Background: Healthcare workers (HCWs) are essential for immunization delivery; however, vaccine hesitancy among this population poses a significant threat to public health. Understanding the implementation challenges and determinants of hesitancy across healthcare professions and international healthcare systems is critical for developing effective vaccination programs.

Aim: This narrative review synthesizes evidence on the challenges of vaccination program implementation and hesitancy management strategies in healthcare settings from the perspectives of physicians, pharmacists, nurses, laboratory professionals, and specialists in public health, preventive medicine, and occupational medicine across diverse international healthcare systems.

Methods: A comprehensive literature search was conducted using PubMed, MEDLINE, Scopus, and Web of Science for articles published until December 2023. Studies examining vaccination program implementation, vaccine hesitancy among HCWs, and the intervention strategies were included. Data were synthesized thematically into categories of implementation barriers, determinants of hesitancy, professional perspectives, and intervention effectiveness.

Results: COVID-19 vaccine hesitancy among HCWs ranged from 4.3% to 72% globally, with nurses and allied health professionals demonstrating higher hesitancy rates than physicians. Key implementation barriers include inadequate cold chain infrastructure (only 61% of facilities in developing regions maintained adequate standards), interoperability failures in electronic registries, and resource constraints. Safety concerns (69-74% of HCWs), mistrust in vaccine development processes, and misinformation emerged as primary hesitancy drivers. Multicomponent interventions combining education, communication, and institutional policies demonstrated superior effectiveness (RR 1.58; 95% CI: 1.49-1.68) compared to single-strategy approaches. Mandatory vaccination policies achieved coverage rates exceeding 94%, whereas voluntary policies typically plateaued at 60%. Significant geographic disparities were observed: HCW hepatitis B vaccination reached 67-79% in high-income countries versus 18-39% in low-income settings.

Conclusion: Effective vaccination programs require profession-specific, multi-component interventions that address trust, convenience, and the organizational culture. A staged implementation approach that begins with accessible voluntary programs and incorporates mandatory policies when voluntary approaches fail offers the most evidence-based pathway to optimal HCW vaccination coverage.