Research into Vaccine Booster Hesitancy in healthcare professionals

Research team from the Faculty of Medicine at Masaryk University evaluates booster hesitancy with a National Cross-sectional Study among 3,454 Czech healthcare workers, marking one of the earliest studies of its kind.

9 Dec 2021

This study revealed a high level of booster dose (BD) acceptance (71.3%), while 12.2% were still hesitant and 16.6% were against the currently available BD.

The survey covered all the fourteen regions of Czech Republic through an online, validated self-administered questionnaire (SAQ) supported by the Institute of Health Information and statistics of ČR and Masaryk University that explored the participants’ demographic characteristics, COVID-19 infection and vaccine anamneses, willingness to receive the booster dose, and the psychosocial drivers of vaccine booster hesitancy.

Among the responders, 80.9% were females, 30.3% were medical professionals, and 50.5% were ≤ 47 years old, which is representative sample for Czech healthcare professionals. Most of the participants were already vaccinated (95.2%), and BTN162b2 was the most administered vaccine (90.7%) said Dr. Klugar the first author of the study and director of CEHBC-KT, IBA, LF MU.

Detailed results of the study were published in the Vaccines, which is one of the highest ranked journals focused on vaccination. Details are available here.

Medical professionals, males, and older participants were more likely to accept BD rather than allied health professionals, females, and younger participants. Although, participants younger ≤47 had the lowest acceptance rate, the acceptance rate was still quite high approaching 66% added Dr. Abanoub Riad, corresponding author of the study and acting deputy director of Cochrane Czech Republic, CEBHC-KT.

The most commonly mentioned promoter for BD acceptance was protection of family (83.0%), protection of one’s own health (82.7%), protection of patients (70.4%), community health protection (66.4%), and having lesser restrictions on the social activities (49.8%). The employer's endorsement was the least commonly cited predictor for BD acceptance, reported only by 3.4% of the participants said Prof. Andrea Pokorná senior author of the study and vice dean of Faculty of Medicine, Masaryk University.

The BD perceived effectiveness against severe illness, symptomatic infection, and community transmission was a significant and strong predictor for acceptance while, interestingly, the effectiveness against the circulating variants was not that important for our target population.

The ethical dilemma of vaccine equity was observed in more than one-third (37.6%) of the Czech healthcare workers who disagreed to receive the BD after learning that this may affect the access of some population groups to the vaccines.

Our study hence, emphasizes not just the trust in the booster dose effectiveness and safety but also focuses on the potential ethical conflicts and the need for the individual’s risk-benefit ratio of booster doses to become more favorable especially among frontline workers.

Using altruistic motivators to enhance COVID-19 vaccine BD uptake seems to be more effective than mandating the vaccines, because those motivators were the most commonly cited predictors for BD acceptance while the least cited predictor was employer’s endorsement. Moreover, older adults were significantly more inclined to accept the BD, which is an important message for policy makers.


We acknowledge health professionals who participated on the study invitations were sent to the chairs of the professional medical societies, which are members of the Czech Medical Association of J. E. Purkyně (CzMA; Prague, Czech Republic), the member institutions coordinators of the Czech Clinical Research Infrastructure Network (CZECRIN; Brno, Czech Republic), and the inpatient healthcare facilities managers within the network of the Central Adverse Events Reporting System of the Institute of Health Information and Statistics of the Czech Republic (IHIS‐CR; Prague, Czech Republic) in order to facilitate participation in the study by circulating the survey uniform resource locator (URL) through their respective networks. Another channel was used in collaboration with the Ministry of Health to also include healthcare providers for inpatient long‐term care; the professional association of non‐medical healthcare workers, i.e., Czech Nursing Association (ČAS), Union of Physical Therapists of the Czech Republic (UNIFY‐ČR), Chamber of Midwives of the Czech Republic (ČKPA), Association of College Nurses (SVVS), Association of Higher Education Educators in the Non‐Medical Health Professions (AVVNZP), and Association of Social Service Providers of the Czech Republic (APSS‐ČR). The study was further promoted through the official websites of professional medical and allied healthcare societies, in addition to the website of the Czech Ministry of Health.

Are you interested in this topic? The CEBH-KT research team is working on further interesting research on COVID-19 vaccination and vaccine hesitancy in the framework of the COVAST project, more information is available here.

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