à coleta de dados, 80% foram obtidos online e 20% presencialmente. Os questionários online foram colocados à disposição através de plataformas em redes sociais ou por meio dos e-mails nos próprios serviços de saúde. Sete pesquisas ocorreram mediante aplicação de entrevistas presenciais.

Após leitura integral dos textos e análise das informações relacionadas ao perfil, pôde-se constatar que os profissionais de saúde do sexo masculino ⁵5 Briko NI, Korshunov VA, Mindlina AY, et al. Healthcare workers’ acceptance of COVID-19 vaccination in Russia. Int J Environ Res Public Health. 2022 [acesso em 2022 nov 20]; 19(7):4136. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8998926/pdf/ijerph-19-04136.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,¹⁰10 Janssen C, Maillard A, Bodelet C, et al. Hesitancy towards COVID-19 vaccination among healthcare workers: a multi-centric survey in france. Vaccines (Basel). 2021 [acesso em 2022 nov 20]; 9(6):547. Disponível em: https://www.mdpi.com/2076-393X/9/6/547.
https://www.mdpi.com/2076-393X/9/6/547... ,¹¹11 Kara EB, Can G, Pirdal BZ, et al. COVID-19 vaccine hesitancy in healthcare personnel: a university hospital experience. Vaccines (Basel). 2021 [acesso em 2022 nov 20]; 9(11):1343. Disponível em: https://www.mdpi.com/2076-393X/9/11/1343.
https://www.mdpi.com/2076-393X/9/11/1343... ,¹²12 Tuong VC, Thota KS, Reep M, et al. COVID-19 vaccine acceptance among rural appalachian healthcare workers (Eastern Kentucky/West Virginia): a cross-sectional study. Cureus. 2021 [acesso em 2022 nov 20]; 13(8):e16842. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8410864/pdf/cureus-0013-00000016842.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,¹⁸18 Yan YY, Wang HT, Fan TY, et al. Vaccination coverage among COVID-19 prevention and control management teams at primary healthcare facilities in China and their attitudes towards COVID-19 vaccine: a cross-sectional online survey. BMJ Open. 2022 [acesso em 2022 nov 20]; 12(4):e056345. Disponível em: https://bmjopen.bmj.com/content/12/4/e056345.long.
https://bmjopen.bmj.com/content/12/4/e05... ,¹⁹19 Wang H, Huang YM, Su XY, et al. Acceptance of the COVID-19 vaccine based on the health belief model: a multicenter national survey among medical care workers in China. Hum. vaccin. Immunother. 2022 [acesso em 2022 nov 20]; 18(5):2076523. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9481094/pdf/KHVI_18_2076523.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,²⁰20 Saddik B, Al-Bluwi N, Shukla A, et al. Determinants of healthcare workers perceptions, acceptance and choice of COVID-19 vaccines: a cross-sectional study from the United Arab Emirates. Hum. vaccin. Immunother. 2022 [acesso em 2022 nov 20]; 18(1):1-9. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8928822/pdf/KHVI_18_1994300.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,²²22 Öncel S, Alvur M, Çakıcı Ö. Turkish healthcare workers’ personal and parental attitudes to COVID-19 vaccination from a role modeling perspective. Cureus. 2022 [acesso em 2022 nov 20]; 14(2):e22555. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8958126/pdf/cureus-0014-00000022555.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,²⁵25 Maraqa B, Nazzal Z, Rabi R, et al. COVID-19 vaccine hesitancy among health care workers in Palestine: a call for action. Prev Med. 2021 [acesso em 2022 nov 20]; (149):106618. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8117476/pdf/main.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,²⁶26 Maqsood MB, Islam MA, Al Qarni A, et al. Assessment of COVID-19 vaccine acceptance and reluctance among staff working in public healthcare settings of Saudi Arabia: a multicenter study. Front Public Health. 2022 [acesso em 2022 Nov 20]; (10):847282. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9196634/pdf/fpubh-10-847282.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,³¹31 Kose S, Mandiracioglu A, Sahin S, et al. Vaccine hesitancy of the COVID-19 by health care personnel. Int J Clin Pract. 2021 [acesso em 2022 nov 20]; 75(5):e13917. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7883260/pdf/IJCP-75-0.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,³²32 İkiışık H, Sezerol MA, Taşçı Y, et al. COVID-19 vaccine hesitancy and related factors among primary healthcare workers in a district of Istanbul: a cross-sectional study from Turkey. Fam. Med. Community Health. 2022 [acesso em 2022 nov 20]; 10(2):e001430. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9039154/pdf/fmch-2021-001430.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,³⁶36 Gagneux-Brunon A, Detoc M, Bruel S, et al. Intention to get vaccinations against COVID-19 in french healthcare workers during the first pandemic wave: a cross-sectional survey. J Hosp Infect. 2021 [acesso em 2022 nov 20]; (108):168-73. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7699157/pdf/main.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,³⁸38 Dzieciolowska S, Hamel D, Gadio S, et al. Covid-19 vaccine acceptance, hesitancy, and refusal among Canadian healthcare workers: a multicenter survey. Am J Infect Control. 2021 [acesso em 2022 nov 20]; 49(9):1152-7. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8079260/pdf/main.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,⁴⁴44 Askarian M, Semenov A, Llopis F, et al. The COVID-19 vaccination acceptance/hesitancy rate and its determinants among healthcare workers of 91 countries: a multicenter cross-sectional study. EXCLI J. 2022 [acesso em 2022 nov 20]; (21):93-103. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8859647/pdf/EXCLI-21-93.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... , com idades mais avançadas ⁵5 Briko NI, Korshunov VA, Mindlina AY, et al. Healthcare workers’ acceptance of COVID-19 vaccination in Russia. Int J Environ Res Public Health. 2022 [acesso em 2022 nov 20]; 19(7):4136. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8998926/pdf/ijerph-19-04136.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,¹⁰10 Janssen C, Maillard A, Bodelet C, et al. Hesitancy towards COVID-19 vaccination among healthcare workers: a multi-centric survey in france. Vaccines (Basel). 2021 [acesso em 2022 nov 20]; 9(6):547. Disponível em: https://www.mdpi.com/2076-393X/9/6/547.
https://www.mdpi.com/2076-393X/9/6/547... ,¹²12 Tuong VC, Thota KS, Reep M, et al. COVID-19 vaccine acceptance among rural appalachian healthcare workers (Eastern Kentucky/West Virginia): a cross-sectional study. Cureus. 2021 [acesso em 2022 nov 20]; 13(8):e16842. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8410864/pdf/cureus-0013-00000016842.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,¹⁸18 Yan YY, Wang HT, Fan TY, et al. Vaccination coverage among COVID-19 prevention and control management teams at primary healthcare facilities in China and their attitudes towards COVID-19 vaccine: a cross-sectional online survey. BMJ Open. 2022 [acesso em 2022 nov 20]; 12(4):e056345. Disponível em: https://bmjopen.bmj.com/content/12/4/e056345.long.
https://bmjopen.bmj.com/content/12/4/e05... ,¹⁹19 Wang H, Huang YM, Su XY, et al. Acceptance of the COVID-19 vaccine based on the health belief model: a multicenter national survey among medical care workers in China. Hum. vaccin. Immunother. 2022 [acesso em 2022 nov 20]; 18(5):2076523. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9481094/pdf/KHVI_18_2076523.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,²¹21 Nomhwange T, Wariri O, Nkereuwem E, et al. COVID-19 vaccine hesitancy amongst healthcare workers: an assessment of its magnitude and determinants during the initial phase of national vaccine deployment in Nigeria. eClinicalMedicine. 2022 [acesso em 2022 nov 20]; (50):101499. Disponível em: https://www.thelancet.com/action/showPdf?pii=S2589-5370%2822%2900229-2.
https://www.thelancet.com/action/showPdf... ,²²22 Öncel S, Alvur M, Çakıcı Ö. Turkish healthcare workers’ personal and parental attitudes to COVID-19 vaccination from a role modeling perspective. Cureus. 2022 [acesso em 2022 nov 20]; 14(2):e22555. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8958126/pdf/cureus-0014-00000022555.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,³⁶36 Gagneux-Brunon A, Detoc M, Bruel S, et al. Intention to get vaccinations against COVID-19 in french healthcare workers during the first pandemic wave: a cross-sectional survey. J Hosp Infect. 2021 [acesso em 2022 nov 20]; (108):168-73. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7699157/pdf/main.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,³⁹39 Dubov A, Distelberg BJ, Abdul-Mutakabbir JC, et al. Predictors of COVID-19 vaccine acceptance and hesitancy among healthcare workers in southern California: not just “anti” vs. “pro” vaccine. Vaccines (Basel). 2021 [acesso em 2022 nov 20]; 9(12):1428. Disponível em: https://www.mdpi.com/2076-393X/9/12/1428.
https://www.mdpi.com/2076-393X/9/12/1428... , maiores índices de escolaridade ¹⁰10 Janssen C, Maillard A, Bodelet C, et al. Hesitancy towards COVID-19 vaccination among healthcare workers: a multi-centric survey in france. Vaccines (Basel). 2021 [acesso em 2022 nov 20]; 9(6):547. Disponível em: https://www.mdpi.com/2076-393X/9/6/547.
https://www.mdpi.com/2076-393X/9/6/547... ,¹¹11 Kara EB, Can G, Pirdal BZ, et al. COVID-19 vaccine hesitancy in healthcare personnel: a university hospital experience. Vaccines (Basel). 2021 [acesso em 2022 nov 20]; 9(11):1343. Disponível em: https://www.mdpi.com/2076-393X/9/11/1343.
https://www.mdpi.com/2076-393X/9/11/1343... ,¹⁸18 Yan YY, Wang HT, Fan TY, et al. Vaccination coverage among COVID-19 prevention and control management teams at primary healthcare facilities in China and their attitudes towards COVID-19 vaccine: a cross-sectional online survey. BMJ Open. 2022 [acesso em 2022 nov 20]; 12(4):e056345. Disponível em: https://bmjopen.bmj.com/content/12/4/e056345.long.
https://bmjopen.bmj.com/content/12/4/e05... ,¹⁹19 Wang H, Huang YM, Su XY, et al. Acceptance of the COVID-19 vaccine based on the health belief model: a multicenter national survey among medical care workers in China. Hum. vaccin. Immunother. 2022 [acesso em 2022 nov 20]; 18(5):2076523. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9481094/pdf/KHVI_18_2076523.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,²²22 Öncel S, Alvur M, Çakıcı Ö. Turkish healthcare workers’ personal and parental attitudes to COVID-19 vaccination from a role modeling perspective. Cureus. 2022 [acesso em 2022 nov 20]; 14(2):e22555. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8958126/pdf/cureus-0014-00000022555.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,²⁵25 Maraqa B, Nazzal Z, Rabi R, et al. COVID-19 vaccine hesitancy among health care workers in Palestine: a call for action. Prev Med. 2021 [acesso em 2022 nov 20]; (149):106618. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8117476/pdf/main.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,³⁴34 Halbrook M, Gadoth A, Martin-Blais R, et al. Longitudinal assessment of coronavirus disease 2019 vaccine acceptance and uptake among frontline medical workers in Los Angeles, California. Clin Infect Dis. 2022 [acesso em 2022 nov 20]; 74(7):1166-73. Disponível em: https://academic.oup.com/cid/article/74/7/1166/6325325?login=false.
https://academic.oup.com/cid/article/74/... ,⁴⁴44 Askarian M, Semenov A, Llopis F, et al. The COVID-19 vaccination acceptance/hesitancy rate and its determinants among healthcare workers of 91 countries: a multicenter cross-sectional study. EXCLI J. 2022 [acesso em 2022 nov 20]; (21):93-103. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8859647/pdf/EXCLI-21-93.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... e casados ²¹21 Nomhwange T, Wariri O, Nkereuwem E, et al. COVID-19 vaccine hesitancy amongst healthcare workers: an assessment of its magnitude and determinants during the initial phase of national vaccine deployment in Nigeria. eClinicalMedicine. 2022 [acesso em 2022 nov 20]; (50):101499. Disponível em: https://www.thelancet.com/action/showPdf?pii=S2589-5370%2822%2900229-2.
https://www.thelancet.com/action/showPdf... estiveram mais dispostos a aceitar a vacinação contra a Covid-19. Já as profissionais de saúde do sexo feminino ⁷7 Al-Sanafi M, Sallam M. Psychological determinants of COVID-19 vaccine acceptance among healthcare workers in kuwait: a cross-sectional study using the 5c and vaccine conspiracy beliefs scales. Vaccines (Basel). 2021 [acesso em 2022 nov 20]; 9(7):701. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8310287/pdf/vaccines-09-00701.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,¹⁰10 Janssen C, Maillard A, Bodelet C, et al. Hesitancy towards COVID-19 vaccination among healthcare workers: a multi-centric survey in france. Vaccines (Basel). 2021 [acesso em 2022 nov 20]; 9(6):547. Disponível em: https://www.mdpi.com/2076-393X/9/6/547.
https://www.mdpi.com/2076-393X/9/6/547... ,¹⁷17 Yilma D, Mohammed R, Abdela SG, et al. COVID-19 vaccine acceptability among healthcare workers in Ethiopia: Do we practice what we preach? Trop Med Int Health. 2022 [acesso em 2022 nov 20]; 27(4):418-25. Disponível em: https://onlinelibrary.wiley.com/doi/10.1111/tmi.13742.
https://onlinelibrary.wiley.com/doi/10.1... ,²²22 Öncel S, Alvur M, Çakıcı Ö. Turkish healthcare workers’ personal and parental attitudes to COVID-19 vaccination from a role modeling perspective. Cureus. 2022 [acesso em 2022 nov 20]; 14(2):e22555. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8958126/pdf/cureus-0014-00000022555.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,²⁹29 Kumar R, Alabdulla M, Elhassan NM, et al. Qatar healthcare workers’ COVID-19 vaccine hesitancy and attitudes: a national cross-sectional survey. Front Public Health. 2021 [acesso em 2022 nov 20]; (9):727748. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8424093/pdf/fpubh-09-727748.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,³⁴34 Halbrook M, Gadoth A, Martin-Blais R, et al. Longitudinal assessment of coronavirus disease 2019 vaccine acceptance and uptake among frontline medical workers in Los Angeles, California. Clin Infect Dis. 2022 [acesso em 2022 nov 20]; 74(7):1166-73. Disponível em: https://academic.oup.com/cid/article/74/7/1166/6325325?login=false.
https://academic.oup.com/cid/article/74/... ,³⁵35 Gatto NM, Lee JE, Massai D, et al. Correlates of COVID-19 vaccine acceptance, hesitancy and refusal among employees of a safety net California county health system with an early and aggressive vaccination program: results from a cross-sectional survey. Vaccines (Basel). 2021 [acesso em 2022 nov 20]; 9(10):1152. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8540702/pdf/vaccines-09-01152.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,⁴²42 Aw J, Seah SSY, Seng BJJ, et al. COVID-19-Related vaccine hesitancy among community hospitals’ healthcare workers in Singapore. Vaccines (Basel). 2022 [acesso em 2022 nov 20]; 10(4):537. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9032808/pdf/vaccines-10-00537.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... , mais jovens ⁸8 Amuzie CI, Odini F, Kalu KU, et al. COVID-19 vaccine hesitancy among healthcare workers and its socio-demographic determinants in Abia State, Southeastern Nigeria: a cross-sectional study. Pan Afr Med J. 2021 [acesso em 2022 nov 20]; (40):10. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8490164/pdf/PAMJ-40-10.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,¹¹11 Kara EB, Can G, Pirdal BZ, et al. COVID-19 vaccine hesitancy in healthcare personnel: a university hospital experience. Vaccines (Basel). 2021 [acesso em 2022 nov 20]; 9(11):1343. Disponível em: https://www.mdpi.com/2076-393X/9/11/1343.
https://www.mdpi.com/2076-393X/9/11/1343... ,²⁸28 Leigh JP, Moss SJ, White TM, et al. Factors affecting COVID-19 vaccine hesitancy among healthcare providers in 23 countries. Vaccine. 2022 [acesso em 2022 nov 20]; 40(31):4081-9. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9068669/pdf/main.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,⁴²42 Aw J, Seah SSY, Seng BJJ, et al. COVID-19-Related vaccine hesitancy among community hospitals’ healthcare workers in Singapore. Vaccines (Basel). 2022 [acesso em 2022 nov 20]; 10(4):537. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9032808/pdf/vaccines-10-00537.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... , solteiras ⁸8 Amuzie CI, Odini F, Kalu KU, et al. COVID-19 vaccine hesitancy among healthcare workers and its socio-demographic determinants in Abia State, Southeastern Nigeria: a cross-sectional study. Pan Afr Med J. 2021 [acesso em 2022 nov 20]; (40):10. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8490164/pdf/PAMJ-40-10.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... , com menores rendas salariais ⁸8 Amuzie CI, Odini F, Kalu KU, et al. COVID-19 vaccine hesitancy among healthcare workers and its socio-demographic determinants in Abia State, Southeastern Nigeria: a cross-sectional study. Pan Afr Med J. 2021 [acesso em 2022 nov 20]; (40):10. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8490164/pdf/PAMJ-40-10.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,¹⁰10 Janssen C, Maillard A, Bodelet C, et al. Hesitancy towards COVID-19 vaccination among healthcare workers: a multi-centric survey in france. Vaccines (Basel). 2021 [acesso em 2022 nov 20]; 9(6):547. Disponível em: https://www.mdpi.com/2076-393X/9/6/547.
https://www.mdpi.com/2076-393X/9/6/547... ,²⁸28 Leigh JP, Moss SJ, White TM, et al. Factors affecting COVID-19 vaccine hesitancy among healthcare providers in 23 countries. Vaccine. 2022 [acesso em 2022 nov 20]; 40(31):4081-9. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9068669/pdf/main.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,³⁵35 Gatto NM, Lee JE, Massai D, et al. Correlates of COVID-19 vaccine acceptance, hesitancy and refusal among employees of a safety net California county health system with an early and aggressive vaccination program: results from a cross-sectional survey. Vaccines (Basel). 2021 [acesso em 2022 nov 20]; 9(10):1152. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8540702/pdf/vaccines-09-01152.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,³⁹39 Dubov A, Distelberg BJ, Abdul-Mutakabbir JC, et al. Predictors of COVID-19 vaccine acceptance and hesitancy among healthcare workers in southern California: not just “anti” vs. “pro” vaccine. Vaccines (Basel). 2021 [acesso em 2022 nov 20]; 9(12):1428. Disponível em: https://www.mdpi.com/2076-393X/9/12/1428.
https://www.mdpi.com/2076-393X/9/12/1428... ,⁴⁴44 Askarian M, Semenov A, Llopis F, et al. The COVID-19 vaccination acceptance/hesitancy rate and its determinants among healthcare workers of 91 countries: a multicenter cross-sectional study. EXCLI J. 2022 [acesso em 2022 nov 20]; (21):93-103. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8859647/pdf/EXCLI-21-93.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... , menores níveis de escolaridade ⁷7 Al-Sanafi M, Sallam M. Psychological determinants of COVID-19 vaccine acceptance among healthcare workers in kuwait: a cross-sectional study using the 5c and vaccine conspiracy beliefs scales. Vaccines (Basel). 2021 [acesso em 2022 nov 20]; 9(7):701. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8310287/pdf/vaccines-09-00701.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,¹⁰10 Janssen C, Maillard A, Bodelet C, et al. Hesitancy towards COVID-19 vaccination among healthcare workers: a multi-centric survey in france. Vaccines (Basel). 2021 [acesso em 2022 nov 20]; 9(6):547. Disponível em: https://www.mdpi.com/2076-393X/9/6/547.
https://www.mdpi.com/2076-393X/9/6/547... ,²⁸28 Leigh JP, Moss SJ, White TM, et al. Factors affecting COVID-19 vaccine hesitancy among healthcare providers in 23 countries. Vaccine. 2022 [acesso em 2022 nov 20]; 40(31):4081-9. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9068669/pdf/main.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,³⁵35 Gatto NM, Lee JE, Massai D, et al. Correlates of COVID-19 vaccine acceptance, hesitancy and refusal among employees of a safety net California county health system with an early and aggressive vaccination program: results from a cross-sectional survey. Vaccines (Basel). 2021 [acesso em 2022 nov 20]; 9(10):1152. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8540702/pdf/vaccines-09-01152.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,⁴³43 Adeniyi OV, Stead D, Singata-Madliki M, et al. Acceptance of COVID-19 vaccine among the healthcare workers in the Eastern Cape, South Africa: a cross sectional study. Vaccines (Basel). 2021 [acesso em 2022 nov 20]; 9(6):666. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8233726/.
https://www.ncbi.nlm.nih.gov/pmc/article... ,⁴⁴44 Askarian M, Semenov A, Llopis F, et al. The COVID-19 vaccination acceptance/hesitancy rate and its determinants among healthcare workers of 91 countries: a multicenter cross-sectional study. EXCLI J. 2022 [acesso em 2022 nov 20]; (21):93-103. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8859647/pdf/EXCLI-21-93.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... e pertencentes a categorias não médicas ⁵5 Briko NI, Korshunov VA, Mindlina AY, et al. Healthcare workers’ acceptance of COVID-19 vaccination in Russia. Int J Environ Res Public Health. 2022 [acesso em 2022 nov 20]; 19(7):4136. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8998926/pdf/ijerph-19-04136.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,⁷7 Al-Sanafi M, Sallam M. Psychological determinants of COVID-19 vaccine acceptance among healthcare workers in kuwait: a cross-sectional study using the 5c and vaccine conspiracy beliefs scales. Vaccines (Basel). 2021 [acesso em 2022 nov 20]; 9(7):701. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8310287/pdf/vaccines-09-00701.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,⁸8 Amuzie CI, Odini F, Kalu KU, et al. COVID-19 vaccine hesitancy among healthcare workers and its socio-demographic determinants in Abia State, Southeastern Nigeria: a cross-sectional study. Pan Afr Med J. 2021 [acesso em 2022 nov 20]; (40):10. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8490164/pdf/PAMJ-40-10.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,¹¹11 Kara EB, Can G, Pirdal BZ, et al. COVID-19 vaccine hesitancy in healthcare personnel: a university hospital experience. Vaccines (Basel). 2021 [acesso em 2022 nov 20]; 9(11):1343. Disponível em: https://www.mdpi.com/2076-393X/9/11/1343.
https://www.mdpi.com/2076-393X/9/11/1343... ,¹⁸18 Yan YY, Wang HT, Fan TY, et al. Vaccination coverage among COVID-19 prevention and control management teams at primary healthcare facilities in China and their attitudes towards COVID-19 vaccine: a cross-sectional online survey. BMJ Open. 2022 [acesso em 2022 nov 20]; 12(4):e056345. Disponível em: https://bmjopen.bmj.com/content/12/4/e056345.long.
https://bmjopen.bmj.com/content/12/4/e05... ,²²22 Öncel S, Alvur M, Çakıcı Ö. Turkish healthcare workers’ personal and parental attitudes to COVID-19 vaccination from a role modeling perspective. Cureus. 2022 [acesso em 2022 nov 20]; 14(2):e22555. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8958126/pdf/cureus-0014-00000022555.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,²⁵25 Maraqa B, Nazzal Z, Rabi R, et al. COVID-19 vaccine hesitancy among health care workers in Palestine: a call for action. Prev Med. 2021 [acesso em 2022 nov 20]; (149):106618. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8117476/pdf/main.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,²⁶26 Maqsood MB, Islam MA, Al Qarni A, et al. Assessment of COVID-19 vaccine acceptance and reluctance among staff working in public healthcare settings of Saudi Arabia: a multicenter study. Front Public Health. 2022 [acesso em 2022 Nov 20]; (10):847282. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9196634/pdf/fpubh-10-847282.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,²⁷27 Li G, Zhong Y, Htet H, et al. COVID-19 vaccine acceptance and associated factors among unvaccinated workers at a tertiary hospital in southern Thailand. Health Serv. Res. Manag. Epidemiol. 2022 [acesso em 2022 nov 20]; (9):-1-8. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8891901/pdf/10.1177_23333928221083057.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,³⁶36 Gagneux-Brunon A, Detoc M, Bruel S, et al. Intention to get vaccinations against COVID-19 in french healthcare workers during the first pandemic wave: a cross-sectional survey. J Hosp Infect. 2021 [acesso em 2022 nov 20]; (108):168-73. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7699157/pdf/main.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,⁴⁰40 Di Gennaro F, Murri R, Segala FV, et al. Attitudes towards Anti-SARS-CoV2 vaccination among healthcare workers: results from a national survey in Italy. Viruses. 2021 [acesso em 2022 nov 20]; 13(3):371. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7996832/.
https://www.ncbi.nlm.nih.gov/pmc/article... ,⁴³43 Adeniyi OV, Stead D, Singata-Madliki M, et al. Acceptance of COVID-19 vaccine among the healthcare workers in the Eastern Cape, South Africa: a cross sectional study. Vaccines (Basel). 2021 [acesso em 2022 nov 20]; 9(6):666. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8233726/.
https://www.ncbi.nlm.nih.gov/pmc/article... se apresentaram com maiores índices de hesitação vacinal.

Os dados de caracterização dos artigos, como autoria, país e ano de publicação, foco, amostra, desfecho e nível de evidência foram descritos de acordo com o que se pode observar no quadro 1 a seguir.

A comparação entre as informações apontadas nos artigos também tornou possível categorizar os fatores associados à hesitação vacinal e à aceitação dos profissionais de saúde, em relação à vacinação contra a Covid-19.

Fatores associados à hesitação vacinal

Os dados provenientes dos artigos analisados possibilitaram a identificação de alguns fatores prevalentes, tais como: dúvidas sobre a eficácia das vacinas ²2 Ashok N, Krishnamurthy K, Singh K, et al. High COVID-19 Vaccine hesitancy among healthcare workers: should such a trend require closer attention by policymakers? Cureus. 2021 [acesso em 2022 nov 20]; 13(9):e17990. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8519358/pdf/cureus-0013-00000017990.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,¹¹11 Kara EB, Can G, Pirdal BZ, et al. COVID-19 vaccine hesitancy in healthcare personnel: a university hospital experience. Vaccines (Basel). 2021 [acesso em 2022 nov 20]; 9(11):1343. Disponível em: https://www.mdpi.com/2076-393X/9/11/1343.
https://www.mdpi.com/2076-393X/9/11/1343... ,¹⁷17 Yilma D, Mohammed R, Abdela SG, et al. COVID-19 vaccine acceptability among healthcare workers in Ethiopia: Do we practice what we preach? Trop Med Int Health. 2022 [acesso em 2022 nov 20]; 27(4):418-25. Disponível em: https://onlinelibrary.wiley.com/doi/10.1111/tmi.13742.
https://onlinelibrary.wiley.com/doi/10.1... ,¹⁹19 Wang H, Huang YM, Su XY, et al. Acceptance of the COVID-19 vaccine based on the health belief model: a multicenter national survey among medical care workers in China. Hum. vaccin. Immunother. 2022 [acesso em 2022 nov 20]; 18(5):2076523. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9481094/pdf/KHVI_18_2076523.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,²⁰20 Saddik B, Al-Bluwi N, Shukla A, et al. Determinants of healthcare workers perceptions, acceptance and choice of COVID-19 vaccines: a cross-sectional study from the United Arab Emirates. Hum. vaccin. Immunother. 2022 [acesso em 2022 nov 20]; 18(1):1-9. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8928822/pdf/KHVI_18_1994300.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,²⁴24 Mathur M, Verma A, Mathur N, et al. Predictors and perceptions of healthcare workers regarding vaccines safety in the initial phase of COVID-19 vaccination drive in western part of india: a regression analysis. Cureus. 2022 [acesso em 2022 nov 20]; 14(1):e21267. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8842488/.
https://www.ncbi.nlm.nih.gov/pmc/article... ,²⁵25 Maraqa B, Nazzal Z, Rabi R, et al. COVID-19 vaccine hesitancy among health care workers in Palestine: a call for action. Prev Med. 2021 [acesso em 2022 nov 20]; (149):106618. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8117476/pdf/main.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,²⁶26 Maqsood MB, Islam MA, Al Qarni A, et al. Assessment of COVID-19 vaccine acceptance and reluctance among staff working in public healthcare settings of Saudi Arabia: a multicenter study. Front Public Health. 2022 [acesso em 2022 Nov 20]; (10):847282. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9196634/pdf/fpubh-10-847282.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,²⁷27 Li G, Zhong Y, Htet H, et al. COVID-19 vaccine acceptance and associated factors among unvaccinated workers at a tertiary hospital in southern Thailand. Health Serv. Res. Manag. Epidemiol. 2022 [acesso em 2022 nov 20]; (9):-1-8. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8891901/pdf/10.1177_23333928221083057.pdf.
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https://www.ncbi.nlm.nih.gov/pmc/article... ,²⁹29 Kumar R, Alabdulla M, Elhassan NM, et al. Qatar healthcare workers’ COVID-19 vaccine hesitancy and attitudes: a national cross-sectional survey. Front Public Health. 2021 [acesso em 2022 nov 20]; (9):727748. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8424093/pdf/fpubh-09-727748.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,³¹31 Kose S, Mandiracioglu A, Sahin S, et al. Vaccine hesitancy of the COVID-19 by health care personnel. Int J Clin Pract. 2021 [acesso em 2022 nov 20]; 75(5):e13917. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7883260/pdf/IJCP-75-0.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,³³33 Hoffman BL, Boness CL, Chu KH, et al. COVID-19 vaccine hesitancy, acceptance, and promotion among healthcare workers: a mixed-methods analysis. J Community Health. 2022 [acesso em 2022 nov 20]; 47(5):750-8. Disponível em: https://link.springer.com/content/pdf/10.1007/s10900-022-01095-3.pdf?pdf=button.
https://link.springer.com/content/pdf/10... ,³⁴34 Halbrook M, Gadoth A, Martin-Blais R, et al. Longitudinal assessment of coronavirus disease 2019 vaccine acceptance and uptake among frontline medical workers in Los Angeles, California. Clin Infect Dis. 2022 [acesso em 2022 nov 20]; 74(7):1166-73. Disponível em: https://academic.oup.com/cid/article/74/7/1166/6325325?login=false.
https://academic.oup.com/cid/article/74/... ,³⁷37 Fares S, Elmnyer MM, Mohamed SS, et al. COVID-19 vaccination perception and attitude among healthcare workers in Egypt. J. Prim Care Community Health. 2021 [acesso em 2022 nov 20]; 12:1-9. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8111272/pdf/10.1177_21501327211013303.pdf.
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https://www.ncbi.nlm.nih.gov/pmc/article... , insegurança relacionada à escassez de estudos sobre vacinas contra a Covid-19 ²2 Ashok N, Krishnamurthy K, Singh K, et al. High COVID-19 Vaccine hesitancy among healthcare workers: should such a trend require closer attention by policymakers? Cureus. 2021 [acesso em 2022 nov 20]; 13(9):e17990. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8519358/pdf/cureus-0013-00000017990.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,¹⁷17 Yilma D, Mohammed R, Abdela SG, et al. COVID-19 vaccine acceptability among healthcare workers in Ethiopia: Do we practice what we preach? Trop Med Int Health. 2022 [acesso em 2022 nov 20]; 27(4):418-25. Disponível em: https://onlinelibrary.wiley.com/doi/10.1111/tmi.13742.
https://onlinelibrary.wiley.com/doi/10.1... ,¹⁹19 Wang H, Huang YM, Su XY, et al. Acceptance of the COVID-19 vaccine based on the health belief model: a multicenter national survey among medical care workers in China. Hum. vaccin. Immunother. 2022 [acesso em 2022 nov 20]; 18(5):2076523. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9481094/pdf/KHVI_18_2076523.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,²⁰20 Saddik B, Al-Bluwi N, Shukla A, et al. Determinants of healthcare workers perceptions, acceptance and choice of COVID-19 vaccines: a cross-sectional study from the United Arab Emirates. Hum. vaccin. Immunother. 2022 [acesso em 2022 nov 20]; 18(1):1-9. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8928822/pdf/KHVI_18_1994300.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,²¹21 Nomhwange T, Wariri O, Nkereuwem E, et al. COVID-19 vaccine hesitancy amongst healthcare workers: an assessment of its magnitude and determinants during the initial phase of national vaccine deployment in Nigeria. eClinicalMedicine. 2022 [acesso em 2022 nov 20]; (50):101499. Disponível em: https://www.thelancet.com/action/showPdf?pii=S2589-5370%2822%2900229-2.
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https://www.ncbi.nlm.nih.gov/pmc/article... ,²⁹29 Kumar R, Alabdulla M, Elhassan NM, et al. Qatar healthcare workers’ COVID-19 vaccine hesitancy and attitudes: a national cross-sectional survey. Front Public Health. 2021 [acesso em 2022 nov 20]; (9):727748. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8424093/pdf/fpubh-09-727748.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,³¹31 Kose S, Mandiracioglu A, Sahin S, et al. Vaccine hesitancy of the COVID-19 by health care personnel. Int J Clin Pract. 2021 [acesso em 2022 nov 20]; 75(5):e13917. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7883260/pdf/IJCP-75-0.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,³⁷37 Fares S, Elmnyer MM, Mohamed SS, et al. COVID-19 vaccination perception and attitude among healthcare workers in Egypt. J. Prim Care Community Health. 2021 [acesso em 2022 nov 20]; 12:1-9. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8111272/pdf/10.1177_21501327211013303.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,³⁸38 Dzieciolowska S, Hamel D, Gadio S, et al. Covid-19 vaccine acceptance, hesitancy, and refusal among Canadian healthcare workers: a multicenter survey. Am J Infect Control. 2021 [acesso em 2022 nov 20]; 49(9):1152-7. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8079260/pdf/main.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,⁴⁰40 Di Gennaro F, Murri R, Segala FV, et al. Attitudes towards Anti-SARS-CoV2 vaccination among healthcare workers: results from a national survey in Italy. Viruses. 2021 [acesso em 2022 nov 20]; 13(3):371. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7996832/.
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https://www.ncbi.nlm.nih.gov/pmc/article... e, de modo atrelado, medo de eventos adversos ou efeitos colaterais ¹⁰10 Janssen C, Maillard A, Bodelet C, et al. Hesitancy towards COVID-19 vaccination among healthcare workers: a multi-centric survey in france. Vaccines (Basel). 2021 [acesso em 2022 nov 20]; 9(6):547. Disponível em: https://www.mdpi.com/2076-393X/9/6/547.
https://www.mdpi.com/2076-393X/9/6/547... ,¹¹11 Kara EB, Can G, Pirdal BZ, et al. COVID-19 vaccine hesitancy in healthcare personnel: a university hospital experience. Vaccines (Basel). 2021 [acesso em 2022 nov 20]; 9(11):1343. Disponível em: https://www.mdpi.com/2076-393X/9/11/1343.
https://www.mdpi.com/2076-393X/9/11/1343... ,¹²12 Tuong VC, Thota KS, Reep M, et al. COVID-19 vaccine acceptance among rural appalachian healthcare workers (Eastern Kentucky/West Virginia): a cross-sectional study. Cureus. 2021 [acesso em 2022 nov 20]; 13(8):e16842. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8410864/pdf/cureus-0013-00000016842.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,¹⁹19 Wang H, Huang YM, Su XY, et al. Acceptance of the COVID-19 vaccine based on the health belief model: a multicenter national survey among medical care workers in China. Hum. vaccin. Immunother. 2022 [acesso em 2022 nov 20]; 18(5):2076523. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9481094/pdf/KHVI_18_2076523.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,²⁰20 Saddik B, Al-Bluwi N, Shukla A, et al. Determinants of healthcare workers perceptions, acceptance and choice of COVID-19 vaccines: a cross-sectional study from the United Arab Emirates. Hum. vaccin. Immunother. 2022 [acesso em 2022 nov 20]; 18(1):1-9. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8928822/pdf/KHVI_18_1994300.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,²²22 Öncel S, Alvur M, Çakıcı Ö. Turkish healthcare workers’ personal and parental attitudes to COVID-19 vaccination from a role modeling perspective. Cureus. 2022 [acesso em 2022 nov 20]; 14(2):e22555. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8958126/pdf/cureus-0014-00000022555.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,²³23 Moirangthem S, Olivier C, Gagneux-Brunon A, et al. Social conformism and confidence in systems as additional psychological antecedents of vaccination: a survey to explain intention for COVID-19 vaccination among healthcare and welfare sector workers, France, December 2020 to February 2021. Euro Surveill. 2022 [acesso em 2022 nov 20]; 27(17):2100617. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9052769/pdf/eurosurv-27-17-3.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,²⁵25 Maraqa B, Nazzal Z, Rabi R, et al. COVID-19 vaccine hesitancy among health care workers in Palestine: a call for action. Prev Med. 2021 [acesso em 2022 nov 20]; (149):106618. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8117476/pdf/main.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,²⁶26 Maqsood MB, Islam MA, Al Qarni A, et al. Assessment of COVID-19 vaccine acceptance and reluctance among staff working in public healthcare settings of Saudi Arabia: a multicenter study. Front Public Health. 2022 [acesso em 2022 Nov 20]; (10):847282. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9196634/pdf/fpubh-10-847282.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,³¹31 Kose S, Mandiracioglu A, Sahin S, et al. Vaccine hesitancy of the COVID-19 by health care personnel. Int J Clin Pract. 2021 [acesso em 2022 nov 20]; 75(5):e13917. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7883260/pdf/IJCP-75-0.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,³²32 İkiışık H, Sezerol MA, Taşçı Y, et al. COVID-19 vaccine hesitancy and related factors among primary healthcare workers in a district of Istanbul: a cross-sectional study from Turkey. Fam. Med. Community Health. 2022 [acesso em 2022 nov 20]; 10(2):e001430. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9039154/pdf/fmch-2021-001430.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,³³33 Hoffman BL, Boness CL, Chu KH, et al. COVID-19 vaccine hesitancy, acceptance, and promotion among healthcare workers: a mixed-methods analysis. J Community Health. 2022 [acesso em 2022 nov 20]; 47(5):750-8. Disponível em: https://link.springer.com/content/pdf/10.1007/s10900-022-01095-3.pdf?pdf=button.
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https://www.ncbi.nlm.nih.gov/pmc/article... ,⁸8 Amuzie CI, Odini F, Kalu KU, et al. COVID-19 vaccine hesitancy among healthcare workers and its socio-demographic determinants in Abia State, Southeastern Nigeria: a cross-sectional study. Pan Afr Med J. 2021 [acesso em 2022 nov 20]; (40):10. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8490164/pdf/PAMJ-40-10.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,¹⁸18 Yan YY, Wang HT, Fan TY, et al. Vaccination coverage among COVID-19 prevention and control management teams at primary healthcare facilities in China and their attitudes towards COVID-19 vaccine: a cross-sectional online survey. BMJ Open. 2022 [acesso em 2022 nov 20]; 12(4):e056345. Disponível em: https://bmjopen.bmj.com/content/12/4/e056345.long.
https://bmjopen.bmj.com/content/12/4/e05... ,¹⁹19 Wang H, Huang YM, Su XY, et al. Acceptance of the COVID-19 vaccine based on the health belief model: a multicenter national survey among medical care workers in China. Hum. vaccin. Immunother. 2022 [acesso em 2022 nov 20]; 18(5):2076523. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9481094/pdf/KHVI_18_2076523.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,²¹21 Nomhwange T, Wariri O, Nkereuwem E, et al. COVID-19 vaccine hesitancy amongst healthcare workers: an assessment of its magnitude and determinants during the initial phase of national vaccine deployment in Nigeria. eClinicalMedicine. 2022 [acesso em 2022 nov 20]; (50):101499. Disponível em: https://www.thelancet.com/action/showPdf?pii=S2589-5370%2822%2900229-2.
https://www.thelancet.com/action/showPdf... ,⁴⁰40 Di Gennaro F, Murri R, Segala FV, et al. Attitudes towards Anti-SARS-CoV2 vaccination among healthcare workers: results from a national survey in Italy. Viruses. 2021 [acesso em 2022 nov 20]; 13(3):371. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7996832/.
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https://www.ncbi.nlm.nih.gov/pmc/article... .

Alguns fatores foram identificados com menor prevalência, tais como: preocupações relacionadas com a gravidez e a lactação ¹²12 Tuong VC, Thota KS, Reep M, et al. COVID-19 vaccine acceptance among rural appalachian healthcare workers (Eastern Kentucky/West Virginia): a cross-sectional study. Cureus. 2021 [acesso em 2022 nov 20]; 13(8):e16842. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8410864/pdf/cureus-0013-00000016842.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,¹⁷17 Yilma D, Mohammed R, Abdela SG, et al. COVID-19 vaccine acceptability among healthcare workers in Ethiopia: Do we practice what we preach? Trop Med Int Health. 2022 [acesso em 2022 nov 20]; 27(4):418-25. Disponível em: https://onlinelibrary.wiley.com/doi/10.1111/tmi.13742.
https://onlinelibrary.wiley.com/doi/10.1... ,²¹21 Nomhwange T, Wariri O, Nkereuwem E, et al. COVID-19 vaccine hesitancy amongst healthcare workers: an assessment of its magnitude and determinants during the initial phase of national vaccine deployment in Nigeria. eClinicalMedicine. 2022 [acesso em 2022 nov 20]; (50):101499. Disponível em: https://www.thelancet.com/action/showPdf?pii=S2589-5370%2822%2900229-2.
https://www.thelancet.com/action/showPdf... ,³³33 Hoffman BL, Boness CL, Chu KH, et al. COVID-19 vaccine hesitancy, acceptance, and promotion among healthcare workers: a mixed-methods analysis. J Community Health. 2022 [acesso em 2022 nov 20]; 47(5):750-8. Disponível em: https://link.springer.com/content/pdf/10.1007/s10900-022-01095-3.pdf?pdf=button.
https://link.springer.com/content/pdf/10... , não obrigatoriedade do uso das vacinas ¹⁰10 Janssen C, Maillard A, Bodelet C, et al. Hesitancy towards COVID-19 vaccination among healthcare workers: a multi-centric survey in france. Vaccines (Basel). 2021 [acesso em 2022 nov 20]; 9(6):547. Disponível em: https://www.mdpi.com/2076-393X/9/6/547.
https://www.mdpi.com/2076-393X/9/6/547... ,²²22 Öncel S, Alvur M, Çakıcı Ö. Turkish healthcare workers’ personal and parental attitudes to COVID-19 vaccination from a role modeling perspective. Cureus. 2022 [acesso em 2022 nov 20]; 14(2):e22555. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8958126/pdf/cureus-0014-00000022555.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,³³33 Hoffman BL, Boness CL, Chu KH, et al. COVID-19 vaccine hesitancy, acceptance, and promotion among healthcare workers: a mixed-methods analysis. J Community Health. 2022 [acesso em 2022 nov 20]; 47(5):750-8. Disponível em: https://link.springer.com/content/pdf/10.1007/s10900-022-01095-3.pdf?pdf=button.
https://link.springer.com/content/pdf/10... ,³⁷37 Fares S, Elmnyer MM, Mohamed SS, et al. COVID-19 vaccination perception and attitude among healthcare workers in Egypt. J. Prim Care Community Health. 2021 [acesso em 2022 nov 20]; 12:1-9. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8111272/pdf/10.1177_21501327211013303.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... , questões políticas associadas às vacinas contra a Covid-19 ³³33 Hoffman BL, Boness CL, Chu KH, et al. COVID-19 vaccine hesitancy, acceptance, and promotion among healthcare workers: a mixed-methods analysis. J Community Health. 2022 [acesso em 2022 nov 20]; 47(5):750-8. Disponível em: https://link.springer.com/content/pdf/10.1007/s10900-022-01095-3.pdf?pdf=button.
https://link.springer.com/content/pdf/10... ,³⁴34 Halbrook M, Gadoth A, Martin-Blais R, et al. Longitudinal assessment of coronavirus disease 2019 vaccine acceptance and uptake among frontline medical workers in Los Angeles, California. Clin Infect Dis. 2022 [acesso em 2022 nov 20]; 74(7):1166-73. Disponível em: https://academic.oup.com/cid/article/74/7/1166/6325325?login=false.
https://academic.oup.com/cid/article/74/... ,³⁹39 Dubov A, Distelberg BJ, Abdul-Mutakabbir JC, et al. Predictors of COVID-19 vaccine acceptance and hesitancy among healthcare workers in southern California: not just “anti” vs. “pro” vaccine. Vaccines (Basel). 2021 [acesso em 2022 nov 20]; 9(12):1428. Disponível em: https://www.mdpi.com/2076-393X/9/12/1428.
https://www.mdpi.com/2076-393X/9/12/1428... , crenças em informes associados à conspiração ¹⁷17 Yilma D, Mohammed R, Abdela SG, et al. COVID-19 vaccine acceptability among healthcare workers in Ethiopia: Do we practice what we preach? Trop Med Int Health. 2022 [acesso em 2022 nov 20]; 27(4):418-25. Disponível em: https://onlinelibrary.wiley.com/doi/10.1111/tmi.13742.
https://onlinelibrary.wiley.com/doi/10.1... ,³⁹39 Dubov A, Distelberg BJ, Abdul-Mutakabbir JC, et al. Predictors of COVID-19 vaccine acceptance and hesitancy among healthcare workers in southern California: not just “anti” vs. “pro” vaccine. Vaccines (Basel). 2021 [acesso em 2022 nov 20]; 9(12):1428. Disponível em: https://www.mdpi.com/2076-393X/9/12/1428.
https://www.mdpi.com/2076-393X/9/12/1428... , questionamentos relacionados à duração do efeito protetivo das vacinas ³¹31 Kose S, Mandiracioglu A, Sahin S, et al. Vaccine hesitancy of the COVID-19 by health care personnel. Int J Clin Pract. 2021 [acesso em 2022 nov 20]; 75(5):e13917. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7883260/pdf/IJCP-75-0.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,³⁸38 Dzieciolowska S, Hamel D, Gadio S, et al. Covid-19 vaccine acceptance, hesitancy, and refusal among Canadian healthcare workers: a multicenter survey. Am J Infect Control. 2021 [acesso em 2022 nov 20]; 49(9):1152-7. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8079260/pdf/main.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... , preocupações com questões de acesso à vacinação ¹⁹19 Wang H, Huang YM, Su XY, et al. Acceptance of the COVID-19 vaccine based on the health belief model: a multicenter national survey among medical care workers in China. Hum. vaccin. Immunother. 2022 [acesso em 2022 nov 20]; 18(5):2076523. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9481094/pdf/KHVI_18_2076523.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,³³33 Hoffman BL, Boness CL, Chu KH, et al. COVID-19 vaccine hesitancy, acceptance, and promotion among healthcare workers: a mixed-methods analysis. J Community Health. 2022 [acesso em 2022 nov 20]; 47(5):750-8. Disponível em: https://link.springer.com/content/pdf/10.1007/s10900-022-01095-3.pdf?pdf=button.
https://link.springer.com/content/pdf/10... , acometimentos anteriores da própria Covid-19 ¹¹11 Kara EB, Can G, Pirdal BZ, et al. COVID-19 vaccine hesitancy in healthcare personnel: a university hospital experience. Vaccines (Basel). 2021 [acesso em 2022 nov 20]; 9(11):1343. Disponível em: https://www.mdpi.com/2076-393X/9/11/1343.
https://www.mdpi.com/2076-393X/9/11/1343... ,²⁴24 Mathur M, Verma A, Mathur N, et al. Predictors and perceptions of healthcare workers regarding vaccines safety in the initial phase of COVID-19 vaccination drive in western part of india: a regression analysis. Cureus. 2022 [acesso em 2022 nov 20]; 14(1):e21267. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8842488/.
https://www.ncbi.nlm.nih.gov/pmc/article... , tempo insuficiente para a avaliação dos benefícios da vacina e para o reforço da tomada de decisão ³⁰30 Koh SWC, Liow Y, Loh VWK, et al. COVID-19 vaccine acceptance and hesitancy among primary healthcare workers in Singapore. BMC Prim Care. 2022 [acesso em 2022 nov 20]; 23(1):81. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9010198/pdf/12875_2022_Article_1693.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,³⁸38 Dzieciolowska S, Hamel D, Gadio S, et al. Covid-19 vaccine acceptance, hesitancy, and refusal among Canadian healthcare workers: a multicenter survey. Am J Infect Control. 2021 [acesso em 2022 nov 20]; 49(9):1152-7. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8079260/pdf/main.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... , e crença no risco de infertilidade ¹⁴14 Tricco AC, Lillie E, Zarin W, et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and explanation. Ann Intern Med. 2018 [acesso em 2023 abr 14]; 169(7):467-73. Disponível em: https://www.acpjournals.org/doi/full/10.7326/M18-0850?rfr_dat=cr_pub++0pubmed&url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org.
https://www.acpjournals.org/doi/full/10.... ,²⁹29 Kumar R, Alabdulla M, Elhassan NM, et al. Qatar healthcare workers’ COVID-19 vaccine hesitancy and attitudes: a national cross-sectional survey. Front Public Health. 2021 [acesso em 2022 nov 20]; (9):727748. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8424093/pdf/fpubh-09-727748.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... .

Fatores que favorecem a aceitação dos profissionais de saúde em relação à vacinação contra a Covid-19

Entre os fatores que favoreceram a aceitação de vacinas contra a Covid-19, sobressaíram-se questões como: vacinação anterior contra a influenza ²2 Ashok N, Krishnamurthy K, Singh K, et al. High COVID-19 Vaccine hesitancy among healthcare workers: should such a trend require closer attention by policymakers? Cureus. 2021 [acesso em 2022 nov 20]; 13(9):e17990. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8519358/pdf/cureus-0013-00000017990.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,¹¹11 Kara EB, Can G, Pirdal BZ, et al. COVID-19 vaccine hesitancy in healthcare personnel: a university hospital experience. Vaccines (Basel). 2021 [acesso em 2022 nov 20]; 9(11):1343. Disponível em: https://www.mdpi.com/2076-393X/9/11/1343.
https://www.mdpi.com/2076-393X/9/11/1343... ,¹²12 Tuong VC, Thota KS, Reep M, et al. COVID-19 vaccine acceptance among rural appalachian healthcare workers (Eastern Kentucky/West Virginia): a cross-sectional study. Cureus. 2021 [acesso em 2022 nov 20]; 13(8):e16842. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8410864/pdf/cureus-0013-00000016842.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,²⁰20 Saddik B, Al-Bluwi N, Shukla A, et al. Determinants of healthcare workers perceptions, acceptance and choice of COVID-19 vaccines: a cross-sectional study from the United Arab Emirates. Hum. vaccin. Immunother. 2022 [acesso em 2022 nov 20]; 18(1):1-9. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8928822/pdf/KHVI_18_1994300.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,²³23 Moirangthem S, Olivier C, Gagneux-Brunon A, et al. Social conformism and confidence in systems as additional psychological antecedents of vaccination: a survey to explain intention for COVID-19 vaccination among healthcare and welfare sector workers, France, December 2020 to February 2021. Euro Surveill. 2022 [acesso em 2022 nov 20]; 27(17):2100617. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9052769/pdf/eurosurv-27-17-3.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,²⁵25 Maraqa B, Nazzal Z, Rabi R, et al. COVID-19 vaccine hesitancy among health care workers in Palestine: a call for action. Prev Med. 2021 [acesso em 2022 nov 20]; (149):106618. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8117476/pdf/main.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,²⁶26 Maqsood MB, Islam MA, Al Qarni A, et al. Assessment of COVID-19 vaccine acceptance and reluctance among staff working in public healthcare settings of Saudi Arabia: a multicenter study. Front Public Health. 2022 [acesso em 2022 Nov 20]; (10):847282. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9196634/pdf/fpubh-10-847282.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,³⁰30 Koh SWC, Liow Y, Loh VWK, et al. COVID-19 vaccine acceptance and hesitancy among primary healthcare workers in Singapore. BMC Prim Care. 2022 [acesso em 2022 nov 20]; 23(1):81. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9010198/pdf/12875_2022_Article_1693.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,³¹31 Kose S, Mandiracioglu A, Sahin S, et al. Vaccine hesitancy of the COVID-19 by health care personnel. Int J Clin Pract. 2021 [acesso em 2022 nov 20]; 75(5):e13917. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7883260/pdf/IJCP-75-0.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,³⁵35 Gatto NM, Lee JE, Massai D, et al. Correlates of COVID-19 vaccine acceptance, hesitancy and refusal among employees of a safety net California county health system with an early and aggressive vaccination program: results from a cross-sectional survey. Vaccines (Basel). 2021 [acesso em 2022 nov 20]; 9(10):1152. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8540702/pdf/vaccines-09-01152.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,³⁶36 Gagneux-Brunon A, Detoc M, Bruel S, et al. Intention to get vaccinations against COVID-19 in french healthcare workers during the first pandemic wave: a cross-sectional survey. J Hosp Infect. 2021 [acesso em 2022 nov 20]; (108):168-73. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7699157/pdf/main.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,³⁹39 Dubov A, Distelberg BJ, Abdul-Mutakabbir JC, et al. Predictors of COVID-19 vaccine acceptance and hesitancy among healthcare workers in southern California: not just “anti” vs. “pro” vaccine. Vaccines (Basel). 2021 [acesso em 2022 nov 20]; 9(12):1428. Disponível em: https://www.mdpi.com/2076-393X/9/12/1428.
https://www.mdpi.com/2076-393X/9/12/1428... ,⁴⁰40 Di Gennaro F, Murri R, Segala FV, et al. Attitudes towards Anti-SARS-CoV2 vaccination among healthcare workers: results from a national survey in Italy. Viruses. 2021 [acesso em 2022 nov 20]; 13(3):371. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7996832/.
https://www.ncbi.nlm.nih.gov/pmc/article... ,⁴¹41 Barello S, Maiorino G, Palamenghi L, et al. Exploring the motivational roots of getting vaccinated against COVID-19 in a population of vaccinated pediatric healthcare professionals: evidence from an Italian cross-sectional study. Vaccines (Basel). 2022 [acesso em 2022 nov 20]; 10(3):467. Disponível em: https://www.mdpi.com/2076-393X/10/3/467.
https://www.mdpi.com/2076-393X/10/3/467... ,⁴⁴44 Askarian M, Semenov A, Llopis F, et al. The COVID-19 vaccination acceptance/hesitancy rate and its determinants among healthcare workers of 91 countries: a multicenter cross-sectional study. EXCLI J. 2022 [acesso em 2022 nov 20]; (21):93-103. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8859647/pdf/EXCLI-21-93.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... , confiança na produção e na eficácia das vacinas contra a Covid-19 ⁵5 Briko NI, Korshunov VA, Mindlina AY, et al. Healthcare workers’ acceptance of COVID-19 vaccination in Russia. Int J Environ Res Public Health. 2022 [acesso em 2022 nov 20]; 19(7):4136. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8998926/pdf/ijerph-19-04136.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,¹⁷17 Yilma D, Mohammed R, Abdela SG, et al. COVID-19 vaccine acceptability among healthcare workers in Ethiopia: Do we practice what we preach? Trop Med Int Health. 2022 [acesso em 2022 nov 20]; 27(4):418-25. Disponível em: https://onlinelibrary.wiley.com/doi/10.1111/tmi.13742.
https://onlinelibrary.wiley.com/doi/10.1... ,¹⁹19 Wang H, Huang YM, Su XY, et al. Acceptance of the COVID-19 vaccine based on the health belief model: a multicenter national survey among medical care workers in China. Hum. vaccin. Immunother. 2022 [acesso em 2022 nov 20]; 18(5):2076523. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9481094/pdf/KHVI_18_2076523.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,²⁰20 Saddik B, Al-Bluwi N, Shukla A, et al. Determinants of healthcare workers perceptions, acceptance and choice of COVID-19 vaccines: a cross-sectional study from the United Arab Emirates. Hum. vaccin. Immunother. 2022 [acesso em 2022 nov 20]; 18(1):1-9. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8928822/pdf/KHVI_18_1994300.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,²²22 Öncel S, Alvur M, Çakıcı Ö. Turkish healthcare workers’ personal and parental attitudes to COVID-19 vaccination from a role modeling perspective. Cureus. 2022 [acesso em 2022 nov 20]; 14(2):e22555. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8958126/pdf/cureus-0014-00000022555.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,²³23 Moirangthem S, Olivier C, Gagneux-Brunon A, et al. Social conformism and confidence in systems as additional psychological antecedents of vaccination: a survey to explain intention for COVID-19 vaccination among healthcare and welfare sector workers, France, December 2020 to February 2021. Euro Surveill. 2022 [acesso em 2022 nov 20]; 27(17):2100617. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9052769/pdf/eurosurv-27-17-3.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,²⁴24 Mathur M, Verma A, Mathur N, et al. Predictors and perceptions of healthcare workers regarding vaccines safety in the initial phase of COVID-19 vaccination drive in western part of india: a regression analysis. Cureus. 2022 [acesso em 2022 nov 20]; 14(1):e21267. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8842488/.
https://www.ncbi.nlm.nih.gov/pmc/article... ,²⁷27 Li G, Zhong Y, Htet H, et al. COVID-19 vaccine acceptance and associated factors among unvaccinated workers at a tertiary hospital in southern Thailand. Health Serv. Res. Manag. Epidemiol. 2022 [acesso em 2022 nov 20]; (9):-1-8. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8891901/pdf/10.1177_23333928221083057.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,²⁹29 Kumar R, Alabdulla M, Elhassan NM, et al. Qatar healthcare workers’ COVID-19 vaccine hesitancy and attitudes: a national cross-sectional survey. Front Public Health. 2021 [acesso em 2022 nov 20]; (9):727748. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8424093/pdf/fpubh-09-727748.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,³²32 İkiışık H, Sezerol MA, Taşçı Y, et al. COVID-19 vaccine hesitancy and related factors among primary healthcare workers in a district of Istanbul: a cross-sectional study from Turkey. Fam. Med. Community Health. 2022 [acesso em 2022 nov 20]; 10(2):e001430. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9039154/pdf/fmch-2021-001430.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,³³33 Hoffman BL, Boness CL, Chu KH, et al. COVID-19 vaccine hesitancy, acceptance, and promotion among healthcare workers: a mixed-methods analysis. J Community Health. 2022 [acesso em 2022 nov 20]; 47(5):750-8. Disponível em: https://link.springer.com/content/pdf/10.1007/s10900-022-01095-3.pdf?pdf=button.
https://link.springer.com/content/pdf/10... ,³⁴34 Halbrook M, Gadoth A, Martin-Blais R, et al. Longitudinal assessment of coronavirus disease 2019 vaccine acceptance and uptake among frontline medical workers in Los Angeles, California. Clin Infect Dis. 2022 [acesso em 2022 nov 20]; 74(7):1166-73. Disponível em: https://academic.oup.com/cid/article/74/7/1166/6325325?login=false.
https://academic.oup.com/cid/article/74/... ,³⁷37 Fares S, Elmnyer MM, Mohamed SS, et al. COVID-19 vaccination perception and attitude among healthcare workers in Egypt. J. Prim Care Community Health. 2021 [acesso em 2022 nov 20]; 12:1-9. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8111272/pdf/10.1177_21501327211013303.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,³⁸38 Dzieciolowska S, Hamel D, Gadio S, et al. Covid-19 vaccine acceptance, hesitancy, and refusal among Canadian healthcare workers: a multicenter survey. Am J Infect Control. 2021 [acesso em 2022 nov 20]; 49(9):1152-7. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8079260/pdf/main.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... , receio de riscos por contágio/exposição à Covid-19 ⁵5 Briko NI, Korshunov VA, Mindlina AY, et al. Healthcare workers’ acceptance of COVID-19 vaccination in Russia. Int J Environ Res Public Health. 2022 [acesso em 2022 nov 20]; 19(7):4136. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8998926/pdf/ijerph-19-04136.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,⁷7 Al-Sanafi M, Sallam M. Psychological determinants of COVID-19 vaccine acceptance among healthcare workers in kuwait: a cross-sectional study using the 5c and vaccine conspiracy beliefs scales. Vaccines (Basel). 2021 [acesso em 2022 nov 20]; 9(7):701. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8310287/pdf/vaccines-09-00701.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,¹⁹19 Wang H, Huang YM, Su XY, et al. Acceptance of the COVID-19 vaccine based on the health belief model: a multicenter national survey among medical care workers in China. Hum. vaccin. Immunother. 2022 [acesso em 2022 nov 20]; 18(5):2076523. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9481094/pdf/KHVI_18_2076523.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,²²22 Öncel S, Alvur M, Çakıcı Ö. Turkish healthcare workers’ personal and parental attitudes to COVID-19 vaccination from a role modeling perspective. Cureus. 2022 [acesso em 2022 nov 20]; 14(2):e22555. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8958126/pdf/cureus-0014-00000022555.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,²⁴24 Mathur M, Verma A, Mathur N, et al. Predictors and perceptions of healthcare workers regarding vaccines safety in the initial phase of COVID-19 vaccination drive in western part of india: a regression analysis. Cureus. 2022 [acesso em 2022 nov 20]; 14(1):e21267. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8842488/.
https://www.ncbi.nlm.nih.gov/pmc/article... ,²⁵25 Maraqa B, Nazzal Z, Rabi R, et al. COVID-19 vaccine hesitancy among health care workers in Palestine: a call for action. Prev Med. 2021 [acesso em 2022 nov 20]; (149):106618. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8117476/pdf/main.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,²⁹29 Kumar R, Alabdulla M, Elhassan NM, et al. Qatar healthcare workers’ COVID-19 vaccine hesitancy and attitudes: a national cross-sectional survey. Front Public Health. 2021 [acesso em 2022 nov 20]; (9):727748. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8424093/pdf/fpubh-09-727748.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,³⁰30 Koh SWC, Liow Y, Loh VWK, et al. COVID-19 vaccine acceptance and hesitancy among primary healthcare workers in Singapore. BMC Prim Care. 2022 [acesso em 2022 nov 20]; 23(1):81. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9010198/pdf/12875_2022_Article_1693.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,³⁶36 Gagneux-Brunon A, Detoc M, Bruel S, et al. Intention to get vaccinations against COVID-19 in french healthcare workers during the first pandemic wave: a cross-sectional survey. J Hosp Infect. 2021 [acesso em 2022 nov 20]; (108):168-73. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7699157/pdf/main.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,³⁷37 Fares S, Elmnyer MM, Mohamed SS, et al. COVID-19 vaccination perception and attitude among healthcare workers in Egypt. J. Prim Care Community Health. 2021 [acesso em 2022 nov 20]; 12:1-9. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8111272/pdf/10.1177_21501327211013303.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,³⁸38 Dzieciolowska S, Hamel D, Gadio S, et al. Covid-19 vaccine acceptance, hesitancy, and refusal among Canadian healthcare workers: a multicenter survey. Am J Infect Control. 2021 [acesso em 2022 nov 20]; 49(9):1152-7. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8079260/pdf/main.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,⁴¹41 Barello S, Maiorino G, Palamenghi L, et al. Exploring the motivational roots of getting vaccinated against COVID-19 in a population of vaccinated pediatric healthcare professionals: evidence from an Italian cross-sectional study. Vaccines (Basel). 2022 [acesso em 2022 nov 20]; 10(3):467. Disponível em: https://www.mdpi.com/2076-393X/10/3/467.
https://www.mdpi.com/2076-393X/10/3/467... e infecção anterior por Covid-19 ¹¹11 Kara EB, Can G, Pirdal BZ, et al. COVID-19 vaccine hesitancy in healthcare personnel: a university hospital experience. Vaccines (Basel). 2021 [acesso em 2022 nov 20]; 9(11):1343. Disponível em: https://www.mdpi.com/2076-393X/9/11/1343.
https://www.mdpi.com/2076-393X/9/11/1343... ,¹⁷17 Yilma D, Mohammed R, Abdela SG, et al. COVID-19 vaccine acceptability among healthcare workers in Ethiopia: Do we practice what we preach? Trop Med Int Health. 2022 [acesso em 2022 nov 20]; 27(4):418-25. Disponível em: https://onlinelibrary.wiley.com/doi/10.1111/tmi.13742.
https://onlinelibrary.wiley.com/doi/10.1... ,²³23 Moirangthem S, Olivier C, Gagneux-Brunon A, et al. Social conformism and confidence in systems as additional psychological antecedents of vaccination: a survey to explain intention for COVID-19 vaccination among healthcare and welfare sector workers, France, December 2020 to February 2021. Euro Surveill. 2022 [acesso em 2022 nov 20]; 27(17):2100617. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9052769/pdf/eurosurv-27-17-3.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,²⁴24 Mathur M, Verma A, Mathur N, et al. Predictors and perceptions of healthcare workers regarding vaccines safety in the initial phase of COVID-19 vaccination drive in western part of india: a regression analysis. Cureus. 2022 [acesso em 2022 nov 20]; 14(1):e21267. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8842488/.
https://www.ncbi.nlm.nih.gov/pmc/article... ,³³33 Hoffman BL, Boness CL, Chu KH, et al. COVID-19 vaccine hesitancy, acceptance, and promotion among healthcare workers: a mixed-methods analysis. J Community Health. 2022 [acesso em 2022 nov 20]; 47(5):750-8. Disponível em: https://link.springer.com/content/pdf/10.1007/s10900-022-01095-3.pdf?pdf=button.
https://link.springer.com/content/pdf/10... , além de adesão às vacinas contra a Covid-19 ampliando a recomendação destas a outras pessoas ⁵5 Briko NI, Korshunov VA, Mindlina AY, et al. Healthcare workers’ acceptance of COVID-19 vaccination in Russia. Int J Environ Res Public Health. 2022 [acesso em 2022 nov 20]; 19(7):4136. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8998926/pdf/ijerph-19-04136.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,¹⁷17 Yilma D, Mohammed R, Abdela SG, et al. COVID-19 vaccine acceptability among healthcare workers in Ethiopia: Do we practice what we preach? Trop Med Int Health. 2022 [acesso em 2022 nov 20]; 27(4):418-25. Disponível em: https://onlinelibrary.wiley.com/doi/10.1111/tmi.13742.
https://onlinelibrary.wiley.com/doi/10.1... ,²⁷27 Li G, Zhong Y, Htet H, et al. COVID-19 vaccine acceptance and associated factors among unvaccinated workers at a tertiary hospital in southern Thailand. Health Serv. Res. Manag. Epidemiol. 2022 [acesso em 2022 nov 20]; (9):-1-8. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8891901/pdf/10.1177_23333928221083057.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,³⁵35 Gatto NM, Lee JE, Massai D, et al. Correlates of COVID-19 vaccine acceptance, hesitancy and refusal among employees of a safety net California county health system with an early and aggressive vaccination program: results from a cross-sectional survey. Vaccines (Basel). 2021 [acesso em 2022 nov 20]; 9(10):1152. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8540702/pdf/vaccines-09-01152.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,³⁸38 Dzieciolowska S, Hamel D, Gadio S, et al. Covid-19 vaccine acceptance, hesitancy, and refusal among Canadian healthcare workers: a multicenter survey. Am J Infect Control. 2021 [acesso em 2022 nov 20]; 49(9):1152-7. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8079260/pdf/main.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... . Em menor proporção, foram observados fatores como: fontes seguras de informações ²2 Ashok N, Krishnamurthy K, Singh K, et al. High COVID-19 Vaccine hesitancy among healthcare workers: should such a trend require closer attention by policymakers? Cureus. 2021 [acesso em 2022 nov 20]; 13(9):e17990. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8519358/pdf/cureus-0013-00000017990.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,²²22 Öncel S, Alvur M, Çakıcı Ö. Turkish healthcare workers’ personal and parental attitudes to COVID-19 vaccination from a role modeling perspective. Cureus. 2022 [acesso em 2022 nov 20]; 14(2):e22555. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8958126/pdf/cureus-0014-00000022555.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,²⁵25 Maraqa B, Nazzal Z, Rabi R, et al. COVID-19 vaccine hesitancy among health care workers in Palestine: a call for action. Prev Med. 2021 [acesso em 2022 nov 20]; (149):106618. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8117476/pdf/main.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,³⁷37 Fares S, Elmnyer MM, Mohamed SS, et al. COVID-19 vaccination perception and attitude among healthcare workers in Egypt. J. Prim Care Community Health. 2021 [acesso em 2022 nov 20]; 12:1-9. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8111272/pdf/10.1177_21501327211013303.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... , crença em saúde ¹⁰10 Janssen C, Maillard A, Bodelet C, et al. Hesitancy towards COVID-19 vaccination among healthcare workers: a multi-centric survey in france. Vaccines (Basel). 2021 [acesso em 2022 nov 20]; 9(6):547. Disponível em: https://www.mdpi.com/2076-393X/9/6/547.
https://www.mdpi.com/2076-393X/9/6/547... ,¹⁹19 Wang H, Huang YM, Su XY, et al. Acceptance of the COVID-19 vaccine based on the health belief model: a multicenter national survey among medical care workers in China. Hum. vaccin. Immunother. 2022 [acesso em 2022 nov 20]; 18(5):2076523. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9481094/pdf/KHVI_18_2076523.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,²⁷27 Li G, Zhong Y, Htet H, et al. COVID-19 vaccine acceptance and associated factors among unvaccinated workers at a tertiary hospital in southern Thailand. Health Serv. Res. Manag. Epidemiol. 2022 [acesso em 2022 nov 20]; (9):-1-8. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8891901/pdf/10.1177_23333928221083057.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,⁴¹41 Barello S, Maiorino G, Palamenghi L, et al. Exploring the motivational roots of getting vaccinated against COVID-19 in a population of vaccinated pediatric healthcare professionals: evidence from an Italian cross-sectional study. Vaccines (Basel). 2022 [acesso em 2022 nov 20]; 10(3):467. Disponível em: https://www.mdpi.com/2076-393X/10/3/467.
https://www.mdpi.com/2076-393X/10/3/467... , cargo ou função desempenhada no período da pandemia ²⁶26 Maqsood MB, Islam MA, Al Qarni A, et al. Assessment of COVID-19 vaccine acceptance and reluctance among staff working in public healthcare settings of Saudi Arabia: a multicenter study. Front Public Health. 2022 [acesso em 2022 Nov 20]; (10):847282. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9196634/pdf/fpubh-10-847282.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,³⁰30 Koh SWC, Liow Y, Loh VWK, et al. COVID-19 vaccine acceptance and hesitancy among primary healthcare workers in Singapore. BMC Prim Care. 2022 [acesso em 2022 nov 20]; 23(1):81. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9010198/pdf/12875_2022_Article_1693.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,³⁵35 Gatto NM, Lee JE, Massai D, et al. Correlates of COVID-19 vaccine acceptance, hesitancy and refusal among employees of a safety net California county health system with an early and aggressive vaccination program: results from a cross-sectional survey. Vaccines (Basel). 2021 [acesso em 2022 nov 20]; 9(10):1152. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8540702/pdf/vaccines-09-01152.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... , maior compreensão da doença ²⁵25 Maraqa B, Nazzal Z, Rabi R, et al. COVID-19 vaccine hesitancy among health care workers in Palestine: a call for action. Prev Med. 2021 [acesso em 2022 nov 20]; (149):106618. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8117476/pdf/main.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,²⁹29 Kumar R, Alabdulla M, Elhassan NM, et al. Qatar healthcare workers’ COVID-19 vaccine hesitancy and attitudes: a national cross-sectional survey. Front Public Health. 2021 [acesso em 2022 nov 20]; (9):727748. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8424093/pdf/fpubh-09-727748.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... , confiança nos programas de imunização ¹⁹19 Wang H, Huang YM, Su XY, et al. Acceptance of the COVID-19 vaccine based on the health belief model: a multicenter national survey among medical care workers in China. Hum. vaccin. Immunother. 2022 [acesso em 2022 nov 20]; 18(5):2076523. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9481094/pdf/KHVI_18_2076523.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,²³23 Moirangthem S, Olivier C, Gagneux-Brunon A, et al. Social conformism and confidence in systems as additional psychological antecedents of vaccination: a survey to explain intention for COVID-19 vaccination among healthcare and welfare sector workers, France, December 2020 to February 2021. Euro Surveill. 2022 [acesso em 2022 nov 20]; 27(17):2100617. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9052769/pdf/eurosurv-27-17-3.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... e influência de familiares/amigos ³⁵35 Gatto NM, Lee JE, Massai D, et al. Correlates of COVID-19 vaccine acceptance, hesitancy and refusal among employees of a safety net California county health system with an early and aggressive vaccination program: results from a cross-sectional survey. Vaccines (Basel). 2021 [acesso em 2022 nov 20]; 9(10):1152. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8540702/pdf/vaccines-09-01152.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... .

Discussão

A hesitação vacinal atualmente é considerada como um problema de saúde pública. Especialmente quando se trata de hesitação vacinal contra a Covid-19 entre profissionais de saúde, devido à responsabilidade que eles deveriam assumir em relação à promoção da vacinação entre a população ⁷7 Al-Sanafi M, Sallam M. Psychological determinants of COVID-19 vaccine acceptance among healthcare workers in kuwait: a cross-sectional study using the 5c and vaccine conspiracy beliefs scales. Vaccines (Basel). 2021 [acesso em 2022 nov 20]; 9(7):701. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8310287/pdf/vaccines-09-00701.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,⁴⁰40 Di Gennaro F, Murri R, Segala FV, et al. Attitudes towards Anti-SARS-CoV2 vaccination among healthcare workers: results from a national survey in Italy. Viruses. 2021 [acesso em 2022 nov 20]; 13(3):371. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7996832/.
https://www.ncbi.nlm.nih.gov/pmc/article... .

No Brasil, ainda que a APS ¹⁸18 Yan YY, Wang HT, Fan TY, et al. Vaccination coverage among COVID-19 prevention and control management teams at primary healthcare facilities in China and their attitudes towards COVID-19 vaccine: a cross-sectional online survey. BMJ Open. 2022 [acesso em 2022 nov 20]; 12(4):e056345. Disponível em: https://bmjopen.bmj.com/content/12/4/e056345.long.
https://bmjopen.bmj.com/content/12/4/e05... seja o campo de maior circulação de vacinadores e da própria população em busca de vacinas contra a Covid-19, ocorrendo em Unidades Básicas de Saúde ou em Unidades de Saúde da Família ⁴⁵45 Brasília, DF. Secretaria de Estado de Saúde do Distrito Federal. Plano operacional de vacinação contra COVID-19. [Brasília, DF]: SES-DF; 2021. [acesso em 2022 nov 20]. Disponível em: https://www.saude.df.gov.br/documents/37101/98481/Plano_54453103_PLANO_OPERACIONAL_DE__VACINACAO_CONTRA_A_COVID_19_versao_2-1.pdf.
https://www.saude.df.gov.br/documents/37... , cabe destacar o fato de que existem poucos estudos sobre hesitação ou aceitação vacinal, o que dificulta a percepção do posicionamento tomado pelos profissionais diretamente envolvidos com a vacinação nesse âmbito.

Em relação aos fatores que interferem no processo de decisão vacinal dos profissionais de saúde, puderam ser observadas algumas similaridades entre alguns estudos, no que diz respeito à maior tendência de aceitação vacinal dos profissionais de saúde do sexo masculino, com idades mais avançadas, maiores índices de escolaridade e casados ⁴⁶46 Li M, Luo Y, Watson R, et al. Healthcare workers’ (HCWs) attitudes and related factors towards COVID-19 vaccination: a rapid systematic review. Postgrad Med J. 2021 [acesso em 2022 nov 20]; 99(1172):520-528. Disponível em: https://doi.org/10.1136/postgradmedj-2021-140195.
https://doi.org/10.1136/postgradmedj-202... . Em contrapartida, as profissionais de saúde do sexo feminino, mais jovens, com menores níveis de escolaridade, menores rendas salariais e solteiras se apresentaram com maiores tendências à hesitação vacinal ¹¹11 Kara EB, Can G, Pirdal BZ, et al. COVID-19 vaccine hesitancy in healthcare personnel: a university hospital experience. Vaccines (Basel). 2021 [acesso em 2022 nov 20]; 9(11):1343. Disponível em: https://www.mdpi.com/2076-393X/9/11/1343.
https://www.mdpi.com/2076-393X/9/11/1343... ,²⁸28 Leigh JP, Moss SJ, White TM, et al. Factors affecting COVID-19 vaccine hesitancy among healthcare providers in 23 countries. Vaccine. 2022 [acesso em 2022 nov 20]; 40(31):4081-9. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9068669/pdf/main.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,³⁵35 Gatto NM, Lee JE, Massai D, et al. Correlates of COVID-19 vaccine acceptance, hesitancy and refusal among employees of a safety net California county health system with an early and aggressive vaccination program: results from a cross-sectional survey. Vaccines (Basel). 2021 [acesso em 2022 nov 20]; 9(10):1152. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8540702/pdf/vaccines-09-01152.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,³⁹39 Dubov A, Distelberg BJ, Abdul-Mutakabbir JC, et al. Predictors of COVID-19 vaccine acceptance and hesitancy among healthcare workers in southern California: not just “anti” vs. “pro” vaccine. Vaccines (Basel). 2021 [acesso em 2022 nov 20]; 9(12):1428. Disponível em: https://www.mdpi.com/2076-393X/9/12/1428.
https://www.mdpi.com/2076-393X/9/12/1428... .

Uma questão que vale ser destacada é a identificação de maior hesitação vacinal em profissionais não médicos, como se pôde perceber entre os(as) profissionais de enfermagem ³⁶36 Gagneux-Brunon A, Detoc M, Bruel S, et al. Intention to get vaccinations against COVID-19 in french healthcare workers during the first pandemic wave: a cross-sectional survey. J Hosp Infect. 2021 [acesso em 2022 nov 20]; (108):168-73. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7699157/pdf/main.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,⁴⁷47 Lindner-Pawłowicz K, Mydlikowska-Śmigórska A, Łampika K, et al. COVID-19 Vaccination acceptance among healthcare workers and general population at the very beginning of the national vaccination program in poland: a cross-sectional, Exploratory Study. Vaccines (Basel). 2021 [acesso em 2022 nov 20]; 10(1):66. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8779375/pdf/vaccines-10-00066.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... . Em alguma medida, este achado dialoga com o fato de as demais profissões da área da saúde terem a predominância de mulheres ⁴⁸48 Boniol M, McIsaac M, Xu L, et al. Gender equity in the health workforce: analysis of 104 countries. Genebra: World Health Organization; 2019. [acesso em 2022 nov 20]. Disponível em: https://apps.who.int/iris/bitstream/handle/10665/311314/WHO-HIS-HWF-Gender-WP1-2019.1-eng.pdf?sequence=1&isAllowed=y.
https://apps.who.int/iris/bitstream/hand... . De certa forma, tal apontamento corrobora com os achados desta revisão ao confirmar que a hesitação vacinal em profissionais de saúde encontra-se mais vinculada ao sexo feminino.

Em relação à hesitação, foram identificadas, em grande parte dos artigos, a insegurança relacionada à escassez de estudos sobre as vacinas contra a Covid-19 e a desconfiança relacionada aos processos de produção de vacinas. Essas questões tanto podem estar atreladas aos posicionamentos contrários à vacinação como também aos questionamentos referentes ao uso das vacinas contra a Covid-19 de modo emergencial, em uma perspectiva de urgência no controle da pandemia ⁴⁹49 Palamenghi L, Barello S, Boccia S, et al. Mistrust in biomedical research and vaccine hesitancy: the forefront challenge in the battle against COVID-19 in Italy. Eur J Epidemiol. 2020 [acesso em 2022 nov 20]; 35(8):785-8. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7431109/pdf/10654_2020_Article_675.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... . Em continuidade a esta discussão, surge a preocupação com a segurança e a eficácia das vacinas, que também aparece no rol dos artigos como um dos fatores contribuintes para a hesitação ⁵⁰50 Troiano G, Nardi A. Vaccine hesitancy in the era of COVID-19. Public Health. 2021 [acesso em 2022 nov 20]; (194):245-51. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7931735/.
https://www.ncbi.nlm.nih.gov/pmc/article... . Por outro lado, confiar no processo de desenvolvimento das vacinas contra a Covid-19 dialoga com a tendência de aceitação vacinal ⁵¹51 Skirrow H, Barnett S, Bell S, et al. Women’s views on accepting COVID-19 vaccination during and after pregnancy, and for their babies: a multi-methods study in the UK. BMC Pregnancy Childbirth. 2022 [acesso em 2022 nov 20]; 22(33):1-15. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8759061/pdf/12884_2021_Article_4321.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... .

Outro fator marcante nos artigos foi o medo de eventos adversos ou efeitos colaterais provenientes das vacinas contra a Covid-19. Alguns estudos chamaram a atenção para a divulgação de mensagens de risco de doenças, supostas complicações associadas ao uso da vacina, alertando para a incerteza gerada pelo desconhecimento e a no -vidade relacionada às vacinas contra a Covid-19, o que pode ter sido determinante para a hesitação vacinal ⁵²52 Thunström L, Ashworth M, Finnoff D, et al. Hesitancy Toward a COVID-19 Vaccine. Ecohealth. 2021 [acesso em 2022 nov 20]; 18(1):44-60. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8175934/pdf/10393_2021_Article_1524.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... . A crença em notícias veiculadas nas mídias sociais se apresenta como possibilidade de vinculação à hesitação vacinal ⁵³53 AlJamaan F, Temsah MH, Alhasan K, et al. SARS-CoV-2 variants and the global pandemic challenged by vaccine uptake during the emergence of the delta variant: a national survey seeking vaccine hesitancy causes. J Infect Public Health. 2022 [acesso em 2022 nov 20]; 15(7):773-80. Disponível em: https://www.sciencedirect.com/science/article/pii/S1876034122001526.
https://www.sciencedirect.com/science/ar... . Entretanto, o acesso às informações embasadas em evidências científicas atualizadas poderá contribuir para ampliar a aceitação vacinal ⁵⁴54 Ward C, Megaw L, White S, et al. COVID-19 vaccination rates in an antenatal population: a survey of women’s perceptions, factors influencing vaccine uptake and potential contributors to vaccine hesitancy. Aust N Z J Obstet Gynaecol. 2022 [acesso em 2022 nov 20]; 62(5):695-700. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9111353/pdf/AJO-9999-0.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... .

Ainda sobre a utilização de redes sociais como fontes de informações, estudos sugerem que promover o compartilhamento de narrativas e experiências exitosas relacionadas à vacina nas mídias sociais, combinadas com intervenções que buscam razões específicas para a aceitação vacinal, viabiliza instrumentalizar processos de decisão consciente da população, sendo eficazes para a redução da hesitação vacinal contra a Covid-19 ³³33 Hoffman BL, Boness CL, Chu KH, et al. COVID-19 vaccine hesitancy, acceptance, and promotion among healthcare workers: a mixed-methods analysis. J Community Health. 2022 [acesso em 2022 nov 20]; 47(5):750-8. Disponível em: https://link.springer.com/content/pdf/10.1007/s10900-022-01095-3.pdf?pdf=button.
https://link.springer.com/content/pdf/10... .

O exercício profissional associado à função desempenhada no enfrentamento da pandemia apresentou-se relacionado com maior probabilidade de aceitação das vacinas contra a Covid-19, diante da preocupação em se proteger ⁵⁵55 Kwok KO, Li KK, Wei WI, et al. Editor’s choice: influenza vaccine uptake, COVID-19 vaccination intention and vaccine hesitancy among nurses: a survey. Int J Nurs Stud. 2021 [acesso em 2022 nov 20]; (114):103854. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7831770/pdf/main.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... .

A aceitação de vacinas contra a Covid-19 foi apontada nos artigos analisados a partir de associações relacionadas, prioritariamente, à adesão à vacinação contra a influenza antes da pandemia, ao receio de riscos por contágio/ exposição à Covid-19, a infecções anteriores por Covid-19 e ao acesso a fontes confiáveis e seguras de informações.

Estudos concluíram que a vacinação anterior contra a influenza foi um fator amplamente associado pelos profissionais à aceitação vacinal contra a Covid-19 ⁵⁴54 Ward C, Megaw L, White S, et al. COVID-19 vaccination rates in an antenatal population: a survey of women’s perceptions, factors influencing vaccine uptake and potential contributors to vaccine hesitancy. Aust N Z J Obstet Gynaecol. 2022 [acesso em 2022 nov 20]; 62(5):695-700. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9111353/pdf/AJO-9999-0.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... . Outro fator que poderia interferir nessa aceitação vacinal se refere à responsabilidade com familiares e com a sociedade ⁵²52 Thunström L, Ashworth M, Finnoff D, et al. Hesitancy Toward a COVID-19 Vaccine. Ecohealth. 2021 [acesso em 2022 nov 20]; 18(1):44-60. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8175934/pdf/10393_2021_Article_1524.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,⁵⁴54 Ward C, Megaw L, White S, et al. COVID-19 vaccination rates in an antenatal population: a survey of women’s perceptions, factors influencing vaccine uptake and potential contributors to vaccine hesitancy. Aust N Z J Obstet Gynaecol. 2022 [acesso em 2022 nov 20]; 62(5):695-700. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9111353/pdf/AJO-9999-0.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... . Alguns artigos levaram em consideração o modelo de crença em saúde influenciando o processo de decisão vacinal. Dessa forma, uma barreira à vacinação, advinda de crenças limitantes,foi a percepção do indivíduo em se considerar saudável ⁵⁶56 Hossain MS, Islam MS, Pardhan S, et al. Beliefs, barriers and hesitancy towards the COVID-19 vaccine among Bangladeshi residents: findings from a cross-sectional study. PLoS One. 2022 [acesso em 2022 nov 20]; 17(8):e0269944. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9398020/pdf/pone.0269944.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... .

Diante desse contexto, um importante fator de ampliação da cobertura vacinal foi a recomendação vacinal por parte dos setores vinculados ao Estado ¹⁹19 Wang H, Huang YM, Su XY, et al. Acceptance of the COVID-19 vaccine based on the health belief model: a multicenter national survey among medical care workers in China. Hum. vaccin. Immunother. 2022 [acesso em 2022 nov 20]; 18(5):2076523. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9481094/pdf/KHVI_18_2076523.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,²³23 Moirangthem S, Olivier C, Gagneux-Brunon A, et al. Social conformism and confidence in systems as additional psychological antecedents of vaccination: a survey to explain intention for COVID-19 vaccination among healthcare and welfare sector workers, France, December 2020 to February 2021. Euro Surveill. 2022 [acesso em 2022 nov 20]; 27(17):2100617. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9052769/pdf/eurosurv-27-17-3.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... ,⁴¹41 Barello S, Maiorino G, Palamenghi L, et al. Exploring the motivational roots of getting vaccinated against COVID-19 in a population of vaccinated pediatric healthcare professionals: evidence from an Italian cross-sectional study. Vaccines (Basel). 2022 [acesso em 2022 nov 20]; 10(3):467. Disponível em: https://www.mdpi.com/2076-393X/10/3/467.
https://www.mdpi.com/2076-393X/10/3/467... . Instituições como o Ministério da Saúde, no Brasil, tiveram um papel fundamental no estímulo a condutas profissionais que visavam ao alcance da população no engajamento à vacinação contra a Covid-19.

Sendo assim, é imprescindível validar os espaços de educação permanente, que proporcionaram a escuta, buscaram sanar dúvidas, disseminaram dados com segurança e apresentaram evidências científicas da eficácia do uso da vacinação ¹⁸18 Yan YY, Wang HT, Fan TY, et al. Vaccination coverage among COVID-19 prevention and control management teams at primary healthcare facilities in China and their attitudes towards COVID-19 vaccine: a cross-sectional online survey. BMJ Open. 2022 [acesso em 2022 nov 20]; 12(4):e056345. Disponível em: https://bmjopen.bmj.com/content/12/4/e056345.long.
https://bmjopen.bmj.com/content/12/4/e05... ,²⁰20 Saddik B, Al-Bluwi N, Shukla A, et al. Determinants of healthcare workers perceptions, acceptance and choice of COVID-19 vaccines: a cross-sectional study from the United Arab Emirates. Hum. vaccin. Immunother. 2022 [acesso em 2022 nov 20]; 18(1):1-9. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8928822/pdf/KHVI_18_1994300.pdf.
https://www.ncbi.nlm.nih.gov/pmc/article... , assim sensibilizando e conscientizando profissionais sobre os riscos percebidos da Covid-19.

Considerações finais

Entre os fatores associados à decisão vacinal de profissionais de saúde contra a Covid-19 foram identificados aspectos como: dúvidas sobre a eficácia das vacinas, insegurança pela escassez de estudos sobre vacinas contra a Covid-19, desconfiança com os processos de produção, medo de efeitos adversos provenientes das vacinas e informações veiculadas em mídias sociais. Já o engajamento à vacinação prévia contra a influenza e o compromisso de proteger familiares, assim como a confiança na eficácia das vacinas e o receio pelo risco de contágio por Covid-19, estiveram associados à aceitação vacinal.

Foi possível observar, nesta revisão, que os profissionais de saúde do sexo masculino, com idades mais avançadas e maiores escolaridades apresentaram maior aceitação vacinal; e as profissionais de saúde do sexo feminino, mais jovens, com menores níveis de escolaridade e renda apontaram tendência à hesitação vacinal. Além disso, em termos de categoria profissional, tomando como exemplo a enfermagem, esta apresenta associação à hesitação vacinal, quando comparada à medicina.

Contraditoriamente, os fatores relacionados à hesitação vacinal dos profissionais de saúde contra a Covid-19 podem interferir tanto na própria vacinação quanto na recomendação de vacinas contra a Covid-19 à população em geral. Estas informações necessitam ser divulgadas com vistas à identificação de estratégias que contribuam para a ampliação da cobertura vacinal contra a Covid-19.

Percebe-se, na amostragem desta revisão, que o cenário da APS não foi alvo de produções científicas nesse período na mesma proporção das unidades hospitalares. Como o primeiro nível de atenção à saúde tem grande circulação de pessoas em busca de vacinação no Brasil, existindo protagonismo dos profissionais vacinadores nesse processo, torna-se necessário ampliar investigações relacionadas diretamente aos profissionais vinculados à APS.

A limitação do estudo pode estar relacionada ao número dos achados, devido ao período estudado no cenário da APS. Por isto, incita-se a produção de revisões de escopo e novas pesquisas relacionadas à temática no campo estudado.

Sendo assim, conhecer e divulgar os fatores que interferem no processo decisório dos profissionais de saúde pode ser considerado um dos movimentos mais estratégicos de ampliação dos processos de cobertura vacinal contra a Covid-19, estando suas repercussões atreladas tanto à proteção da saúde dos próprios profissionais quanto à da saúde da população em geral.

Referências

Datas de Publicação

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