COVID-19 vaccination intentions amongst care-professionals in the field of intellectual disability: a scoping review

Abstract

Background: A worldwide vaccination program is the chosen strategy against the COVID-19 pandemic. Vaccine hesitancy however, forms a threat because vaccine uptake is voluntary in most countries. Care-professionals of people with intellectual disabilities are exposed to greater risks than other healthcare workers due to the vulnerable group they attend to and the assisted-living facilities in which they often work. Little is still known of the reasons for vaccine hesitancy in this specific group in contrast to those of other healthcare workers. Objective: To provide insight in the intentions and attitudes on COVID-vaccination of healthcare workers, including those who care for people with intellectual disabilities, by means of a scoping review. Methods: The databases that were searched for papers are CINAHL, APA PsycArticles, APA PsycInfo, Web of Science, Semantic Scolar, Prospero, Outbreak Science, Cochrane and Scopus. The search was broadened to healthcare workers in general because only two papers were found on those caring for people with intellectual disabilities. A total of 26 papers were identified concerning the vaccine intentions of 43,199 healthcare workers worldwide. Data were gathered both quantitively and qualitatively. The papers were analysed for all themes regarding vaccine willingness and vaccine hesitancy.Results: The themes that came to light included: percentages of vaccine willingness, predictors of willingness differentiated by 11 sub-themes (mainly profession, age, gender and past vaccine behaviour), attitudes of willingness and hesitancy differentiated by 19 sub-themes (perceived COVID treat and protecting others for willingness, concerns on vaccine safety and efficacy for hesitancy), sources of vaccination information, contextual factors and changes in COVID-19 vaccine acceptance over time and finally, future strategies for interventions. Conclusions: There was overlap in the percentages of vaccination, predictors of vaccine willingness and the attitudes of vaccine willingness and hesitancy between healthcare workers and those caring for people with intellectual disabilities. Vaccine safety and efficacy are the most prominent concerns with regard to vaccine hesitancy. Therefore, future strategies for interventions should address vaccine safety and efficacy. Furthermore, interventions are recommended to be interactive in order to facilitate exchange. Discussion groups that are able to address specific concerns and personal experiences, show to be effective in addressing vaccine hesitancy. Accurate information can also be made more accessible to target groups by promoting videos on social media platforms. Hence, further research is necessary to specify more precisely the attitudes of healthcare workers caring for people with intellectual disabilities and in more countries worldwide.

Understanding the barriers and facilitators of vaccine hesitancy towards the COVID-19 vaccine in healthcare workers and healthcare students worldwide: An Umbrella Review

“…Nineteen reviews were published in 2021 and 12 in 2022, which captured primary studies published from February 2020 to August 2021 [ 31 ]. Nine reviews were published in Asia (China [ 26 , 28 , 42 ], Jordan [ 32 ], Thailand [ 33 ], Malaysia [ 27 ], Bangladesh [ 29 ], Pakistan [ 40 ], Iran [ 41 ]), eight in the USA [ 5 , 23 , 30 , 36 , 43 , 45 , 47 , 48 ], seven in Europe (Italy [ 35 , 38 ], The Netherlands [ 22 , 49 ], Greece [ 25 ], Czech Republic [ 37 ], Slovakia [ 31 ]), six in Africa (Ethiopia [ 21 , 34 , 39 ], Ghana [ 24 ], Nigeria [ 44 ], Burkina Faso [ 20 ]) and one in Canada [ 46 ]. Of the 31 reviews, 14 assessed the methodological quality of the primary studies included in their review.…”

“…The sociodemographic characteristics of the populations included in the reviews are outlined in Table 4 . Nine reviews focused on HCWs [ 5 , 22 – 25 , 28 , 34 , 42 , 48 ], three reviews focused on healthcare students [ 26 , 27 , 31 ] and 19 included a mixed population either containing a subset of HCWs [ 21 , 30 , 32 , 33 , 41 , 43 , 44 , 47 , 49 ] or subsets of both HCWs and healthcare students [ 20 , 29 , 35 – 40 , 45 , 46 ]. There was large variability in occupational roles reported for the HCWs, but Physicians, Nurses, Dentists, Pharmacists, Midwives, Physiotherapists and General Practitioners were the most commonly cited occupational roles across the reviews.…”

“…Vaccine-related factors : HCWs who had concerns regarding the adverse long-term side effects of the vaccine [ 5 , 20 , 22 , 24 , 32 – 34 , 36 , 40 , 42 , 46 – 49 ], as well as concerns about the tolerability of vaccine side effects [ 20 ] and its impacts on fertility [ 48 ] were more hesitant to accept a COVID-19 vaccine. As were those who had concerns about the safety [ 5 , 22 – 24 , 30 , 32 – 34 , 36 , 38 , 42 – 48 ], quality [ 33 , 47 , 48 ] and effectiveness or efficacy [ 5 , 20 , 22 , 24 , 30 , 32 , 33 , 36 , 38 , 42 – 48 ] of COVID-19 vaccines. Alternatively, HCWs who displayed less concern for serious vaccine side-effects [ 36 ] and perceived the vaccine to be safe [ 20 , 34 , 39 , 48 , 49 ] and effective [ 20 , 21 , 32 – 34 , 36 , 46 …”

“…Alternatively, HCWs who displayed less concern for serious vaccine side-effects [ 36 ] and perceived the vaccine to be safe [ 20 , 34 , 39 , 48 , 49 ] and effective [ 20 , 21 , 32 – 34 , 36 , 46 , 48 ] were more accepting of a vaccine. Greater hesitancy was also shown by individuals who had concerns about the rapid development [ 5 , 22 , 33 , 41 , 42 , 48 , 49 ] and approval [ 42 , 48 ] of COVID-19 vaccines, as well as the short duration of clinical trials [ 20 , 24 , 33 , 34 , 48 ]. Moreover, distrust of the expedited vaccine production, healthcare policies and regulatory policies [ 34 , 42 ] and perceived politicisation of the vaccines [ 5 , 23 , 42 ] were associated with greater hesitancy in HCWs.…”

Understanding the barriers and facilitators of COVID-19 vaccine hesitancy amongst healthcare workers and healthcare students worldwide: An umbrella review protocol

“…As a result, numerous systematic reviews and meta-analyses have been conducted to identify the most significant factors associated with vaccine hesitancy in this population. However, there is wide variation in the factors that have been reported as the main determinants of vaccine hesitancy between the systematic reviews, such as demographics (age, gender, professional role) [20][21][22], previous vaccination history [23], perceptions of vaccine safety and effectiveness [24,25], and trust in government and medical establishments [23,26]. Currently, results from meta-analyses provide contradictory evidence.…”