Locatelli Giulia, Luciani Michela, Fabrizi Diletta, Albanesi Beatrice, Conti Alessio, Clari Marco, Renzi Erika, Massimi Azzurra, Ausili Davide
School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.
Department of Sciences of Public Health and Pediatrics, University of Torino, Torino, Italy.
J Clin Nurs. 2025 Oct;34(10):4005-4037. doi: 10.1111/jocn.17852. Epub 2025 Jun 25.
Vaccinations are essential to ensure protection for healthcare professionals, patients and communities. However, vaccination hesitancy has been reported among healthcare professionals. Nurses are the main, first and direct point of contact for patients and citizens in most healthcare services, but only a minority of studies investigated vaccination hesitancy and uptake specifically in this population. Thus, this study aimed to explore the determinants and motivations of vaccination hesitancy and uptake among nurses.
Systematic review with a narrative synthesis approach.
We included primary research exploring determinants or motivations of vaccination hesitancy or uptake among nurses. No time or geographical limit was applied. Generalised random-effects linear models with a logit link were used to calculate the pooled estimated proportions for vaccine uptake among nurses.
We explored nine databases (2023).
The initial search identified 3452 records; 42 records were eventually included in this review. Older age, longer professional experience, lack of confidence in vaccine safety and effectiveness and cost associated with the vaccine were among the most common determinants of vaccine hesitancy. Safety concerns, complacency (e.g., beliefs of not needing the vaccine), and accessibility (e.g., logistics) were among the most common motivations for being vaccine hesitant. Having strong confidence in the vaccine, a high sense of collective responsibility, previous vaccination uptake/positive intentions towards future vaccination, weaker vaccine complacency, and older age were among the most common determinants of vaccine uptake. Willingness to protect themselves and/or others, contribute to the herd immunity, and comply with recommendations were among the most common motivations for vaccine uptake. The pooled prevalence of influenza vaccine uptake among nurses was 44% (95% CI: 35-73).
The findings of this systematic review with meta-analysis could guide the identification of strategies to reduce barriers and further improve facilitators to eventually increase vaccine uptake in nurses.
IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: This study contributes to further understanding nurses' beliefs, barriers, and facilitators towards vaccination. By doing so, these results could guide the identification of strategies to reduce barriers and further improve facilitators to eventually increase vaccine uptake in nurses.
We have adhered to relevant EQUATOR guidelines, in particular to the PRISMA checklist.
No patient or public contribution.
PROSPERO number: CRD42020212252.
疫苗接种对于确保医护人员、患者及社区获得保护至关重要。然而，据报道医护人员中存在疫苗接种犹豫现象。在大多数医疗服务中，护士是患者和公众的主要、首要及直接接触点，但仅有少数研究专门调查了这一人群中的疫苗接种犹豫及接种情况。因此，本研究旨在探讨护士中疫苗接种犹豫及接种的决定因素和动机。
采用叙述性综合方法的系统评价。
我们纳入了探索护士中疫苗接种犹豫或接种的决定因素或动机的原始研究。未设定时间或地理限制。使用具有logit链接的广义随机效应线性模型来计算护士中疫苗接种的合并估计比例。
我们检索了9个数据库（2023年）。
初步检索共识别出3452条记录；最终本综述纳入了42条记录。年龄较大、专业经验较长、对疫苗安全性和有效性缺乏信心以及与疫苗相关的费用是疫苗接种犹豫最常见的决定因素。安全担忧、自满情绪（如认为不需要接种疫苗）以及可及性（如后勤保障）是疫苗接种犹豫最常见的动机。对疫苗有强烈信心、高度的集体责任感、既往接种情况/对未来接种的积极意愿、较弱的疫苗自满情绪以及年龄较大是疫苗接种最常见的决定因素。愿意保护自己和/或他人、促进群体免疫以及遵守建议是疫苗接种最常见的动机。护士中流感疫苗接种的合并患病率为44%（95%置信区间：35 - 73）。
这项带有荟萃分析的系统评价结果可为确定减少障碍及进一步改善促进因素的策略提供指导，最终提高护士的疫苗接种率。
对专业和/或患者护理的意义：本研究有助于进一步了解护士对疫苗接种的信念、障碍和促进因素。通过这样做，这些结果可为确定减少障碍及进一步改善促进因素的策略提供指导，最终提高护士的疫苗接种率。
我们遵循了相关的EQUATOR指南，特别是PRISMA清单。
无患者或公众参与。
PROSPERO编号：CRD42020212252。
