"Same principles, different decisions": A qualitative study exploring the attitudes of COVID-19 vaccination among school staff in Switzerland.

During the COVID-19 pandemic, Switzerland prioritized vaccination for school staff to mitigate the economic and societal impacts of school closures. However, there is limited research on vaccine acceptance and hesitancy among school staff in Switzerland. This study aimed to explore the arguments used by school staff to justify COVID-19 vaccination decisions in public and private institutions across Switzerland's German-, French-, and Italian-speaking regions. Participants were recruited using purposive sampling from a national survey and through snowball techniques. Data were collected from interviews with 47 participants employed in nurseries, kindergartens, primary schools, middle schools, and special education facilities, conducted between November 2021 and March 2022. Interviews were analyzed using a primarily inductive approach, complemented by elements of abductive and deductive reasoning to identify key principles guiding decision-making. Among the participants, 36 had received at least one dose of the COVID-19 vaccine, while 11 remained unvaccinated. We extracted four main themes: respondents considered four principles (i.e. self-protection, protection of others, return to normality, and institutional loyalty) as starting points in their decision-making process and then developed different arguments, either in support or against vaccination. The findings illustrate the complexity of vaccine hesitancy within the school context, where individual decisions are shaped by a combination of rational, moral, political and identity-related factors. This study contributes to the theoretical understanding of vaccination decision-making processes, particularly in school settings. It highlights the importance of considering vaccine hesitancy in the workplace and underscores the need for tailored communication strategies that address specific concerns within professional groups.