Empowering Educators: Italian Nurses’ Knowledge, Attitudes, Practices, and Vaccine Hesitancy

Abstract Background Vaccine hesitancy (VH) among healthcare workers is a prevalent global phenomenon and a public health concern. The study aims were i) identifying knowledge, attitudes, and practices (KAP); ii) estimating the prevalence of VH regarding recommended vaccines for healthcare workers (HWs). Methods Multicenter cross-sectional study of an Italian sample of nurses and nursing students. Following a systematic review (PROSPERO ID:CRD42020212252), a validated questionnaire was used (Cronbach’s alpha=0.82). Two multivariable logistic regression model were built to identify predictors of (1) VH to the recommended vaccine for HWs; (2) acceptance of the fourth COVID-19 vaccine dose. Results 226 participants were enrolled (169 nurses; 57 students). Regarding KAP: only four nurses (1.8%) had adequate knowledge among vaccine recommended for HWs, whereas 30% (N = 66) reported never having recommended vaccinations during clinical practice. 106 (46%) nurses/students reported VH for at least one of the vaccines recommended for HWs - high levels of VH were recorded for influenza vaccination (N = 88,38.9%) and fourth COVID-19 vaccine dose (N = 100,44.3%). At the multivariable analysis, (1) significant associations with highest levels of VH were found for nurses who reported having at least one child (OR:5.42, 95%CI: 1.64-17.89) and who had not received any dose of influenza vaccination in the last 5 years (OR:13.25, 95%CI: 5.29-33.16). Lowest odds of VH was found for nurses employed in Primary Health Care (OR:0.17, 95%CI: 0.03-0.98); (2) routinely recommending vaccinations during practice (OR:0.38, 95% CI: 0.15-0.95) was associated with acceptance of fourth COVID-19 vaccine dose. Conversely, reliance on social media as the primary information source seemed to be a predictor of COVID-19 vaccine refusal (OR:2.05 95% CI: 1.31-3.20). Conclusions Preliminary results identified predictors of VH among nurses, offering insights for organizations to effectively tailor public health interventions. Key messages • High levels of vaccine hesitancy among nurses towards recommended vaccines for healthcare workers pose a threat to patient safety. • Empowering ‘educators’ through focused public health interventions is essential to address factors contributing to vaccine hesitancy among healthcare workers.