¹Klinikum Nürnberg, Paracelsus Medical University Nuremberg, Nürnberg, Germany
²Paracelsus Medical University Salzburg, Salzburg, Austria

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Background: The Health Belief Model (HBM) describes the effects of health-related perceptions and beliefs on behaviour. It is based on the assumption that people are more likely to engage in health-promoting behaviour if they consider the respective measure to be effective and acceptable. The HBM can predict vaccination willingness. Vaccines are medicines that prepare the immune system of healthy people. This activation of the body’s own defense mechanisms is similar to the effect of alternative (including homeopathic) remedies. However, the approval process of vaccines is analogous to that of conventional medicines for the acute treatment of diseases. In this study, we examine the health beliefs of healthcare workers and whether there is an association between health beliefs and the occurrence of side effects after COVID-19 vaccination.

Materials and Methods: This study evaluated adverse event (AE) rates after the first and second doses of mRNA vaccines (mainly Corminaty) from 982 health care workers (HCWs) of Nuremberg Hospital, one of the largest municipal hospitals in Europe (vaccinated between December 2020 and summer 2021). Moreover, we investigated health beliefs (e.g. about prevention and drugs, N=315) with a health belief questionnaire validated by Häussinger et al. [1]. Fisher’s exact and Pearson’s chi-square tests were used to analyse cross-tabulations. The significance level was set at 5%, no correction was made for multiple testing.

Results: Almost all vaccine recipients view vaccination as an important preventive measure (>95%), ensure that their vaccination status is complete, and have participated in vaccination to protect themselves (>97%), family members (>90%), and patients (83%). Around two-thirds expected significant side effects from the vaccination. Just over a quarter feared significant side effects. Approximately 40% assumed that conventional drugs have more side effects than alternative medicines. The latter suffered significantly more often from headaches after the first vaccination than those who did not assume this (p<0.01). Similarly, those who preferred alternative medicines suffered significantly more often from myalgia and headaches than those who did not tend toward alternative medicines (p<0.05).

Conclusion: Our sample shows a high willingness to be vaccinated. The found associations could indicate that vaccination, with its associated side effects, was perceived as a conventional medication. Detailed communication and education about the approval of the vaccines, their side effects, and the invasive measurement may have contributed to this. Experienced side effects are associated with reduced willingness to be vaccinated. To encourage vaccination and reduce potential nocebo effects, it may be helpful to highlight the characteristics of vaccines that are different to conventional drugs.

Literatur

[1] Häussinger C, Ruhl UE, Hach I. Health beliefs and over-the-counter product use. Ann Pharmacother. 2009 Jun;43(6):1122-7. DOI: 10.1345/aph.1L547