Comparative analysis of COVID-19 vaccine and booster acceptance among healthcare workers in public and private sectors in KwaZulu-Natal, South Africa.

IF 1.3 Q4 HEALTH CARE SCIENCES & SERVICES

Health SA Gesondheid Pub Date : 2026-07-07 eCollection Date: 2026-01-01 DOI:10.4102/hsag.v31i0.3331

Viloshini K Manickum, Lehlohonolo J Mathibe

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Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic posed unprecedented global health challenges, necessitating accelerated COVID-19 vaccine development. However, vaccine and booster hesitancy among healthcare workers (HCWs) presented a barrier globally and in South Africa (SA).

Aim: This study aimed to determine the level of vaccine and booster acceptance among HCWs in public, private and public-private sectors in KwaZulu-Natal (KZN), SA, and to identify the key reasons of vaccine and booster acceptance and refusal.

Setting: This study was conducted across KZN.

Methods: A quantitative, descriptive, cross-sectional survey was conducted from October 2024 to April 2025 among doctors, nurses and pharmacists using an online questionnaire. Three hundred and thirty-one HCWs participated in this study with a reliable and standardised questionnaire. Data analysis included descriptive and inferential statistics. Relevant ethics committees and participants provided ethical approval.

Results: Average vaccine acceptance rate for vaccine and booster was 92.4% (n = 306) and 73.7% (n = 244), respectively. Public-private recorded the highest acceptance rates for vaccine (96.3%) and booster (85.1%). Primary reasons for vaccine refusal included vaccine-related illness in family (52.4%, n = 11) and rapid development and safety concerns (64%, n = 16), predominantly among private sector. Main booster refusal reasons included safety of multiple booster doses (50%, n = 32) and antibodies from previous COVID-19 infection, mostly in the public sector.

Conclusion: Addressing complex determinants of vaccine hesitancy across healthcare sectors necessitates an integrated and sustained approach reinforced by multidisciplinary stakeholder engagement.

Contribution: This study contributes to future pandemic preparedness and vaccination programmes by elucidating reasons influencing vaccine acceptance and refusal among HCWs.

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南非夸祖鲁-纳塔尔省公共和私营部门卫生保健工作者对COVID-19疫苗和加强剂接受程度的比较分析

背景：2019冠状病毒病（COVID-19）大流行带来了前所未有的全球卫生挑战，有必要加快COVID-19疫苗的开发。然而，在全球和南非，卫生保健工作者（HCWs）对疫苗和增强剂的犹豫是一个障碍。目的：本研究旨在确定南非夸祖鲁-纳塔尔省公共、私营和公私部门卫生保健工作者对疫苗和增强剂的接受程度，并确定疫苗和增强剂接受和拒绝的主要原因。背景：本研究在KZN地区进行。方法：从2024年10月至2025年4月，采用在线问卷对医生、护士和药剂师进行定量、描述性、横断面调查。331名医护人员用一份可靠和标准化的问卷参与了这项研究。数据分析包括描述性统计和推断性统计。相关伦理委员会和参与者提供了伦理批准。结果：疫苗和加强剂的平均疫苗合格率分别为92.4% （n = 306）和73.7% （n = 244）。公立-私立医院的疫苗接受率最高（96.3%），助推器接受率最高（85.1%）。拒绝接种疫苗的主要原因包括家庭中的疫苗相关疾病（52.4%,n = 11）和快速发展和安全问题（64%,n = 16），主要发生在私营部门。拒绝接种强化疫苗的主要原因包括多次加强剂量的安全性（50%,n = 32）和先前感染COVID-19的抗体，主要是在公共部门。结论：解决卫生保健部门疫苗犹豫的复杂决定因素需要一种综合和持续的方法，并由多学科利益攸关方参与加强。贡献：本研究通过阐明影响卫生保健工作者接受和拒绝疫苗的原因，有助于未来的大流行防范和疫苗接种规划。

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