Acceptance of COVID-19 Vaccination Among Health System Personnel

Abstract

Introduction: One-third of the general public will not accept Coronavirus disease 2019 (COVID-19) vaccination but factors influencing vaccine acceptance among health care personnel (HCP) are not known. We investigated barriers and facilitators to vaccine acceptance within 3 months of regulatory approval (primary outcome) among adult employees and students at a tertiary-care, academic medical center.Methods: We used a cross-sectional survey design with multivariable logistic regression. Covariates included age, gender, educational attainment, self-reported health status, concern about COVID-19, direct patient interaction, and prior influenza immunization.Results: Of 18,250 eligible persons, 3,347 participated. Two in 5 (40.5%) HCP intend to delay (n = 1020; 30.6%) or forgo (n = 331; 9.9%) vaccination. Male sex (adjusted OR [aOR], 2.43; 95% confidence interval [CI], 2.00-2.95; P < .001), prior influenza vaccination (aOR, 2.35; 95% CI, 1.75-3.18; P < .001), increased concern about COVID-19 (aOR, 2.40; 95% CI, 2.07-2.79; P < .001), and postgraduate education (aOR, 1.41; 95% CI, 1.21-1.65; P < .001) -but not age, direct patient interaction, or self-reported overall health -were associated with vaccine acceptance in multivariable analysis. Barriers to vaccination included concerns about long-term side effects (n = 1197, 57.1%), safety (n = 1152, 55.0%), efficacy (n = 777, 37.1%), risk-to-benefit ratio (n = 650, 31.0%), and cost (n = 255, 12.2%).Subgroup analysis of Black respondents indicates greater hesitancy to accept vaccination (only 24.8% within 3 months; aOR 0.13; 95% CI, 0.08-0.21; P < .001).Conclusions: Many HCP intend to delay or refuse COVID-19 vaccination. Policymakers should impartially address concerns about safety, efficacy, side effects, risk-to-benefit ratio, and cost. Further research with minority subgroups is urgently needed.

Prevalence and Predictors of COVID-19 Vaccination Acceptance among Greek Health Care Workers and Administrative Officers of Primary Health Care Centers: A Nationwide Study Indicating Aspects for a Role Model

“…Many studies conducted, for example, in Germany [ 37 ], Canada [ 38 ], India [ 39 ] and the USA [ 40 ] following the release of vaccines describe a vaccine acceptance level comparable with our study. However, other studies conducted in Germany [ 41 ], the United Arabic Emirates [ 42 ], Czech Republic [ 43 ] and the USA [ 44 ] reveal lower vaccine acceptance levels compared to our study.…”

COVID-19 Vaccine Booster Hesitancy (VBH) of Healthcare Workers in Czechia: National Cross-Sectional Study

“…The favourable risk-benefit ratio estimation was a significant and robust predictor of BD acceptance among our participants. The same finding was reported earlier among several population groups, e.g., Czech university students [70], Palestinian healthcare students [71], and American HCW [116], who were more likely to accept COVID-19 vaccine when they had favourable risk-benefit ratio assessment. This fundamental concept of an individual's risk-benefit ratio assessment has been widely used in vaccine communication and vaccine hesitancy research, as it portrays perceived effectiveness and safety of the vaccine from one side and perceived susceptibility to the infection from another side [117].…”

COVID-19 Vaccine Hesitancy in Healthcare Personnel: A University Hospital Experience

“…Our study showed that previous and current health perceptions did not affect COVID-19 vaccine acceptance. Similarly, other studies conducted in China by applying the SF-12 scale, and conducted in USA, no difference was encountered in the group considering vaccination and the hesitant group [11,18]. On examination of the studies evaluating the effect of having a chronic disease on vaccine acceptance, a review article examining COVID-19 vaccine hesitancy in healthcare workers, having a chronic illness was associated with a higher rate of COVID-19 vaccine acceptance [9].…”

“…In a systematic review exploring COVID-19 vaccine hesitancy in healthcare workers, direct contact/care with COVID-19 patients or higher perceived risk and fear of being infected with COVID-19 were associated with lower COVID-19 vaccination hesitancy in more than half of the studies [9]. Distinctively, another study, assessing vaccine acceptance of healthcare personnel, identified no correlation between COVID-19 vaccine acceptance and having a work role involving direct patient interaction [18]. As for our study, there was also no significant impact of working in the departments providing one-to-one care to a COVID-19 patient on the decision to have a COVID-19 vaccine.…”

“…When we reviewed the literature, we also discovered these three reasons were among the most common causes of indecision. In another study conducted in the USA, the reason for delaying or rejecting the vaccine was evaluated; concerns regarding side effects, safety and efficacy were amongst the top three most common reasons [18]. Similarly, in another study investigating COVID-19 vaccine hesitancy in healthcare workers, these three reasons are the ones encountered most commonly [9].…”