Promising Strategies to Support COVID-19 Vaccination of Healthcare Personnel: Qualitative Insights from the VHA National Implementation

Abstract

Background In August 2021, up to 30% of Americans were uncertain about taking the COVID-19 vaccine, including some healthcare personnel (HCP). Objective Our objective was to identify barriers and facilitators of the Veterans Health Administration (VHA) HCP vaccination program. Design We conducted key informant interviews with employee occupational health (EOH) providers, using snowball recruitment. Participants Participants included 43 VHA EOH providers representing 29 of VHA’s regionally diverse healthcare systems. Approach Thematic analysis elucidated 5 key themes and specific strategies recommended by EOH. Key Results Implementation themes reflected logistics of distribution (supply), addressing any vaccine concerns or hesitancy (demand), and learning health system strategies/approaches for shared learnings. Specifically, themes included the following: (1) use interdisciplinary task forces to leverage diverse skillsets for vaccine implementation; (2) invest in processes and align resources with priorities, including creating detailed processes, addressing time trade-offs for personnel involved in vaccine clinics by suspending everything non-essential, designating process/authority to shift personnel where needed, and proactively involving leaders to support resource allocation/alignment; (3) expect and accommodate vaccine buy-in occurring over time: prepare for some HCP’s slow buy-in, align buy-in facilitation with identities and motivation, and encourage word-of-mouth and hyper-local testimonials; (4) overcome misinformation with trustworthy communication: tailor communication to individuals and address COVID vaccines “in every encounter,” leverage proactive institutional messaging to reinforce information, and invite bi-directional conversations about any vaccine concerns. A final overarching theme focused on learning health system needs and structures: (5) use existing and newly developed communication channels to foster shared learning across teams and sites. Conclusions Expecting deliberation allows systems to prepare for complex distribution logistics (supply) and make room for conversations that are trustworthy, bi-directional, and identity aligned (demand). Ideally, organizations provide time for conversations that address individual concerns, foster bi-directional shared decision-making, respect HCP beliefs and identities, and emphasize shared identities as healthcare providers.

Impact of the COVID-19 vaccination mandate on the primary care workforce and differences between rural and urban settings to inform future policy decision-making

“…This tension may be seen with novel viruses and future vaccinations, as people could view new vaccine products differently than familiar ones. Strategies that provide time to discuss vaccines, address individual concerns, and respect diverse beliefs may lead to increased acceptance and decreased impact on morale and tensions around implementation [ 47 ]. These specific strategies may also help assuage some common reasons for vaccination hesitancy among HCP including concerns about safety and efficacy [ 3 ], trust [ 48 ], and personal right infringement [ 49 ].…”

From Crisis to Opportunity: A Qualitative Study on Rehabilitation Therapists’ Experiences and Post-Pandemic Perspectives

“…"Bottom-up" communication channels were absent, which, when making decisions, limited listening to and considering staff's experience and expertise [81]. While some promising information and communication practices from hospital case studies have been identified [81,82], attention has also been paid to communication approaches supporting COVID-19 vaccination of the healthcare workforce [83,84] and the public [85]. Therefore, future comparative analyses could help identify the best health crisis communication practices.…”

Qualitative interview study of strategies to support healthcare personnel mental health through an occupational health lens

“…Indeed, in another high-need context (eg, preventing infection and vaccine deployment), occupational health led innovation and collaboration with multiple other departments across the Veterans Health Administration (VHA) to effectively protect its more than 500 000 healthcare personnel. 13 Objective Cognizant of the shifting role of occupational health during the evolving crisis of COVID-19, we conducted a national qualitative needs assessment of employee occupational health clinicians who were very much at the centre of organisational responses. For the study we report here, we explored and expanded themes around mental health from the lens of occupational health clinicians.…”

“…Occupational health clinicians may be very well positioned to leverage new attention on healthcare personnel mental health, initially driven by COVID-19, to respond to the increasing mental health needs of healthcare personnel. Indeed, in another high-need context (eg, preventing infection and vaccine deployment), occupational health led innovation and collaboration with multiple other departments across the Veterans Health Administration (VHA) to effectively protect its more than 500 000 healthcare personnel 13…”

“…Indeed, in another high-need context (eg, preventing infection and vaccine deployment), occupational health led innovation and collaboration with multiple other departments across the Veterans Health Administration (VHA) to effectively protect its more than 500 000 healthcare personnel. 13 …”