tetano
Editor, Senior Moderator
BMJ Glob Health
. 2026 Feb 17;11(2):e020513.
doi: 10.1136/bmjgh-2025-020513.
COVID-19 vaccine acceptance and recommendation among health workers in nine countries: a pooled analysis of survey data from 2023 to 2024
Julie Garon Carlton[SUP] 1 [/SUP], Eva Bazant[SUP] 2 [/SUP], Chelsey Griffin[SUP] 3 [/SUP], Katharine M Cooley[SUP] 3 [/SUP], Hongjiang Gao[SUP] 4 [/SUP], Margaret McCarron[SUP] 3 [/SUP], Ahamed Khairul Basher[SUP] 5 [/SUP], Ummi Rukaiya Munni[SUP] 5 [/SUP], Daouda Coulibaly[SUP] 6 [/SUP], Collins Ahorlu[SUP] 7 [/SUP], Chansay Pathammavong[SUP] 8 [/SUP], Phonethipsavanh Nouanthong[SUP] 9 [/SUP], Zeina Farah[SUP] 10 [/SUP], Mohammed Ismaili Alaoui[SUP] 11 [/SUP], Mouad Merabet[SUP] 11 [/SUP], Jeriel Reyes De Silos[SUP] 12 [/SUP], Clyde E Silverio[SUP] 13 [/SUP], Prabda Praphasiri[SUP] 14 15 [/SUP], Darunee Ditsungnoen[SUP] 15 [/SUP], Aicha Hechaichi[SUP] 16 [/SUP], Fatma Ben Youssef[SUP] 16 [/SUP], Joseph S Bresee[SUP] 2 [/SUP], Ann Moen[SUP] 17 18 [/SUP], Jaymin C Patel[SUP] 4 [/SUP]
Affiliations
Introduction: Health workers (HWs) set an example for vaccine recipients, convey vaccine benefits and risks and interface with patients at increased risk for complications in pandemic settings. We explored HWs' acceptance of and recommendation for COVID-19 vaccine with and without previous receipt of seasonal influenza vaccine (SIV) in nine countries.
Methods: In 2023-2024, cross-sectional surveys among HW were conducted in Bangladesh, Cote d'Ivoire, Ghana, Laos, Lebanon, Morocco, Philippines, Thailand and Tunisia. Country researchers used a standard protocol and questionnaire to assess beliefs, perceptions and acceptance around SIV and COVID-19 vaccine and likelihood of recommending these vaccines to patients. Pooled findings were stratified by the presence or absence of a national HW SIV recommendation. Generalised mixed effects models were used to characterise the relationship between receipt of SIV and COVID-19 vaccine acceptance and recommendation, adjusting for WHO region, sex and duration of employment.
Results: Our analysis included 12 296 HWs from nine countries representing four WHO regions: African, Eastern Mediterranean, Southeast Asian and Western Pacific. Five countries had a national HW SIV recommendation (61% of HWs surveyed) prior to COVID-19 vaccine introduction. More than 90% of HWs reported completing the COVID-19 vaccination series, whereas intention to continue receiving annual COVID-19 vaccine was lower (61%). HWs who received SIV in the last season compared with those who did not were more likely to have received one or more COVID-19 booster doses (adjusted OR (aOR) 2.63, 95% CI 2.27 to 3.04) and to have recommended COVID-19 vaccine to patients (aOR 1.53, 95% CI 1.29 to 1.82).
Conclusions: Prior experience with SIV was associated with HW behaviour and recommendations regarding COVID-19 vaccination. Intention to continue receiving COVID-19 vaccines remains a challenge; ongoing training and education for vaccination staff could be beneficial. HWs play a critical role in the successful delivery of new and existing vaccines, particularly in a pandemic setting.
Keywords: COVID-19; Global Health; Health Personnel; Vaccines.
. 2026 Feb 17;11(2):e020513.
doi: 10.1136/bmjgh-2025-020513.
COVID-19 vaccine acceptance and recommendation among health workers in nine countries: a pooled analysis of survey data from 2023 to 2024
Julie Garon Carlton[SUP] 1 [/SUP], Eva Bazant[SUP] 2 [/SUP], Chelsey Griffin[SUP] 3 [/SUP], Katharine M Cooley[SUP] 3 [/SUP], Hongjiang Gao[SUP] 4 [/SUP], Margaret McCarron[SUP] 3 [/SUP], Ahamed Khairul Basher[SUP] 5 [/SUP], Ummi Rukaiya Munni[SUP] 5 [/SUP], Daouda Coulibaly[SUP] 6 [/SUP], Collins Ahorlu[SUP] 7 [/SUP], Chansay Pathammavong[SUP] 8 [/SUP], Phonethipsavanh Nouanthong[SUP] 9 [/SUP], Zeina Farah[SUP] 10 [/SUP], Mohammed Ismaili Alaoui[SUP] 11 [/SUP], Mouad Merabet[SUP] 11 [/SUP], Jeriel Reyes De Silos[SUP] 12 [/SUP], Clyde E Silverio[SUP] 13 [/SUP], Prabda Praphasiri[SUP] 14 15 [/SUP], Darunee Ditsungnoen[SUP] 15 [/SUP], Aicha Hechaichi[SUP] 16 [/SUP], Fatma Ben Youssef[SUP] 16 [/SUP], Joseph S Bresee[SUP] 2 [/SUP], Ann Moen[SUP] 17 18 [/SUP], Jaymin C Patel[SUP] 4 [/SUP]
Affiliations
- PMID: 41702634
- DOI: 10.1136/bmjgh-2025-020513
Introduction: Health workers (HWs) set an example for vaccine recipients, convey vaccine benefits and risks and interface with patients at increased risk for complications in pandemic settings. We explored HWs' acceptance of and recommendation for COVID-19 vaccine with and without previous receipt of seasonal influenza vaccine (SIV) in nine countries.
Methods: In 2023-2024, cross-sectional surveys among HW were conducted in Bangladesh, Cote d'Ivoire, Ghana, Laos, Lebanon, Morocco, Philippines, Thailand and Tunisia. Country researchers used a standard protocol and questionnaire to assess beliefs, perceptions and acceptance around SIV and COVID-19 vaccine and likelihood of recommending these vaccines to patients. Pooled findings were stratified by the presence or absence of a national HW SIV recommendation. Generalised mixed effects models were used to characterise the relationship between receipt of SIV and COVID-19 vaccine acceptance and recommendation, adjusting for WHO region, sex and duration of employment.
Results: Our analysis included 12 296 HWs from nine countries representing four WHO regions: African, Eastern Mediterranean, Southeast Asian and Western Pacific. Five countries had a national HW SIV recommendation (61% of HWs surveyed) prior to COVID-19 vaccine introduction. More than 90% of HWs reported completing the COVID-19 vaccination series, whereas intention to continue receiving annual COVID-19 vaccine was lower (61%). HWs who received SIV in the last season compared with those who did not were more likely to have received one or more COVID-19 booster doses (adjusted OR (aOR) 2.63, 95% CI 2.27 to 3.04) and to have recommended COVID-19 vaccine to patients (aOR 1.53, 95% CI 1.29 to 1.82).
Conclusions: Prior experience with SIV was associated with HW behaviour and recommendations regarding COVID-19 vaccination. Intention to continue receiving COVID-19 vaccines remains a challenge; ongoing training and education for vaccination staff could be beneficial. HWs play a critical role in the successful delivery of new and existing vaccines, particularly in a pandemic setting.
Keywords: COVID-19; Global Health; Health Personnel; Vaccines.