{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T09:35:57Z","timestamp":1785404157041,"version":"3.56.0"},"reference-count":39,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T00:00:00Z","timestamp":1780099200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002380","name":"Hanyang University","doi-asserted-by":"crossref","award":["HY-202200000003466"],"award-info":[{"award-number":["HY-202200000003466"]}],"id":[{"id":"10.13039\/501100002380","id-type":"DOI","asserted-by":"crossref"}]},{"award":["HY-202200000003466"],"award-info":[{"award-number":["HY-202200000003466"]}],"id":[{"id":"https:\/\/ror.org\/046865y68","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Background\/Objectives: Healthcare workers play a critical role in vaccination programs, yet vaccine hesitancy has been widely reported even among this group during the Coronavirus disease 2019 (COVID-19) pandemic. Previous studies have primarily focused on identifying factors associated with vaccine acceptance, offering limited insight into the processes underlying decision-making. This study aimed to synthesize qualitative studies on healthcare workers\u2019 COVID-19 vaccination experiences to develop a comprehensive understanding of their decision-making processes. Methods: A qualitative meta-synthesis was conducted using the thematic synthesis approach proposed by Thomas and Harden. Electronic databases including PubMed, Embase, and CINAHL were searched for qualitative studies published up to February 2026. Thirteen studies were included following PRISMA guidelines. Data were analyzed through line-by-line coding, followed by the development of descriptive and analytical themes. Results: Four analytical themes were identified: (1) vaccination as a dynamic risk\u2013benefit negotiation process, (2) trust as a central mechanism shaping information interpretation, (3) socially embedded and relationally negotiated decision-making, and (4) moral identity as a driver of vaccination behavior. Healthcare workers\u2019 vaccination decision-making was not a static choice but an evolving process shaped by continuous appraisal of risks and benefits, filtered through trust in information and institutions, influenced by social interactions, and guided by professional identity and ethical responsibility. Conclusions: Healthcare workers\u2019 vaccination decision-making is a multidimensional process embedded in cognitive, social, and ethical contexts. Interventions should move beyond individual-level approaches and instead focus on building trust, leveraging social networks, and reinforcing professional identity with implications for future public health crises.<\/jats:p>","DOI":"10.3390\/vaccines14060487","type":"journal-article","created":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T12:45:08Z","timestamp":1780404308000},"page":"487","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Understanding Healthcare Workers\u2019 COVID-19 Vaccination Decision-Making as a Dynamic Process: A Qualitative Meta-Synthesis"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0934-7679","authenticated-orcid":false,"given":"Hye-Young","family":"Jang","sequence":"first","affiliation":[{"name":"College of Nursing, Hanyang University, Seoul 04763, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2708-8543","authenticated-orcid":false,"given":"Young","family":"Ko","sequence":"additional","affiliation":[{"name":"College of Nursing, Gachon University, Incheon 21936, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Song Yi","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Nursing Science, Sunmoon University, Asan-si 31460, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,30]]},"reference":[{"key":"ref_1","unstructured":"Centers for Disease Control and Prevention (2026, April 01). 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