Background: Healthcare and long-term care (LTC) workers were prioritised in the rollout of the COVID-19 vaccines, given their high risk of exposure and close contact with vulnerable populations. Despite the demonstrated effectiveness of the COVID-19 vaccines, high levels of hesitancy among this workforce was observed in the first few months of the COVID-19 vaccine rollout in Canada and abroad. Drivers of vaccine hesitancy among this population have been comprehensively studied and are well described in the literature. Yet, evidence around the measurable impact of strategies introduced to improve vaccine confidence is limited. We sought to identify and describe COVID-19-specific educational interventions, including both informal and formal interventions, introduced to improve vaccine confidence, paying particular attention to those targeting the health and LTC workforce.
Methods: We conducted a scoping review of literature published up to February 2022 on educational interventions introduced to address COVID-19 vaccine hesitancy. In consultation with a medical information scientist, we searched 5 academic databases including, Ovid MEDLINE and Web of Science. We also performed a grey literature search to ensure our review would capture preliminary evidence, as well as descriptions of experiential experiences of COVID-19 vaccine education delivery. We considered all study designs and reports. The data was charted and the results were described narratively according to the following sections: (i) the delivery format of the educational intervention, (ii) educational participants including target audience and facilitators and (iii) content of the educational interventions.
Results: After screening 1,917 titles and abstracts and 72 full-text studies, 7 studies met our inclusion criteria. In addition, we included 6 studies from our grey literature search. Of these, 46% (n=6) included formal evaluations of an educational intervention. Formal, group-based presentations were the most common type of educational intervention in the included studies, the majority of which were conducted virtually. However, presentations were often supplemented with additional educational interventions including one-on-one conversations, group discussions, and expert consultations. The included studies were diverse with respect to the target population the educational interventions were directed towards. Four studies (31%) consisted of educational interventions directed towards minority communities while five studies (38%) described educational interventions introduced within the healthcare or long-term care sectors. All studies involved a healthcare professional in the facilitation of the education. Careful consideration regarding the selection of facilitators was identified as important among interventions targeting minority communities. As such, some studies leveraged faith groups or faith-based organizations as well as trusted community leaders as education facilitators. Moreover, in recognition of the diversity of the health and LTC workforce, the inclusion of diverse facilitators was also specified in two of the five studies (40%) targeting this sector. Given the novelty of the COVID-19 vaccine as well as the unique current context, many studies reported personalized conversations, question periods, and myth-busting as important components of the education.
Conclusions: Our review suggests educational interventions should consider leveraging community (cultural, religious) partnerships when developing and facilitating COVID-19 vaccine education. Train-the-trainer approaches with recognized community members may also be of value as trust and personal connections were identified as an enabler throughout the review.