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Quantifying healthcare and welfare sector workers' preferences around COVID-19 vaccination: a cross-sectional, single-profile discrete-choice experiment in France.

  • Díaz Luévano, Carolina1
  • Sicsic, Jonathan2
  • Pellissier, Gerard3
  • Chyderiotis, Sandra4
  • Arwidson, Pierre5
  • Olivier, Cyril3
  • Gagneux-Brunon, Amandine6, 7
  • Botelho-Nevers, Elisabeth6, 7
  • Bouvet, Elisabeth3
  • Mueller, Judith8, 4
  • 1 Department of Quantitative Methods in Public Health, EHESP French School of Public Health, Paris and Rennes, La Plaine St Denis, France. , (France)
  • 2 LIRAES (EA4470), University of Paris, Paris, France. , (France)
  • 3 Research Group for the Prevention of Occupational Infections in Healthcare Workers (GERES), Paris, France. , (France)
  • 4 Emerging Infectious Disease Epidemiology Unit, Institut Pasteur, Paris, France. , (France)
  • 5 Prevention and Health Promotion, Santé publique France, Saint-Maurice, France. , (France)
  • 6 Department of Infectious Diseases, University Hopital of Saint-Etienne, Saint-Etienne, France. , (France)
  • 7 Chaire PreVacCI, Institut PRESAGE, University Jean Monnet University, Lyon University, Saint-Etienne, France. , (France)
  • 8 Department of Quantitative Methods in Public Health, EHESP French School of Public Health, Paris and Rennes, La Plaine St Denis, France [email protected] , (France)
Published Article
BMJ Open
Publication Date
Oct 04, 2021
DOI: 10.1136/bmjopen-2021-055148
PMID: 34607874


To analyse preferences around promotion of COVID-19 vaccination among workers in the healthcare and welfare sector in Fance at the start of the vaccination campaign. Single-profile discrete-choice experiment. Respondents in three random blocks chose between accepting or rejecting eight hypothetical COVID-19 vaccination scenarios. 4346 healthcare and welfare sector workers in France, recruited through nation-wide snowball sampling, December 2020 to January 2021. The primary outcomes were the effects of attributes' levels on hypothetical acceptance, expressed as ORs relative to the reference level. The secondary outcome was vaccine eagerness as certainty of decision, ranging from -10 to +10. Among all participants, 61.1% made uniform decisions, including 17.2% always refusing vaccination across all scenarios (serial non-demanders). Among 1691 respondents making variable decisions, a strong negative impact on acceptance was observed with 50% vaccine efficacy (compared with 90% efficacy: OR 0.05, 95% CI 0.04 to 0.06) and the mention of a positive benefit-risk balance (compared with absence of severe and frequent side effects: OR 0.40, 0.34 to 0.46). The highest positive impact was the prospect of safely meeting older people and contributing to epidemic control (compared with no indirect protection: OR 4.10, 3.49 to 4.82 and 2.87, 2.34 to 3.50, respectively). Predicted acceptance was 93.8% for optimised communication on messenger RNA vaccines and 16.0% for vector-based vaccines recommended to ≥55-year-old persons. Vaccine eagerness among serial non-demanders slightly but significantly increased with the prospect of safely meeting older people and epidemic control and reduced with lower vaccine efficacy. Vaccine promotion towards healthcare and welfare sector workers who hesitate or refuse vaccination should avoid the notion of benefit-risk balance, while collective benefit communication with personal utility can lever acceptance. Vaccines with limited efficacy will unlikely achieve high uptake. © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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