A Systematic Review and Qualitative Meta-Synthesis on How Decisional Autonomy Promotes Vaccine Rejection or Delay Among Health Care Providers
The development of vaccines is perhaps one of the biggest watershed moments in the history of public health. In spite of the overwhelming evidence that highlights the effectiveness of receiving routine vaccinations, several members of society are increasingly refusing to follow recommended vaccination schedules. While the majority of research in this area has focused on vaccine hesitancy in citizens and parents, there is little research on the factors that promote vaccine hesitancy in health care providers. Identifying factors that promote vaccine hesitancy in health care providers is essential because it may help broaden our understanding of vaccine hesitancy in patients, parents and citizens. Therefore, the goal of this investigation was to examine how professional autonomy and risk perception may promote vaccine acceptance, rejection, and delay in physicians and nurses. We conducted a systematic review and qualitative meta-synthesis of 21 studies that discussed vaccine hesitancy in physicians and nurses. We found that vaccine hesitant nurses and physicians shared similar views towards vaccines. In the majority of studies, nurses and physicians believed that their decision to vaccinate was separate from their role as a healthcare provider. This belief comprised of three themes: decisional autonomy, personal risk perception, and alternatives to vaccination. Both groups believed that mandatory vaccine policies reduced their ability to decide whether vaccination was in their best interests. We argue that decisional autonomy weakens risk perception of disease, which in turn encourage beliefs and behaviours that reinforce a “hero persona.”
By Adebisi Akande, Level V Molecular Biology, Immunology & Disease; Mental Health Studies Student at University of Toronto