The vaccination acceptance, confidence, and conviction on influenza in the Middle East, Eurasia, and Africa among healthcare providers (VACCIMENA-HCP) project 2023: Determinants of vaccination behavior

Objectives: Annual vaccination is the most effective way to prevent and control the health and economic burden of seasonal influenza. Healthcare providers (HCPs) play a crucial role in vaccine acceptance and patient advocacy. This study aimed to explore the barriers and drivers of HCPs’ vaccine acceptance and advocacy for the vaccination of their patients in countries in the Middle East, Eurasia, and Africa. Methods: Healthcare providers from 10 countries (Azerbaijan, Egypt, Libya, Morocco, Nigeria, Pakistan, Russia, Saudi Arabia, Tunisia, and Türkiye) were surveyed using opportunity sampling between 20th December 2022, and 1st March 2023. The previously developed motors of influenza vaccination acceptance (MoVac-Flu) and engagement with vaccination advocacy (MovAd) scales were used. Results: In the final sample of 721 responses, Russia was the leading country, enrolling 37% of all respondents. Sentiment cluster profiles were labeled as “engaged” or “hesitant” and “confident” or “diffident.” Overall, 28% demonstrated hesitancy and 30.5% demonstrated diffident sentiments toward self-vaccination behavior. HCPs exhibited very low rates of routine vaccination and infrequent advocacy of seasonal influenza vaccinations. In contrast, those who felt engaged with influenza vaccination were more likely to be vaccinated themselves and found it easier to incorporate influenza vaccination in their practice. Those who felt engaged in influenza vaccination also felt more confident in advocating for it than those who felt hesitant. The evidence suggests that the strength of the relationship between engagement and confidence varies across countries. Conclusions: This study provides insights into the behavioral patterns of HCPs regarding their own influenza vaccination and advocacy for patient vaccination. Cluster membership was a strong predictor of vaccination behaviors and attitudes, although regional differences were observed. For hesitant and diffident HCPs, tailored strategies to increase awareness and empower them regarding vaccines and vaccine-preventable diseases are crucial. © 2025 The Author(s)