DISCUSSION
This study examined healthcare professionals’ attitudes towards vaccination and their fears in regards to COVID-19 in the period before the COVID-19 vaccination program was available in Turkey. It was found that healthcare professionals experienced moderate levels of COVID-19 fear and that fear of COVID-19 was significantly higher in women. This finding is consistent with the results of various studies reporting that women have higher levels of anxiety and risk perception10,13–15. In early May 2020, more than 150,000 healthcare professionals were infected with COVID-19, and more than 1,400 people died worldwide 16. This is believed to be the most important cause of COVID-19 fear among healthcare professionals.
Influenza and COVID-19 have similar symptoms and more severe infections, complications or fatal outcomes are recorded when an individual has influenza and COVID-19 at the same time17. This study found a significant relationship between the fear of COVID-19 among healthcare professionals and the status of being vaccinated with influenza vaccine and it was concluded that those who received the influenza vaccine had higher COVID-19 fear. Another study determined that the disease progressed more severely in cases where an individual is exposed to COVID-19 virus at the same time he/she contracts the influenza virus. The same study emphasized that the immunization rate against influenza virus is 55-60% in individuals who have been vaccinated and underlined the importance of influenza vaccination in order not to be infected with both coronavirus and influenza virus at the same time 18.
In their compilation of 2017 in regards to vaccination rates in health care professionals in Turkey, Özışık et al. reported that the rate of influenza vaccine varied between 12.3%-35.3% 19 . The increasing demand for influenza vaccine is likely due to the increased awareness of respiratory viral disease 20. Identifying the importance of COVID-19 vaccination and its relationship with the influenza vaccine is believed to shed light on future vaccination campaigns. A significant relationship was found between the educational status of the healthcare professionals participating in the study and the Fear of COVID-19 Scale total score. A study conducted by Mertens et al. found that the fear of COVID-19 decreased when the education level increased 10.
Understanding health professionals’ reservations about vaccination has important implications for public health administrations during outbreaks. Due to the uncertainty of vaccine features such as efficacy, side effects and duration of immunity, 43.4% of healthcare professionals in this study reported that they were undecided about getting the COVID-19 vaccine. Low vaccine acceptance rates were reported in other countries as well (53.7% in Italy and 58.9% in France) which supports this finding 21,22. Low COVID-19 vaccine acceptance rates (52.0%) were reported among healthcare professionals in Malta20. Two studies based on the early stages of the outbreak (February and March) among nurses in Hong Kong reported low COVID-19 acceptance rates (40.0% and 63.0%) 15,23. Contrary to the findings in this study, a study examining the views of physicians, nurses and normal individuals found that 78% of physicians, 61% of nurses and 75% of individuals stated that they wanted to be vaccinated against COVID-19 and it was determined that 60% of physicians, 55% of nurses and 70% of individuals in the general population wanted their children to be vaccinated24. It was concluded that healthcare professionals’ reservations about vaccination was related to lack of sufficient information about the side effects of the vaccine and that increased the level of anxiety in 68.2% of healthcare professionals. Healthcare authorities can organize a vaccination program for healthcare professionals to vaccinate them against COVID-19. Future research is also needed to explore potential strategies for raising awareness and changing attitudes towards vaccination.