COVID-19 vaccination beliefs, attitudes, and behaviours among health and social care workers in the UK: A mixed-methods study

Abstract

Background The UK began delivering its COVID-19 vaccination programme on 8 December 2020, with health and social care workers (H&SCWs) given high priority for vaccination. Despite well-documented occupational exposure risks, however, there is evidence of lower uptake among some H&SCW groups. Methods We used a mixed-methods approach—involving an online cross-sectional survey and semi-structured interviews–to gain insight into COVID-19 vaccination beliefs, attitudes, and behaviours amongst H&SCWs in the UK by socio-demographic and employment variables. 1917 people were surveyed– 1656 healthcare workers (HCWs) and 261 social care workers (SCWs). Twenty participants were interviewed. Findings Workplace factors contributed to vaccination access and uptake. SCWs were more likely to not be offered COVID-19 vaccination than HCWs (OR:1.453, 95%CI: 1.244–1.696). SCWs specifically reported uncertainties around how to access COVID-19 vaccination. Participants who indicated stronger agreement with the statement ‘I would recommend my organisation as a place to work’ were more likely to have been offered COVID-19 vaccination (OR:1.285, 95%CI: 1.056–1.563). Those who agreed more strongly with the statement ‘I feel/felt under pressure from my employer to get a COVID-19 vaccine’ were more likely to have declined vaccination (OR:1.751, 95%CI: 1.271–2.413). Interviewees that experienced employer pressure to get vaccinated felt this exacerbated their vaccine concerns and increased distrust. In comparison to White British and White Irish participants, Black African and Mixed Black African participants were more likely to not be offered (OR:2.011, 95%CI: 1.026–3.943) and more likely to have declined COVID-19 vaccination (OR:5.550, 95%CI: 2.294–13.428). Reasons for declining vaccination among Black African participants included distrust in COVID-19 vaccination, healthcare providers, and policymakers. Conclusion H&SCW employers are in a pivotal position to facilitate COVID-19 vaccination access, by ensuring staff are aware of how to get vaccinated and promoting a workplace environment in which vaccination decisions are informed and voluntary.

COVID-19 Vaccination: An Exploratory Study of the Motivations and Concerns Detailed in the Medical Records of a Regional Australian Population

“…The role of healthcare professionals in influencing the uptake of vaccination has been demonstrated in previous studies [ 45 , 46 ]. In Australia, GPs are integral in the COVID-19 response, providing primary care for patients seeking counselling about COVID-19 vaccination, with many additionally delivering COVID-19 vaccination.…”

Perceived COVID-19 Vaccine Pressure in the Caribbean: Exploring a New Stressor–Strain Phenomenon in the Pandemic

“…The emphasis on 'internalised pressure' (i.e., strain) as opposed to 'reported levels of external societal pressure or demands' allowed the scale to directly capture individuals' mental health strain experience rather than their appraisal of the stressor phenomenon itself (the stressor being external societal demands/pressure). This approach deviates from a previous study [16] where 'vaccine pressure' was measured as an 'external' stressor (as opposed to a psychological strain outcome) in the form of a single-item scale capturing the level of perceived employer pressure on COVID-19 vaccinations.…”

“…Other emerging research and contemporary perspectives on mandatory COVID-19 vaccination agendas have cautioned employers against mandating or coercing employees to take the COVID-19 vaccine since this approach is more likely to exacerbate vaccine hesitancy and distrust [16,45]. In one recent study in Hong Kong which conducted a survey at two different waves (one conducted before the COVID-19 pandemic declaration and one at a later and more severe stage after the pandemic declaration), it was revealed that working individuals (especially those employed in the sales and services industries) were less willing to take the COVID-19 vaccine [46].…”

“…Emerging research [16] revealed that increasing pressure and demands on employees to be vaccinated resulted in lower levels of acceptance and willingness to have a COVID-19 vaccination and exacerbated vaccine concerns and distrust among surveyed health-care professionals in the UK-a phenomenon comparable to the boomerang or backfire effect. Similarly, it was acknowledged that coercive or mandatory vaccine approaches tended to worsen vaccine hesitancy due to the mediating effects of reactance-which involves negative and hostile reactions [14].…”

A Retrospective Cross-Sectional Study on the Risk of Getting Sick with COVID-19, the Course of the Disease, and the Impact of the National Vaccination Program against SARS-CoV-2 on Vaccination among Health Professionals in Poland

“…Similarly, other studies noted that the death of a family member or friend due to COVID-19 increased the chance of getting vaccinated [ 28 ]. Additionally, other studies revealed that contact with people who suffered from COVID-19 [ 29 ] led to higher vaccine acceptance than employer pressure [ 30 ].…”