Examining drivers of coronavirus disease 2019 (COVID-19) vaccine hesitancy among healthcare workers

Abstract

Objective: To assess characteristics and perceptions associated with vaccine hesitancy among healthcare workers in order to increase COVID-19 vaccine uptake in this population. Design: Cross-sectional quantitative survey Setting: Southwest Virginia Participants: A convenience sample of 2,720 employees of a not-for-profit healthcare system Methods: Between March 15-29, 2021, we conducted an Internet-based survey. Our questionnaire assessed sociodemographic and work-related characteristics, vaccine experience and intentions, agreement with vaccine-related perceptions, most important reasons for getting or not getting vaccinated, and trusted sources of information about COVID-19. We used χ2 analyses to assess the relationship between vaccine hesitancy and both characteristics and vaccine-related perceptions. Results: 18% of respondents were classified as vaccine-hesitant. Characteristics significantly associated with hesitancy included Black race/ethnicity, younger age, not having a high-risk household member, and prior personal experience with COVID-19 illness. Hesitancy was also significantly associated with many vaccine-related perceptions, including concerns about short-term and long-term side-effects and a belief that the vaccines are not effective. Among acceptant participants, wanting to protect others and wanting to help end the pandemic were the most common reasons for getting vaccinated. Personal physicians were cited most frequently as trusted source of information about COVID-19 among both vaccine-hesitant and vaccine-acceptant respondents. Conclusions: Educational interventions to decrease vaccine hesitancy amongst healthcare workers should focus on alleviating safety concerns, emphasizing vaccine efficacy, and appealing to a sense of duty. Such interventions should target younger adult audiences. Personal physicians may also be an effective avenue for reducing hesitancy among their patients through patient-centered discussions.

COVID-19 Vaccination Hesitancy among Healthcare Workers—A Review

“…Pregnant or trying to become pregnant HCWs had higher rates of vaccine hesitancy; pregnant women were six times more likely to delay and women trying to become pregnant were three times more likely [156]. Concerns about fertility have also been observed in men [157]. However, a study of HCWs in New York did not find differences in hesitancy among different age groups of women, suggesting that higher rates of female vaccine hesitancy may not be simply explained by concerns over fertility, pregnancy, or breastfeeding [90].…”

“…Others contend that vaccination should not be required or is not necessary for those who have already contracted COVID-19 [110,142]. This may be due to feeling protected from COVID-19 due to previous illness or because those who are more likely to contract COVID-19 had fewer health-protective behaviors in the first place [157]. One study of over 65,000 US HCWs noted a lower vaccination rate among those who had previously been infected with COVID-19 (OR, 0.55; 95% CI, 0.51-0.58, p < 0.0001) [227].…”

Deepening Our Understanding of COVID-19 Vaccine Decision-Making amongst Healthcare Workers in Southwest Virginia, USA Using Exploratory and Confirmatory Factor Analysis

“…One group amongst whom COVID-19 vaccine hesitancy has been especially problematic over the course of the pandemic is healthcare workers (HCWs). Studies of HCWs in various contexts found degrees of hesitancy that ranged between 15% and 30% [ 13 , 14 , 15 , 16 , 17 , 18 , 19 ]. Demographic factors associated with COVID-19 vaccine hesitancy amongst HCWs included younger age [ 13 , 15 , 16 , 20 , 21 , 22 , 23 ], female sex [ 13 , 16 , 17 , 18 , 19 , 21 , 24 , 25 , 26 , 27 ], African American race [ 15 , 16 , 17 , 26 , 27 ], and lower educational attainment [ 17 , 23 , 27 ].…”

“…Studies of HCWs in various contexts found degrees of hesitancy that ranged between 15% and 30% [ 13 , 14 , 15 , 16 , 17 , 18 , 19 ]. Demographic factors associated with COVID-19 vaccine hesitancy amongst HCWs included younger age [ 13 , 15 , 16 , 20 , 21 , 22 , 23 ], female sex [ 13 , 16 , 17 , 18 , 19 , 21 , 24 , 25 , 26 , 27 ], African American race [ 15 , 16 , 17 , 26 , 27 ], and lower educational attainment [ 17 , 23 , 27 ]. Role in healthcare has also been found to be predictive of vaccine hesitancy, with nurses consistently displaying higher levels of hesitancy compared to physicians [ 13 , 15 , 16 , 17 , 18 , 21 , 23 , 24 , 25 , 26 , 27 , 28 ].…”

Decisions to Choose COVID-19 Vaccination by Health Care Workers in a Southern California Safety Net Medical Center Vary by Sociodemographic Factors

“…There is currently limited information [15] regarding how COVID-19 vaccine hesitancy among HCWs may depend on the sociodemographic characteristics of the HCW, such as race/ethnicity, income, and education. Some studies have shown that COVID-19 vaccination acceptance is higher among HCWs identifying as white or Asian [10,16], while Black HCWs may be the most hesitant, followed by Hispanic/Latino HCWs [17].…”