Factors influencing nurses and nursing students' attitudes towards vaccinations: A cross-sectional study

Background: Vaccination hesitancy remains the main obstacle to improving vaccination coverage. Influenza and COVID-19 vaccination coverage among healthcare professionals is essential. It is crucial to study the vaccination attitudes of healthcare professionals as they significantly influence the vaccination attitudes and behaviour of the rest of the population. Objective: The aim of this study was to describe the attitudes of Finnish nurses and nursing students towards COVID-19 and Influenza vaccination and explain what factors influence these attitudes. Design: A cross-sectional study. Setting and participants: A total of 1353 nurses from five hospital organisations and 580 nursing students from eight Universities of Applied Sciences participated in the survey. Participants were invited to complete the questionnaire through Webropol between March and September 2023. Methods: To collect data anonymously, a self-reported web-based questionnaire combining the Vaccination Attitude Examination (VAX) scale and Bergen's Social Media Addiction (BSMA) scale was used. K-means cluster analysis was performed to describe vaccination attitude profiles. Results: Four distinct vaccination attitude profiles were identified: Profile A- Confident Pro-Vaccine (n = 605) exhibited low hesitancy, with high confidence in vaccine safety and effectiveness; Profile B - Cautiously Pro- Vaccine (n = 764) showed moderate hesitancy, mainly concerned about unforeseen future effects; Profile CHesitant with Mistrust (n = 405) expressed high hesitancy, with significant worries about vaccine safety and mistrust in health authorities; and Profile D - Strongly Vaccine-Hesitant (n = 159) demonstrated very high hesitancy, marked by strong beliefs in potential long-term negative effects of vaccination. Significant differences in VAX-scale mean scores were found between the profiles, ranging from 1.27 for Profile A to 6.65 for Profile D. Overall, nursing students were more hesitant than practising nurses, with students being overrepresented in the more hesitant profiles. Clinical training in a COVID-19 unit was associated with more favourable vaccination attitudes among nursing students. The uptake of the full series of COVID-19 and annual Influenza vaccines was generally high in the sample (90.8 % and 87 %, respectively). However, a clear pattern between specific social media use and vaccination attitudes was not found. Major concerns related to vaccine hesitancy focused on the uncertainty of vaccines' long-term effects. Conclusion: This study provides valuable insights into the complex nature of vaccination hesitancy among nurses and nursing students. These findings underscore the need for targeted interventions to address underlying concerns and promote vaccine acceptance within this demographic. In future research, it would be essential to gather more in-depth knowledge, particularly regarding nursing students' attitudes towards vaccination and the factors influencing them.