COVID-19 Vaccine Acceptance and Hesitancy among Singaporean Primary Healthcare Workers

Abstract

BackgroundFactors affecting COVID-19 vaccine acceptance and hesitancy among primary healthcare workers (HCW) remain poorly understood. This study aims to identify factors associated with vaccine acceptance and hesitancy among HCW.MethodsA multi-centre online cross-sectional survey was performed across 6 primary care clinics from May to June 2021, after completion of vaccination exercise. Demographics, profession, years working in healthcare, residential status, presence of chronic medical conditions, self-perceived risk of acquiring COVID-19 and previous influenza vaccination were collected. HCW who accepted vaccine were then asked to rank their top 5 reasons for vaccine acceptance; HCW who were vaccine hesitant had to complete the 5C scale on psychological antecedents of vaccination.Results557 out of 1182 eligible HCW responded (47.1%). 29 were excluded due to existing contraindications. Among 557 respondents, vaccine acceptance rate was 94.9% (n=501) and 5.1% were hesitant (n=27). COVID-19 vaccine acceptance was not associated with sex, age, ethnicity, profession, number of years in healthcare, living status, presence of chronic diseases, self-perceived risk or previous influenza vaccination. The top 3 reasons for COVID-19 vaccine acceptance ranked by 501 HCW were to protect their family and friends, protect themselves from COVID-19 and due to high risk of acquiring COVID-19 because of their jobs. The 15-item questionnaire from the 5C psychological antecedents of vaccination was completed by 27 vaccine hesitant HCW. The mean scores for the components of the 5Cs were: ‘Confidence’ (3.96), ‘Complacency’ (3.23), ‘Constraint’ (2.85), ‘Calculation’ (5.79) and ‘Collective responsibility’ (4.12).ConclusionCOVID-19 vaccine hesitancy is a minute issue among Singapore primary HCW, having achieved close to 95% acceptance rate with 5% hesitancy rate. Future studies can focus on other settings with higher hesitancy rates, and acceptance of booster vaccinations with the emergence of the delta COVID-19 variant.Trial RegistrationThis study was approved by the National Healthcare Group (NHG) Domain Specific Review Board (DSRB), Singapore on 26th April 2021 (Reg No. 2021/00213).

COVID-19 Vaccine Booster Hesitancy among Healthcare Workers: A Retrospective Observational Study in Singapore

“…This was also supported by evidence-based decision making showcased by routine updates to guidelines by a COVID-19 multi-ministry task force, suitable communications, and strong primary care. Among HCW, vaccine hesitancy rates were low due to high self-perceived risk, similar to many studies performed abroad [ 15 ]. Males working in healthcare, ethnicity, and age were associated with increased vaccination uptake [ 16 ].…”

“…Despite evidence and media releases on improved efficacy of Pfizer-Pfizer-Moderna over Pfizer-Pfizer-Pfizer COVID-19 booster combination [ 21 ], close to 90% of HCW opted for the Pfizer booster ( Figure 1 ). We speculated that this was because of ease of accessibility to booster at all clinics (which only carried Pfizer), which corresponded to our previous study where we saw hesitant HCW ranking ‘Constraints’ as the lowest in the 5Cs hesitancy scale [ 15 ].…”

“…Moreover, the rest of the healthcare cluster achieved this rate 1 month later, in mid-January 2022, showing that primary care HCW might have been less hesitant. Cross-referencing with results from our previous study on the same population of HCW, we speculated that this might be due to increased self-perceived risk to COVID-19 importance of protecting oneself and their family [ 12 , 15 ].…”