Vaccinations of healthcare workers (HCWs) aim to directly protect them from occupational diseases, and indirectly protect their patients and communities. However, studies increasingly highlight that HCWs can be vaccine hesitant. This review aims to analyze HCWs’ and public health professionals’ sentiments toward COVID-19 (Coronavirus Disease 2019) vaccination and determinants across different countries. A search strategy was conducted in PubMed using keywords such as “COVID-19”, “sentiment/acceptance”, “healthcare workers”, “vaccine hesitancy”, and “influenza”. A total of 56 articles were selected for in-depth analyses. The highest COVID-19 vaccination uptake was found in an Italian study (98.9%), and the lowest in Cyprus (30%). Older age, male gender, the medical profession, higher education level, presence of comorbidities, and previous influenza vaccination were associated with vaccine acceptance. Factors for low acceptance were perceived side effects of the vaccine, perceived lack of effectiveness and efficacy, and lack of information and knowledge. Factors for acceptance were knowledge, confidence in the vaccine, government, and health authorities, and increased perception of fear and susceptibility. All studies focused on healthcare providers; no studies focusing on public health professionals’ sentiments could be found, indicating a gap in research that needs to be addressed. Interventions must be implemented with vaccination campaigns to improve COVID-19 vaccine acceptance.

INTRODUCTIONThe COVID-19 era highlighted vaccine hesitancy (VH) among health workers (HWs) as a major hurdle to optimum immunization practices. Through the identification of relevant determinants, barriers, and interventions to counteract VH, this literature review examines the impact of the COVID-19 pandemic on HWs' influenza vaccination sentiment. METHODS Studies were identified by searching the PubMed database for articles published between August 2019 and July 2022. The search was restricted to articles in English that were original studies or meta-analyses or reviews. They were included in the review if they covered influenza VH among HWs during the COVID-19 pandemic. Inductive content analysis was used to identify themes that illustrate facilitators, barriers, and consideration. Risk of bias was not assessed. RESULTS Of 924 articles identified, 20 were selected. Of these, 15 were conducted in Europe and focused on healthcare staff, primarily in hospital settings. Within the COVID-19 context, physicians and residents were more willing than nurses to adhere to influenza vaccination. Young HWs, particularly males and those with chronic comorbidities, demonstrated the highest acceptance of the influenza vaccine. HWs' immunization history is associated with higher influenza vaccine adherence. Factors determining HW's acceptance of flu immunization were: healthcare staff's knowledge of the influenza vaccine, concerns about protecting themselves or others, and the rising perception of risk and fear from COVID-19 infection. Main barriers were negative perceptions about vaccine safety and effectiveness, insufficient time for vaccine uptake, and confidence in natural or acquired immunity. In the context of the pandemic, awareness campaigns and targeting vaccine affordability and accessibility were the most adopted interventions to increase vaccine acceptance amongst HWs. CONCLUSIONS In the context of COVID-19, confidence in influenza vaccines and the perception of risk from COVID-19 infection have increased among healthcare staff. To further explore the impact of the pandemic on HWs' sentiment toward influenza vaccination, conducting new empirical studies are strongly recommended.