Despite numerous campaigns, influenza vaccination of healthcare workers remains insufficient in France. The highly cognitive approach of persuasion models in healthcare poorly explains this non-vaccination. A survey of 794 French nurses and nurse aides in 2018 highlights the role of psychological reactance. The greater their perceived threat to freedom due to vaccination pressure, the more it generates situational reactance and strategies for restoring their threatened freedom: denial or minimization of the health threat (low perceptions of severity and vulnerability to influenza) and diminished attractiveness or denigration of the recommended option or its source (low perceptions of efficacy and benefits of vaccination), leading to rejection of the recommended behavior (flu vaccination). This original modeling of variables traditionally seen as antecedents to reactance explains persuasive failure and is contextualized and discussed through objective characteristics (age, profession). Managerial recommendations and avenues of research follow.
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