Exploring Vaccine Hesitancy in Care Home Employees in North West England: A Qualitative Study

Abstract

Objectives: Care homes have experienced a high number of COVID-19 outbreaks, and it is therefore important for care home employees to receive the COVID-19 vaccine. However, there is vaccine hesitancy at a greater rate among this group than in the wider community. We aimed to understand barriers and facilitators to getting the COVID-19 vaccine, as well as views on potential mandatory vaccination policies. Design: Semi-structured interviews. Setting: Care home employees in North West England. Interviews conducted in April 2021. Participants: 10 care home employees (aged 25 to 61 years old) in the North West, who had been invited to have, but had not yet received, the COVID-19 vaccine. Results: We analysed the interviews using a framework analysis. Our analysis identified eight themes: perceived risk of COVID-19, efficacy of the vaccine, concerns about the vaccine, mistrust in authorities, facilitators to getting the vaccine, views on potential mandatory COVID-19 vaccination policies, negative experiences of care work during the COVID-19 pandemic, and communication challenges. Conclusions: The care home employees interviewed at the time of this study reported a low perceived risk of COVID-19, alongside concerns over the efficacy of the vaccine, side effects, and speed of vaccine development, which is exacerbated by mistrust in authorities. Facilitators to getting the vaccine included wanting to protect others, perceived severity of COVID-19, and workplace norms. Making COVID-19 vaccination a condition of deployment may not result in increased willingness to get the COVID-19 vaccination, with most care home employees in this study favouring leaving their job rather than getting vaccinated. At a time when many of the workers already had negative experiences of care work during the pandemic due to perceived negative judgment from others and a perceived lack of support facing care home employees, policies that require vaccination as a condition of deployment were not positively received.

The Effectiveness of Interventions for Increasing COVID-19 Vaccine Uptake: A Systematic Review

“…Participants were also more likely to take action (e.g., through activism) against the policy when the vaccine was mandatory, compared to unrestricted [ 44 ]. This supports research beyond the scope of this review, including a modelling study of COVID-19 vaccine uptake [ 45 ] and interviews with care home staff (pre-print) which suggests mandatory vaccination could lead to staff resignations [ 46 ].…”

Exploration of attitudes regarding uptake of COVID-19 vaccines among vaccine hesitant adults in the UK: a qualitative analysis

“…Although qualitative work has been conducted to explore attitudes towards vaccinations [ 15 – 18 ], much of that work was completed relatively early on in the pandemic during a time at which many groups hadn’t been offered the vaccine, and trials exploring the real world safety and efficacy of the vaccine were ongoing. Very little research has specifically explored attitudes regarding the second or third dose of the vaccine, or age specific concerns for hesitant groups.…”