Department of Global Health, Anthropology and Ecology of Disease Emergence Unit, Institut Pasteur, Paris, France.
Socio-Ecological Health Research Unit, Institute of Tropical Medicine, Antwerp, Belgium.
Vaccine. 2023 Jan 23;41(4):883-891. doi: 10.1016/j.vaccine.2022.10.048. Epub 2022 Oct 27.
Polarized debates about Covid-19 vaccination and vaccine mandates for healthcare workers (HCWs) challenge Belgian HCWs ability to discuss Covid-19 vaccine sentiments with peers and patients.Although studies have identified drivers of HCWs vaccine hesitancy, they do not include effects of workplace interactions and have not addressed consequences beyond vaccine coverage.
Interviews and focus group discussions with 74 HCWs practicing in Belgium addressed Covid-19 vaccine sentiments and experiences of discussing vaccination with peers and patients.
Most participating HCWs reported difficulties discussing Covid-19 vaccination with peers and patients. Unvaccinated HCWs often feared that expressing their vaccine sentiments might upset patients or peers and that they would be suspended. Consequently, they used social cues to evaluate others' openness to vaccine-skeptical discourses and avoided discussing vaccines. Surprisingly, some vaccine-confident HCWs hid their vaccine sentiments to avoid peer and patient conflicts. Both vaccinated and unvaccinated HCWs observed that unvaccinated patients occasionally received suboptimal care. Suboptimal care was central in unvaccinated HCW unwillingness to express their vaccine sentiments to peers. Both vaccinated and unvaccinated HCWs described loss of trust and ruptured social relations with peers and patients holding divergent vaccine sentiments.
Belgian HCW perceived Covid-19 vaccines as a risky discussion topic and engaged in "strategic silences" around vaccination to maintain functional work relationships and employment in health institutions. Loss of trust between HCW and peers or patients, along with suboptimal patient care based on vaccination status, threaten to weaken Belgium's, and by implication, other health systems, and to catalyze preventable disease outbreaks.
关于新冠疫苗接种和医护人员（HCW）疫苗接种强制令的两极化辩论，挑战了比利时 HCW 与同行和患者讨论新冠疫苗态度的能力。尽管研究已经确定了 HCW 疫苗犹豫的驱动因素，但它们没有包括工作场所互动的影响，也没有解决疫苗接种覆盖率以外的后果。
对在比利时执业的 74 名 HCW 进行了访谈和焦点小组讨论，以了解他们对新冠疫苗的态度以及与同行和患者讨论接种疫苗的经验。
大多数参与的 HCW 报告说，与同行和患者讨论新冠疫苗接种存在困难。未接种疫苗的 HCW 经常担心表达他们的疫苗态度可能会让患者或同事感到不安，并且他们可能会被停职。因此，他们利用社会线索来评估他人对疫苗怀疑论话语的开放性，并避免讨论疫苗。令人惊讶的是，一些对疫苗有信心的 HCW 隐藏了他们的疫苗态度，以避免与同行和患者发生冲突。接种疫苗和未接种疫苗的 HCW 都观察到，未接种疫苗的患者偶尔会接受次优的护理。次优护理是未接种疫苗的 HCW 不愿意向同行表达他们的疫苗态度的核心原因。接种疫苗和未接种疫苗的 HCW 都描述了与持有不同疫苗态度的同行和患者之间失去信任和关系破裂。
比利时 HCW 将新冠疫苗视为一个有风险的讨论话题，并围绕接种疫苗采取“策略性沉默”，以维持医疗机构内的功能性工作关系和就业。HCW 与同行或患者之间的信任丧失，以及基于接种疫苗状况的次优患者护理，有可能削弱比利时，以及其他卫生系统的功能，并引发可预防的疾病爆发。
