How should vaccine hesitancy be measured in healthcare workers? A systematic review of the measurement properties of validated tools

The use of validated tools to assess vaccine hesitancy is essential for designing strategies to improve vaccine uptake among healthcare workers (HCWs). This systematic review identified and evaluated tools measuring knowledge, attitudes, practices, vaccine intentions, and vaccine hesitancy in HCWs. Searches were conducted in PubMed, CINAHL, Scopus, Web of Science, PsycINFO, Cochrane Library, and JBI (PROSPERO: CRD42020212252). The methodological quality of the instruments was determined using the COnsensus-based Standards for the selection of health status Measurement Instruments (COSMIN) methodology. Of 11,580 articles screened, 33 studies were included, identifying 32 measurement tools related to vaccines recommended for HCWs, including influenza, HPV, HBV, and pertussis. The King’s Nurses Influenza Vaccination Questionnaire was the most frequently used and demonstrated reliable properties. Two other validated questionnaires showed adequate measurement properties. No validated tool was identified to comprehensively assess vaccine hesitancy across all HCW-recommended vaccines, limiting instrument applicability for broad implementation in healthcare settings.

采用经过验证的工具评估疫苗犹豫（vaccine hesitancy），对于制定提升医护人员（healthcare workers, HCWs）疫苗接种率的策略至关重要。本系统综述针对医护人员群体中用于评估知识、态度、行为、疫苗接种意愿及疫苗犹豫的各类工具，开展了识别与评价工作。检索工作覆盖PubMed、CINAHL、Scopus、Web of Science、PsycINFO、Cochrane图书馆及JBI数据库，本综述的PROSPERO注册号为CRD42020212252。研究采用基于共识的健康测量工具遴选标准（COSMIN）方法，对各测量工具的方法学质量进行评定。本次研究共筛查11580篇文献，最终纳入33项相关研究，识别出32种针对医护人员推荐疫苗的测量工具，涵盖流感疫苗、人乳头瘤病毒（HPV）疫苗、乙型肝炎病毒（HBV）疫苗及百日咳疫苗。金氏护士流感疫苗接种问卷（King’s Nurses Influenza Vaccination Questionnaire）是应用最为广泛的工具，且展现出良好的信度特性。另有两款经过验证的问卷具备充足的测量学性能。目前尚未发现可全面覆盖医护人员推荐接种的所有疫苗类型、用以综合评估疫苗犹豫情况的经过验证工具，这一局限限制了该类工具在医疗场景中大范围推广应用的适用性。