Vaccination Hesitancy among Health-Care-Workers in Academic Hospitals Is Associated with a 12-Fold Increase in the Risk of COVID-19 Infection: A Nine-Month Greek Cohort Study

Abstract

Health-Care-Workers (HCWs) are considered at high risk for SARS-CoV-2 infection. We sought to compare rates and severity of Coronavirus disease 2019 (COVID-19) among vaccinated and unvaccinated HCWs conducting a retrospective cohort study in two tertiary Academic Hospitals, namely Laiko and Attikon, in Athens, Greece. Vaccinated by BNT162b2 Pfizer-BioNTech COVID-19 mRNA vaccine and unvaccinated HCWs were included and data were collected between 1 January 2021 and 15 September 2021. Overall, 2921 of 3219 HCWs without a history of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection were fully vaccinated during the study period (90.7% at each Hospital). Demographic characteristics were comparable between 102/2921 (3.5%) vaccinated and 88/298 (29.5%) unvaccinated HCWs with COVID-19, although age and occupation differed significantly. None were in need of hospital admission in the vaccinated Group, whereas in the unvaccinated Group 4/88 (4.5%) were hospitalized and one (1.1%) died. Multivariable logistic regression analysis revealed that lack of vaccination was an independent risk factor for COVID-19 with an odds ratio 11.54 (95% CI: 10.75–12.40). Vaccination hesitancy among HCWs resulted to highly increased COVID-19 rates; almost one in three unvaccinated HCWs was SARS-CoV-2 infected during the 9-month period. The absolute need of vaccination of HCWs, including boosting dose, is highlighted. Evidence should be used appropriately to overcome any hesitancy.

Did Italy Really Need Compulsory Vaccination against COVID-19 for Healthcare Workers? Results of a Survey in a Centre for Maternal and Child Health

“…Considering the points outlined above, HCWs' hesitancy towards COVID-19 vaccination remains an important public health issue globally [51]. For example, studies carried out before the COVID-19 vaccines were distributed evidenced that vaccine acceptance in Italy was around 53.7% [52,53].…”

Consequences of COVID-19 Vaccine Hesitancy Among Healthcare Providers During the First 10 Months of Vaccine Availability: Scoping Review

“…In a study of HCPs at an Italian hospital, 1% (n = 8) of unvaccinated participants were hospitalized with COVID-19 compared to 0.2% (n = 1) of vaccinated participants (p < .0001) . Likewise, among a sample of hospital-based HCPs in Greece, 4.5% (n = 4) of unvaccinated participants with COVID-19 required hospitalization, and one HCP died (Ntziora et al, 2022). No vaccinated participants experienced these outcomes (Ntziora et al, 2022).…”

“…Likewise, among a sample of hospital-based HCPs in Greece, 4.5% (n = 4) of unvaccinated participants with COVID-19 required hospitalization, and one HCP died (Ntziora et al, 2022). No vaccinated participants experienced these outcomes (Ntziora et al, 2022).…”

“…Vaccine-hesitant HCPs were found to experience numerous consequences that affected their physical health. Unvaccinated HCPs working in hospitals (Amit et al, 2021;Angel et al, 2021;Azamgarhi et al, 2021;Bianchi, Germinario, et al, 2021;Can et al, 2022;Maltezou et al, 2021;Naleway et al, 2022;Ntziora et al, 2022;Redmond et al, 2022) and community settings (Naleway et al, 2022) both experienced higher rates of COVID-19 than vaccinated HCPs. Unvaccinated HCPs also experienced higher rates of symptomatic (Amit et al, 2021;Angel et al, 2021;Can et al, 2022) and asymptomatic COVID-19 infections (Angel et al, 2021).…”

COVID-19 Vaccination Attitude and Behavior among Nurses at a West Texas Regional Hospital

“…While rates of HCW vaccination have improved with time [ 3 ], there are still some HCWs who are resistant. This may be problematic as it can place HCWs at a greater risk of illness [ 8 ], could produce greater strain on healthcare resources due to absenteeism [ 9 ], and fails to limit the spread of SARS-CoV-2 to others [ 10 ]. Healthcare workers are one of the most trusted patient resources regarding vaccination [ 11 ], and vaccine hesitancy from HCWs may exacerbate public vaccine hesitancy.…”