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Experience of COVID-19 Vaccination among Primary Healthcare Workers in Hong Kong: A Qualitative Study

Vaccines 2022, 10(9), 1531; https://doi.org/10.3390/vaccines10091531

by Kai Man Ng^1,*, Tsun Kit Chu¹ and Phyllis Lau^2,3

Reviewer 1:

Tauqeer Hussain Mallhi

Reviewer 2:

Alberto Modenese

Reviewer 3: Anonymous

Vaccines 2022, 10(9), 1531; https://doi.org/10.3390/vaccines10091531

Submission received: 15 August 2022 / Revised: 6 September 2022 / Accepted: 9 September 2022 / Published: 15 September 2022

(This article belongs to the Special Issue SARS-CoV-2 (COVID-19) Vaccination and Compliance/Hesitancy)

Round 1

Reviewer 1 Report

Thank you for the invitation. This is an interesting study. Other quantitative studies could not answer some specific questions that were answered by the authors in this qualitative analysis.

What were the HCWs included in the supporting staff?

Line 160: [Error! Reference source not found.].????

The answers of the HCWs in the manuscript should be italic to distinguish them from the general text.

Please provide the individual demographic data of each respondent in the form of a table.

It is not clear how the theme 3 statements are related to the blasting myths of vaccination.

The limitation section of the manuscript is not available. There are several limitations in the manuscript i.e. generalizability, bias, etc., Please include them before conclusions

The conclusion section is very simple, this section should be revised according to the major findings and should be connected with the directions for future research and policies.

Author Response

Response to Reviewer 1 Comments

Thank you for the invitation. This is an interesting study. Other quantitative studies could not answer some specific questions that were answered by the authors in this qualitative analysis

Thank you Reviewer 1 for the kind comments. We agree that our qualitative approach complemented the quantitative findings in literature.

What were the HCWs included in the supporting staff?

The supporting staff includes clinic clerks, patient care assistants and phlebotomist as listed on line 150-151.

Line 160: [Error! Reference source not found.].????

This same comment was also noted from Reviewers 2 and 3. There appears to be an erroneous hyperlink in the reviewers’ download. The hyperlink in the original manuscript links correctly to Figure 1. Can the Editor please check?

The answers of the HCWs in the manuscript should be italic to distinguish them from the general text.

The quotes have been edited to italic as suggested.

Please provide the individual demographic data of each respondent in the form of a table.

Taking comments from Reviewer 1 and Reviewer 2 into consideration, Table 2 is replaced with a table that listed individual participant’s demographic data rather than summarised demographic data.

It is not clear how the theme 3 statements are related to the blasting myths of vaccination.

Vaccinations were initially thought by many HCWs to be an imposition, but their actual experience were far more palatable than their assumptions eg. the booking process was simpler and quicker than they imagined. The key myth of vaccination was nonetheless about the side effects which were discussed in subtheme ‘Skepticism towards vaccine’ under theme 1. The quotes in theme 3 showed that side effects experienced by participants were much milder and not as severe as what they were made to believe previously. Clarifications have now been made to section 3.3 to make this clearer.

The limitation section of the manuscript is not available. There are several limitations in the manuscript i.e. generalizability, bias, etc., Please include them before conclusions

The limitation section, which includes generalizability and description of possible bias, is available in the last paragraph in Discussion. We can see how Reviewer 1 could miss it, and so have added a sentence “There are limitations to our study.” at the start of the paragraph to clearly identify this section.

The conclusion section is very simple, this section should be revised according to the major findings and should be connected with the directions for future research and policies.

We have amended the conclusions substantially as suggested. Please let us know whether this section is now adequate.

Reviewer 2 Report

Dear Authors,

your paper entitled “Experience of COVID-19 vaccination among primary healthcare workers in Hong Kong: A qualitative study” is interesting, but I believe that it needs major revisions before it can be considered for possible publication, as for my comments listed here below for the different sections of the manuscript.

Best regards,

the Reviewer.

Abstract

1. Authors state “Recent studies show coronavirus disease 2019 (COVID-19) vaccine hesitancy”

I don’t know whether this affirmation is correct: e.g. in my country, i.e. Italy, it is not as >95% of HCW are vaccinated against SARS-CoV-2, also because it is required by a specific norm in order to continue their job. My sense is that similar adhesion rates are also reached in other European and North America countries, while I don’t have a full picture of all the world’s countries. Taking anti-flu vaccine in HCW as a reference, in this case the adhesion rates according to published studies were much lower, around 20-30%, with only some peaks of >50 in specific contexts. Of course there is a hesitancy also for anti-Covid-19 vaccine, as there is for anti-flu, both for the general public as well as for HCW. But I believe that the hesitancy is higher for anti-influenza compared to anti-COVID-19, and moreover it is higher in the general public compared to HCW. Please limit the affirmation to the countries/world areas for which you are sure that the affirmation is correct and give proper updated references (not only one, unless a well designed and and with a sufficiently high number of included studies systematic review or an official report of an international institution as WHO) in order to prove your statement in the introduction.

Introduction

2. Lines 32 and following: you can partially skip this part as I’ve seen many many papers declaring what is SARS-CoV-2 and when it was discovered: we now know all and it is not necessary to explain! Moreover, your statement is a little bit unclear, as the virus was dated back to December 2019, while the first cases in China and an extremely severe epidemic were detected in January, with a spread of the cases during February in many world’s countries. It is true that the pandemic was declared by the WHO on the 11^th March 2020, if I correctly remember.

3. Line 39: a comma missing between “patients” and “particularly”. Moreover, please note that the vaccination is also a fundamental occupational health and safety preventive measure for the protection of the exposed workers, not only of the patients.

4. You cite here a rapid systematic review dated back to 2021: please consider my comment above made for the abstract. We are in the second part of 2022 now, and I think that many other papers on the vaccines’ hesitancy against COVID-19 came out: please update your personal litarature search and references.

5. correctdiscovered unfortunately COVID-19 data become old quite fast, and now we have more that 4.7 milion deaths. Please update the data if you can. Moreover, ref. 1 weblink does not work. Perhaps you can consider also WHO: https://covid19.who.int/

6. Lines 22-24: you refer to extra-UE approvals. Shouldn’t it be appropriate to refer also to AIFA and/or EMA approvals as your study is conducted in Europe?

Methods

7. Looking at the title of your study and the first descriptions provided in the Methods section it seems that your aim was to describe a situation representative of that of the HCW from Hong-Kong. I don’t know how many HCW there are in honk Kong but I suppose various thousands. Only at the beginning of the results section it is clear that your study is a case analysis of 28 interviews only: please change the title of your article and clearly state the type and design of the study in the first paragraph of the Methods section, which has to be expanded.

8. The way you have to cite the contribution of KN to the stuidy sounds a little bit not scientific to me in some points, as e.g. when you tell what is KN’s mother tongue. Please refer to similar studies and look how they report their methods.

Results

9. Table 2: as the number of cases is so low, many rows of the table are not needed: my suggestion is to report standard deviation together with mean age, and to delete age classes. Moreover, for work experience, you can consider ≤10, 11-20 and ≥ 21, instead of <10, 10-19, 20-29 and ≥ 30, saving 1 row with only 1 person represented. Same for the row on “Time between vaccination and launch..:”: the last line “5 or more” can be deleted and included in the previous one to be titled as “4 or more”. The interesting data of the person who waited more than 5 months for the vaccine can be separately reported as text in the results section.

10. Line 160 of the updated .pdf manuscript I believe there is a problem with the citation of the reference.

11. Figure 1: according to my previous observation I don’t agree with the title of the figure, as it seesm that your study represents all the HCW of Hong Kong.

Discussion and References

12. Unfortunately, the discussion and the ref. list, as I highlighted also for the introduction, make me think that you did not check the published scientific literature with a suffient level of attention before writing your study: you cite only 2 works from 2022, while the body of papers published in the latest months on SARS-CoV-2 vaccine hesitancy is very high. Please, this is only an example of what can be found in literature: there are 43 systematic reviews published in 2022 only (other 20 in 2021), while the number of papers published in 2022 on the this topic is of 1,687 to date (more than 3,000 considering 2021). The stream of the PubMed search is: ["COVID-19" AND ("vaccine" OR "Vaccination") AND hesitancy] . I believe that among this vast literature you can find some more similar studies to make comparisons and to be discussed together with your results.

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BACKGROUND: There are widespread concerns that ethnic minorities and migrants may have inadequate access to COVID-19 vaccines. . Improving vaccine uptake among these vulnerable groups is important towards controlling the spread of COVID-19 and r …

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Willingness, refusal and influential factors of parents to vaccinate their children against the COVID-19: A systematic review and meta-analysis.

Galanis P, Vraka I, Siskou O, Konstantakopoulou O, Katsiroumpa A, Kaitelidou D.

Prev Med. 2022 Apr;157:106994. doi: 10.1016/j.ypmed.2022.106994. Epub 2022 Feb 18.

PMID: 35183597 Free PMC article. Review.

The main predictors of parents' intention to vaccinate their children were fathers, older age of parents, higher income, higher levels of perceived threat from the COVID-19, and positive attitudes towards vaccination (e.g. children's complete vaccination …

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Determination of Novel Coronavirus Disease (COVID-19) Vaccine Hesitancy Using a Systematic Review Approach Based on the Scientific Articles in PubMed Database.

Ergün A, Bekar A, Aras B, Dere C, Tekneci D, Sarıçiçek G, Akdere SN, Telli S, Pehlivanlı ŞB, Özyurek Ucael D, Özden ME, Altıntaş E, Aslan D.

Turk Thorac J. 2022 Jan;23(1):70-84. doi: 10.5152/TurkThoracJ.2022.21082.

PMID: 35110204

The keyword "COVID-19" is used in 61 articles (79.2%). The second most frequently used keyword is "vaccine hesitancy" (n = 37, 48.1%), followed by "vaccine" (n = 25, 32.5%). ...CONCLUSION: This study illustrates the recent situation for the coro …

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Global COVID-19 Vaccine Acceptance: A Systematic Review of Associated Social and Behavioral Factors.

Shakeel CS, Mujeeb AA, Mirza MS, Chaudhry B, Khan SJ.

Vaccines (Basel). 2022 Jan 12;10(1):110. doi: 10.3390/vaccines10010110.

PMID: 35062771 Free PMC article. Review.

COVID-19 vaccines have met varying levels of acceptance and hesitancy in different parts of the world, which has implications for eliminating the COVID-19 pandemic. ...Furthermore, poor influenza-vaccination history, as well as conspiracy …

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Frequency of Adverse Events in the Placebo Arms of COVID-19 Vaccine Trials: A Systematic Review and Meta-analysis.

Haas JW, Bender FL, Ballou S, Kelley JM, Wilhelm M, Miller FG, Rief W, Kaptchuk TJ.

JAMA Netw Open. 2022 Jan 4;5(1):e2143955. doi: 10.1001/jamanetworkopen.2021.43955.

PMID: 35040967 Free PMC article.

IMPORTANCE: Adverse events (AEs) after placebo treatment are common in randomized clinical drug trials. Systematic evidence regarding these nocebo responses in vaccine trials is important for COVID-19 vaccination worldwide especially because concern ab …

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Cardiovascular and haematological events post COVID-19 vaccination: A systematic review.

Al-Ali D, Elshafeey A, Mushannen M, Kawas H, Shafiq A, Mhaimeed N, Mhaimeed O, Mhaimeed N, Zeghlache R, Salameh M, Paul P, Homssi M, Mohammed I, Narangoli A, Yagan L, Khanjar B, Laws S, Elshazly MB, Zakaria D.

J Cell Mol Med. 2022 Feb;26(3):636-653. doi: 10.1111/jcmm.17137. Epub 2021 Dec 29.

PMID: 34967105 Free PMC article.

Since COVID-19 took a strong hold around the globe causing considerable morbidity and mortality, a lot of effort was dedicated to manufacturing effective vaccines against SARS-CoV-2. ...This review was undertaken with the aim of putting together all the reported car …

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COVID-19 Disparities and Vaccine Hesitancy in Black Americans: What Ethical Lessons Can Be Learned?

Restrepo N, Krouse HJ.

Otolaryngol Head Neck Surg. 2022 Jun;166(6):1147-1160. doi: 10.1177/01945998211065410. Epub 2021 Dec 14.

PMID: 34905417

DATA SOURCES: An internet search through PubMed, CINAHL, and socINDEX was conducted to identify articles on COVID-19 vaccine hesitation among the Black population between 2020 and 2021. REVIEW METHODS: A systematic review approach was taken to search a …

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What factors promote vaccine hesitancy or acceptance during pandemics? A systematic review and thematic analysis.

Truong J, Bakshi S, Wasim A, Ahmad M, Majid U.

Health Promot Int. 2022 Feb 17;37(1):daab105. doi: 10.1093/heapro/daab105.

PMID: 34244738

Examine the factors that promote vaccine hesitancy or acceptance during pandemics, major epidemics and global outbreaks. ...An understanding of participant experiences and perspectives toward vaccines from previous pandemics will greatly inform the development of st …

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COVID-19 vaccination intention in the first year of the pandemic: A systematic review.

Al-Amer R, Maneze D, Everett B, Montayre J, Villarosa AR, Dwekat E, Salamonson Y.

J Clin Nurs. 2022 Jan;31(1-2):62-86. doi: 10.1111/jocn.15951. Epub 2021 Jul 6.

PMID: 34227179 Free PMC article. Review.

BACKGROUND: As COVID-19 vaccine becomes available worldwide, attention is being directed to community vaccine uptake, to achieve population-wide immunity. ...Findings highlighted that socio-demographic differences, perceptions of risk and susceptibilit …

13. Please expand the limitation section of your discussion, considering the intrinsic limitations of your study design.

Conclusions

14. Please, consider that your conclusions have to be a direct consequence of your results, and that the data you are describing is not representative of the Hong Kong situation.

Author Response

Response to Reviewer 2 Comments

Your paper entitled “Experience of COVID-19 vaccination among primary healthcare workers in Hong Kong: A qualitative study” is interesting, but I believe that it needs major revisions before it can be considered for possible publication, as for my comments listed here below for the different sections of the manuscript.

Thank you Reviewer 2 for the forthrightness. We hope our responses to Reviewer 2’s comments are satisfactory.

Abstract

Authors state “Recent studies show coronavirus disease 2019 (COVID-19) vaccine hesitancy”

We appreciate Reviewer 2’s comment, and we have dived a little bit more into the literature. A recently published (Aug 2022) scoping review of 26 papers (22 cross-sectional surveys, 2 cross-sectional qualitative reports, a commentary and a systematic review), that looked into the intentions and attitudes on COVID-19 vaccination of 43,199 HCWs in 16 different countries in Africa, Asia, Europe (including Italy) and North America, found that vaccine hesitancy does exist in HCWs albeit at varying degrees in different populations. Of the papers that compared HCWs with the general population, 2 papers mentioned significantly higher vaccination willingness for HCWs than the general population while 2 found no statistically significant difference, and one found that doctors and the general population were more willing to get vaccinated than nurses. [Reference: Willems LD, Dyzel V, Sterkenburg PS. COVID-19 Vaccination Intentions amongst Healthcare Workers: A Scoping Review. Int J Environ Res Public Health [Internet]. 2022 Aug 17 [cited 2022 Sep 2];19(16):10192. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9407815/]

Hence, we have now amended the first sentence in the abstract to “Studies show coronavirus disease 2019 (COVID-19) vaccine hesitancy exists among healthcare workers (HCWs).” ie. deleting the mention of the general population.

We have also added the findings from Willems et al’s scoping review to the introduction as suggested by the reviewer in comment no. 4.

Introduction

Lines 32 and following: you can partially skip this part as I’ve seen many many papers declaring what is SARS-CoV-2 and when it was discovered: we now know all and it is not necessary to explain! Moreover, your statement is a little bit unclear, as the virus was dated back to December 2019, while the first cases in China and an extremely severe epidemic were detected in January, with a spread of the cases during February in many world’s countries. It is true that the pandemic was declared by the WHO on the 11^thMarch 2020, if I correctly remember.

We have deleted the first sentence on line 32 as suggested and adjusted the sentence to assist with flow.

Line 39: a comma missing between “patients” and “particularly”. Moreover, please note that the vaccination is also a fundamental occupational health and safety preventive measure for the protection of the exposed workers, not only of the patients.

Comma added. And we agree that vaccination is for the protection of HCWs as well as patients. We have added the mention of the HCWs in the sentence on line 41.

You cite here a rapid systematic review dated back to 2021: please consider my comment above made for the abstract. We are in the second part of 2022 now, and I think that many other papers on the vaccines’ hesitancy against COVID-19 came out: please update your personal litarature search and references.

Please see our response to comment no. 1. Reference 4 is now replaced with another review published in Aug 2022, and the text has been updated accordingly.

correctdiscovered unfortunately COVID-19 data become old quite fast, and now we have more that 4.7 milion deaths. Please update the data if you can. Moreover, ref. 1 weblink does not work. Perhaps you can consider also WHO: https://covid19.who.int/

We believe this is a ‘copy and paste’ error by Reviewer 2. We did not reference any death statistics in the main text and reference 1 does not contain a weblink. We will be happy to respond accordingly if Reviewer 2 could clarify.

Lines 22-24: you refer to extra-UE approvals. Shouldn’t it be appropriate to refer also to AIFA and/or EMA approvals as your study is conducted in Europe?

Again, we believe this is a ‘copy and paste’ error. Lines 22-24 in the Abstract do not refer to any approval. And again, we will be happy to respond accordingly if Reviewer 2 could clarify.

Methods

Looking at the title of your study and the first descriptions provided in the Methods section it seems that your aim was to describe a situation representative of that of the HCW from Hong-Kong. I don’t know how many HCW there are in honk Kong but I suppose various thousands. Only at the beginning of the results section it is clear that your study is a case analysis of 28 interviews only: please change the title of your article and clearly state the type and design of the study in the first paragraph of the Methods section, which has to be expanded.

We stated very clearly in our title that this is a qualitative study. And we stated very clearly in the abstract that 28 HCWs were interviewed. Our phenomenological study approach and interview design, not case analysis, are also stated very clearly in Methods (section 2.1). Qualitative research is not dependent on sample size. Our sample of 28 participants have contributed data that reached data saturation which is the key end point in qualitative research. We feel that our title and the first paragraph of the Methods section are adequate.

The way you have to cite the contribution of KN to the study sounds a little bit not scientific to me in some points, as e.g. when you tell what is KN’s mother tongue. Please refer to similar studies and look how they report their methods.

We disagree with the reviewer. We used the consolidated criteria for reporting qualitative studies (COREQ) checklist to guide the writing of this manuscript. A key component of qualitative research reporting is to describe the researchers, their roles and their relationship with their participants. Not only is this scientific, it is a demonstration of rigour and transparency of the processes in qualitative research. Stating that KN used his mother tongue to conduct the interviews with participants with the same mother tongue gives readers a sense of the rapport between interviewer and interviewees. Author PL has written a similar report stating the use of the interviewer’s native language with their focus group participants. [Saberi S, Wachtler C, Lau P. Are we on the same page? Mental health literacy and access to care: a qualitative study in young Hazara refugees in Melbourne. Aust J Prim Health. 2021 Dec;27(6):450-455. doi: 10.1071/PY21017. PMID: 34802509.]

Reference: Allison Tong, Peter Sainsbury, Jonathan Craig, Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups, International Journal for Quality in Health Care, Volume 19, Issue 6, December 2007, Pages 349–357, https://doi.org/10.1093/intqhc/mzm042

Results

Table 2: as the number of cases is so low, many rows of the table are not needed: my suggestion is to report standard deviation together with mean age, and to delete age classes. Moreover, for work experience, you can consider ≤10, 11-20 and ≥ 21, instead of <10, 10-19, 20-29 and ≥ 30, saving 1 row with only 1 person represented. Same for the row on “Time between vaccination and launch..:”: the last line “5 or more” can be deleted and included in the previous one to be titled as “4 or more”. The interesting data of the person who waited more than 5 months for the vaccine can be separately reported as text in the results section.

As explained in our response to comment no. 7, our sample size is not low but is adequate for qualitative research. We have added another table to describe the demographics of individual participants as per the request of Reviewer 1. We feel that the added table is clearer and more adequately provide context, and so have now replaced the original Table 2 with the new Table.

Line 160 of the updated .pdf manuscript I believe there is a problem with the citation of the reference.

This same comment was also from Reviewers 1 and 3. There appears to be an erroneous hyperlink in the reviewers’ download. The hyperlink in the original manuscript links correctly to Figure 1. Can the Editor please check?

Figure 1: according to my previous observation I don’t agree with the title of the figure, as it seesm that your study represents all the HCW of Hong Kong.

We disagree with the reviewer. Figure 1 is the diagrammatical representation of the “themes and subthemes of the study” which is the title. It does not say that the findings represent all HCWs in Hong Kong.

Discussion and References

Unfortunately, the discussion and the ref. list, as I highlighted also for the introduction, make me think that you did not check the published scientific literature with a suffient level of attention before writing your study: you cite only 2 works from 2022, while the body of papers published in the latest months on SARS-CoV-2 vaccine hesitancy is very high. Please, this is only an example of what can be found in literature: there are 43 systematic reviews published in 2022 only (other 20 in 2021), while the number of papers published in 2022 on the this topic is of 1,687 to date (more than 3,000 considering 2021). The stream of the PubMed search is: ["COVID-19" AND ("vaccine" OR "Vaccination") AND hesitancy] . I believe that among this vast literature you can find some more similar studies to make comparisons and to be discussed together with your results.

Thank you Reviewer 2 for the suggestion. We performed an updated literature search as suggested and updated the references in our Discussion. A new study added as reference 17 which was published in Jan 2022 to support action cues motivating HCWs for vaccination from line 389 to 392. The finding of HCWs fearing of vaccine side effects is now replaced with another paper published in Apr 2022 from line 397 to 399.

Please expand the limitation section of your discussion, considering the intrinsic limitations of your study design.

Recall bias is now mentioned in the limitation section (last paragraph) of Discussion.

Conclusions

Please, consider that your conclusions have to be a direct consequence of your results, and that the data you are describing is not representative of the Hong Kong situation.

We have revised the conclusions substantially in response to Reviewer 1’s suggestion to connect major findings “with the directions for future research and policies”. We reiterate that the aim of qualitative research is not to seek ‘representativeness’ of the study population. Our study approach was to explore and gain an understanding of the ‘phenomenon’ of vaccine hesitation of HCWs in Hong Kong, and our participants were selected to achieve maximum variation to ensure that we have broad representation of views (see Section 2.2). Therefore, within the limitations we have already described in the last paragraph in Discussion, we believe our methods and processes were rigorous and valid to justify our conclusions.

Reviewer 3 Report

This is a qualitative study to evaluate the perception of healthcare workers in Hing Kong on the SARS-CoV-2 vaccination. The article provides us with relevant information when we understand healthcare workers’ thoughts on the SARS-CoV-2 vaccination from a global point of view.

Major)

1) The authors mentioned that a number of participants’ decisions to vaccinate were heavily influenced by government policies or organizational regulatory measures (Line 403). On the other hand, the study identified ‘autonomy’ as a subtheme (Line 205). It would be appreciated if the authors added participant comments on ensuring self-decision making.

2) There might be a limitation on recall bias, which should be briefly mentioned in the discussion.

3) There would be differences in the perception, which was classified in theme ‘1’, between junior and senior healthcare workers.

Minor) reference error in line 160

Overall, the article is well described; however, minor modification is necessary, as mentioned above.

Author Response

Response to Reviewer 3 Comments

Thank you Reviewer 3 for the kind comment.

Major)

Whilst the Hong Kong government actively promotes and encourages vaccination, there are in fact no mandatory measures enforced in Hong Kong, and HCPs and the general public have the rights to make their own decision on vaccination. In the current quote under the subtheme ‘autonomy’, the participant was in fact emphasizing the autonomy they have and describing their self-decision making. We have amended the sentence preceding the quote to make this clearer – “Participants valued the autonomy that they currently have and believed their decisions about whether to vaccinate should be respected.”

To further clarify, we have added “There are currently no mandatory measures enforced in Hong Kong, and HCWs and the general public have their rights to decide whether to vaccinate.” on line 421 under Discussion.

2) There might be a limitation on recall bias, which should be briefly mentioned in the discussion.

Thank you Reviewer 3 for the suggestion. Recall bias is now added to the last paragraph of Discussion.

3) There would be differences in the perception, which was classified in theme ‘1’, between junior and senior healthcare workers.

We agree with Reviewer 3 and this was in fact what we found. We have now added a sentence “In particular, junior HCWs such as supporting staff and some nurses seemed more likely to have such skepticisms.” under subtheme ‘Skepticism towards vaccine’.

Minor) reference error in line 160

This same comment was also from Reviewers 1 and 2. There appears to be an erroneous hyperlink in the reviewers’ download. The hyperlink in the original manuscript links correctly to Figure 1. Can the Editor please check?

Round 2

Reviewer 2 Report

Dear Authors,

your article has been improved after the peer review process and I believe that it is now ready for publication in Vaccines journal.

Best regards,

the Reviewer

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Experience of COVID-19 Vaccination among Primary Healthcare Workers in Hong Kong: A Qualitative Study

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