Background: COVID-19 has caused high morbidity and mortality in UK care homes. Vaccinating staff members and residents will protect care homes from severe clinical cases. Uptake of COVID-19 vaccine first doses in care homes has been higher among residents compared to staff members. Methods: We aimed to identify causes of lower COVID-19 vaccine uptake amongst care home staff members within the Liverpool City Council region. An anonymised online survey was distributed to all care home managers between the 21st and the 29th of January 2021. Descriptive analysis was performed on responses. Results: 46/87 (53%) of Liverpool care homes responded. The mean staff vaccination rate per home was 51.4% (95% CI 43.9-58.8%). The most common reasons for staff not receiving the vaccine were: concerns about lack of vaccine research (37.0%), staff being off-site during vaccination sessions (36.5%), pregnancy and fertility concerns (5.6%), and concerns about allergic reactions (3.2%). Care home managers reported the necessity to combat vaccine hesitancy through meetings and conversations with health professionals, and provision of supporting evidence to dispel vaccine misinformation. Conclusions: Vaccine hesitancy was the main cause for reduced vaccine uptake among care home staff members. These concerns could be addressed by targeted evidence-based training, and a public health communication campaign to build vaccine confidence and increase acceptance of COVID-19 vaccines. The speed of vaccination roll-out has also led to unexpected logistical issues that lowered vaccine uptake rates. Addressing both these challenges could increase uptake by more than 40%.