Table 2.

Exemplary quotes from participants.

Themes	Quote #	Supporting quotes
The contextual challenges of the vaccination decision
Infodemic	1	The media aspect certainly doesn't help … all the things you hear, you read … it certainly doesn't help the undecided to change their minds, that's it. (Male, 61, vaccinated, administrative and domestic sector)
	2	I have well informed myself for months now, and there are too many contradictions, that's it. There are doctors who want to talk, and they won't let them talk. (Female, 57, not vaccinated, health and social sector)
	3	Maybe there is too much information. They [government, media] say "get vaccinated, get vaccinated"! So they [people] say they won't do it because they feel pressured to do it, or because there are too many discordant voices. One you trust and the other you don't. So, eventually one tells you “I don't know what to do anymore and so I flip the coin”. (Male, 32, vaccinated, health and social sector).
De-personalization of the vaccination	4	Things like that, like standing in line to go … my mom used to tell me that it is exactly how they used to go to pick up stamps to receive food or something like that during the war. (Female, 61, vaccinated, health and social sector)
Moralization of the vaccination decision	5	However, anyone who speaks out against the vaccine runs a risk now…. So as much as one says "No" against this vaccine, it's like being told "I'm in favor of this pandemic and therefore in favor of deaths." That's the kind of the mechanism that is developing now. (Male, 46, not vaccinated, health and social sector)
	6	If I did not work in the field, I would be for not doing it. In the sense that it's a vaccine that was done very quickly, and being a single person with no family, I don't see the utility of it for me, personally. But given where I work, I find it a moral duty to the users of the facility. So, if I generally decide not to do the flu shot, and they get the flu, that's one thing. If they get the coronavirus, that's another. We have really experienced it on our skin with extra deaths, it's really more the moral issue of saying "here, do it". Especially if you are in contact with fragile people. (Female, 51, vaccinated, health and social sector)
	7	It's the very fact of being considered not good professionals, right? Or being selfish. Because the fact of doing the vaccine … we have it written all over the institution, even on the website, it really says: the fact of getting vaccinated together, the fact that this allows a return to a normal life … And so the fact that you don't adhere or if you express a doubt, that makes the management … that everybody is judged by the management … as a not so good professional. (Male, 46, not vaccinated, health and social sector)
Fear of discrimination	8	Because sometimes even at work you try to say, "Geez here it was your fault, maybe it was that one who came in [to bring the COVID-19 virus], it was those ones, it was that other one … " I don't want to have these issues, because I guarantee you that being in the middle of the maelstrom is not nice! (Female, 48, vaccinated, health and social sector)
	9	And I would say in a sense, maybe it's a bit of a strong word to say stigmatized…. But actually he [the non vaccinated] is the only one … he has a lot of responsibility, in the sense that he is the only one [to not get vaccinated] … there are only a few anyway … and so the moment you can't make an exit, the moment there are restrictions, you are considered the reason for that. (Female, 31, vaccinated, health and social sector)
	10	Some people ask "but are you vaccinated?" or even precisely when it happens that someone is not well they "blame" the workers who were not vaccinated. "Surely it was you who brought this [virus]". (Female, 40, vaccinated, health and social sector)
	11	There are some who already had to stay home in quarantine because they were not vaccinated, because if they had been vaccinated they could have easily come to work, and that weighs. (Male, 61, vaccinated, administrative and domestic sector)
Patterns of decision-making
Principle-driven	12	Another thing that is an ethical aspect, since I am a practicing Christian believer, I also hang out with people who are both doctors and believers anyway, and they have pointed out that there are studies where they have shown that this vaccine was made quickly and because of the affinity of the RNA with some placenta or with fetuses obtained I don't know how, or not lawfully from abortions and the rest … just to always use human DNA in the easiest stage of replication. That aspect alone for me would be out! Because it's out of question, abortion is out of question, in this case, then especially exploiting abortion for scientific research even more so to produce something that is supposed to help us (…). From this point of view … from the point of view of faith and so even on this alone, I say "No!" I am not against vaccinations. Because vaccinations have saved many people anyway and changed the way we live. (Male, 46, not vaccinated, health and social sector)
Tradition-driven	13	I have a Western scientific background. I rely on, with respect to my expertise, expert guidelines…), it wouldn't make sense for me to doubt now about the vaccine. I don't have any kind of doubt about the vaccine (Female, 41, vaccinated, health and social sector)
	14	I joined because I trust vaccines. (…) I have always got vaccinated. (…) I come from a family where everyone has always got vaccinated. (Female, 42, vaccinated, health and social sector)
Emotion-driven	15	I started absolutely against this vaccination. Absolutely against, I mean, when they started talking I would say, 'but you're crazy, I will never get vaccinated, everything was done too fast, there was no experimentation,' what everybody thinks a little bit, that then in two months you get Dr. Spock's ears. (…) Then when it was time to order the vaccines the director asked who wanted to vaccinate, and I said no again. (…) On the day of vaccination in the nursing home then I went in at 8 a.m. convinced not to get vaccinated … and I came out at noon vaccinated! (…) You have to understand the context: we were coming from a really difficult month, and coming from this really bad month … I can't explain what was in the air that day there: there was enthusiasm, there was hope … We all know it's not going to be the one to save us, but after you've lived through a month like that, and you see the death records coming through your office, you're shocked. We saw the bodies go by in the black bags, know that even the relatives haven't seen them anymore … it hits you. (…) You could breathe in the air that day there, as if there was a light at the end of the tunnel. I came in saying I wasn't taking the vaccine. And then … a little bit this air that I was breathing (…) By the way the media were there, RSI [regional TV station] was there, then they broadcasted the service on TV, and I could hear these operators talking to our health and social workers (…) Then I went up … and I can't explain. They told me: extra doses were prepared. And I said to myself: somebody has to start. And I got vaccinated. (…) It's hard to explain, the day of vaccination … I have a hard time telling, it's an internal feeling that enters you … like a brightness, like a light at the end of the tunnel. I can't explain it in words, it's something you feel inside. There was an atmosphere of … but I don't know, happiness is a big word, however that day … yes, because even though we all know that maybe it doesn't do any good, after all the pain we felt that month there, for us it was like a liberation. It cannot be explained in words. Relief, light … I can't find the words, I don't know. (Female, 55, vaccinated, administrative and domestic sector)
The reflexive pattern based on the assessment of personal relevance vs. collective importance
Detached - Altruistic	16	Not just thinking about the seniors in the nursing home, so my working place, but also a little bit thinking about my parents who are in their eighties and my in-laws who live on the top floor of my house. So a protection almost "for them". (Female, 48, vaccinated, health and social sector)
	17	Let's say yes also because, when there was the first wave of Covid, basically at the end of March, I got it. So I got sick with Covid. And so here, having had it, I actually felt quite protected personally. So I got the vaccine later on more to protect let's say the people around me who have this higher risk. (Female, 48, vaccinated, health and social sector)
	18	Unfortunately, we are responsible for the people, the users we work with. We have responsibility for them, not just ourselves. If my actions, the fact that I don't get vaccinated only affects my personal life, I say, "Fine, do what you want." But you have a responsibility to the other people because of the job you do. If you don't want to do it, change your job, go somewhere else. (Female, 40, vaccinated, health and social sector)
	19	I told myself: “I am going to do it! I will do it”. Because I think it is a common responsibility that we all have, not only as health and social workers, as people working in social facilities, but as citizens. It is how this new pandemic has been handled that I don't agree with. However, I think we need to do it (get vaccinated). (Male, 35, vaccinated, health and social sector)
	20	But I decided to do it more as a matter of responsibility to the people I work with and my relatives. (Female, 40, vaccinated, health and social sector)
	21	As I say to everyone who asks me, with respect to vaccination and the fact that it is something uniquely for me, I would not do it but I do it for others. (…) being a disease that for me could be potentially harmless, whereas for the people around me not only at work but also in my private life it could be much more dangerous. (Female, 38, vaccinated, health and social sector)
Detached - Selfish	22	Oh well, one says “I don't know. I'm still not enough … I don't feel the need yet, I don't get vaccinated for now." (…) Right. Plus one says "I never get vaccinated, I don't feel the need, I've never had a problem and I don't feel the need to get vaccinated, I don't need it." (Male, 43, vaccinated, health and social sector)
Supportive - Convinced	23	[I think it's] definitely a protection towards us, I had the vaccine last week and so I think first of all it protects me. (Male, 26, vaccinated, health and social sector)
	24	It has to be done! Already in the institute where I work they are promoting it a lot, but even before, we say it is the only way to get out of it and back to a pseudo-normality and so I am in favor of it. Also, from what I understand, they have not skipped the steps of verification and control and therefore the vaccine is safe, I am confident. Then I am not completely knowledgeable about this area but I choose the news to rely on. So, premised that I choose to get vaccinated and I agree with respect to the coronavirus vaccination precisely because I think it was the only strategy we have, that we know, to be able to, if we can say, solve the situation. (Female, 31, vaccinated, health and social sector)
	25	I welcome that there is one [vaccine], I do it because I don't want to get it [Covid], I want to be safe. (Female, 43, vaccinated, health and social sector)
	26	So by protecting me, I also protect others. Or at least that is what I have been told. (Female, 38, vaccinated, health and social sector)
Supportive - Patient	27	Since we were the first ones, [my initial position was to] let the others [do it first]. I am not an at-risk person, let the others get vaccinated, I wanted to see the side effects from this vaccine and then possibly at a later time to get vaccinated. (Male, 48, vaccinated, health and social sector)
	28	Basically they compare us to those who get two shots without having had Covid, and so I chose to do just one [shot]. In part to leave the second dose for those who really need it, maybe even more than me, not having got the disease yet. (Female, 43, vaccinated, health and social sector)
Interested - Pragmatic	29	Then one says “I want to get vaccinated because I also want to….”. There is this freedom because of this vaccination passport, right? And one says “so at least I'm free to travel. (Male, 43, vaccinated, health and social sector)
	30	Without vaccination passport, in a while, you won't go anywhere, you'll need it to go to summer concerts, to go abroad, a little bit for everything, and so one starts to say "but if after that I can't go there, I can't go there … then I get vaccinated". (Male, 61, vaccinated, administrative and domestic sector)
Interested - Discriminated	31	Why, especially if there are people who say "I have the relative who has been vaccinated … ", how come some of us [health and social workers caring for people with disabilities] are still waiting, how come our children are still not vaccinated? (Female, 31, vaccinated, health and social sector)
Skeptical - Submitted	32	I finally got vaccinated because I was working there in the home for the elderly but I was not 100% convinced about this vaccine. (Male, 48, vaccinated, health and social sector)
Skeptical - Resistant	33	Then maybe I'll be proven wrong, but if what I know now has been based on this [information, referring to the use of stillbirth fetuses to produce vaccines] … there are a whole series of pieces that I presented to you earlier [referring to information on how vaccines are manufactured], with lack of clarity … now I'm sorry, I say "No!" (Male, 46, not vaccinated, health and social sector)
	34	No, no. I am sure not to get vaccinated. (Female, 57, not vaccinated, administrative and domestic sector)
Watch-and-wait	35	Some colleagues were saying “No, right now I don't do it, I'm waiting … having had the disease right now I don't feel like doing a vaccine, it seems early". (Female, 33, vaccinated, health and social sector)