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Coronavirus disease 2019 (COVID-19) vaccine hesitancy among physicians, physician assistants, nurse practitioners, and nurses in two academic hospitals in Philadelphia

Part of: SARS-CoV-2/COVID-19

Published online by Cambridge University Press:  20 September 2021

Safa K. Browne Open the ORCID record for Safa K. Browne [Opens in a new window] ,
Kristen A. Feemster ,
Angela K. Shen ,
Judith Green-McKenzie ,
Florence M. Momplaisir ,
Walter Faig ,
Paul A. Offit  and
Barbara J. Kuter
Safa K. Browne*
Affiliation:
Vaccine Education Center, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
Kristen A. Feemster
Affiliation:
Vaccine Education Center, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania Division of Infectious Diseases, Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
Angela K. Shen
Affiliation:
Vaccine Education Center, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania Department of Medical Ethics and Health Policy, Perelman School of Medicine, Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania
Judith Green-McKenzie
Affiliation:
Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania Division of Occupational and Environmental Medicine, Department of Emergency Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
Florence M. Momplaisir
Affiliation:
Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
Walter Faig
Affiliation:
Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
Paul A. Offit
Affiliation:
Vaccine Education Center, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania Division of Infectious Diseases, Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
Barbara J. Kuter
Affiliation:
Vaccine Education Center, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
*
Author for correspondence: Safa K. Browne, E-mail: brownes1@chop.edu
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Abstract

Objective:

To evaluate coronavirus disease 2019 (COVID-19) vaccine hesitancy among healthcare personnel (HCP) with significant clinical exposure to COVID-19 at 2 large, academic hospitals in Philadelphia, Pennsylvania.

Design, setting, and participants:

HCP were surveyed in November–December 2020 about their intention to receive the COVID-19 vaccine.

Methods:

The survey measured the intent among HCP to receive a COVID-19 vaccine, timing of vaccination, and reasons for or against vaccination. Among patient-facing HCP, multivariate regression evaluated the associations between healthcare positions (medical doctor, nurse practitioner or physician assistant, and registered nurse) and vaccine hesitancy (intending to decline, delay, or were unsure about vaccination), adjusting for demographic characteristics, reasons why or why not to receive the vaccine, and prior receipt of routine vaccines.

Results:

Among 5,929 HCP (2,253 medical doctors [MDs] and doctors of osteopathy [DOs], 582 nurse practitioners [NPs], 158 physician assistants [PAs], and 2,936 nurses), a higher proportion of nurses (47.3%) were COVID-vaccine hesitant compared with 30.0% of PAs and NPs and 13.1% of MDs and DOs. The most common reasons for vaccine hesitancy included concerns about side effects, the newness of the vaccines, and lack of vaccine knowledge. Regardless of position, Black HCP were more hesitant than White HCP (odds ratio [OR], ∼5) and females were more hesitant than males (OR, ∼2).

Conclusions:

Although most clinical HCP intended to receive a COVID-19 vaccine, intention varied by healthcare position. Consistent with other studies, hesitancy was also significantly associated with race or ethnicity across all positions. These results highlight the importance of understanding and effectively addressing reasons for hesitancy, especially among frontline HCP who are at increased risk of COVID exposure and play a critical role in recommending vaccines to patients.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 43 , Issue 10 , October 2022 , pp. 1424 - 1432
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Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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References

US COVID-19 cases and deaths by State. Centers for Diseases Control and Prevention website. https://covid.cdc.gov/covid-data-tracker/#cases_casesper100klast7days. Published 2021. Accessed August 25, 2021.Google Scholar
COVID-19 vaccines. US Food and Drug Administration website. https://www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/covid-19-vaccines. Published 2021. Accessed August 25, 2021.Google Scholar
COVID-19 vaccinations in the United States. Centers for Diseases Control and Prevention website. https://covid.cdc.gov/covid-data-tracker/#vaccinations. Published 2021. Accessed August 25, 2021.Google Scholar
Kirzinger, A, Kearney, A, Hamel, L, Brodie, M. KFF/The Washington Post Frontline Health Care Workers. The Washington Post/KFF Survey Project website. https://files.kff.org/attachment/Frontline%20Health%20Care%20Workers_Full%20Report_FINAL.pdf. Published 2021. Accessed August 25, 2021.Google Scholar
Talking to patients about vaccine safety. Centers for Diseases Control and Prevention website. https://www.cdc.gov/vaccinesafety/hcproviders/talkingtopatients.html. Published 2021. Accessed August 25, 2021.Google Scholar
Gadoth, A, Halbrook, M, Martin-Blais, R, et al. Cross-sectional assessment of COVID-19 vaccine acceptance among healthcare workers in Los Angeles. Ann Intern Med 2021;174:882–885.CrossRefGoogle ScholarPubMed
Herman, AO. Nearly one-third of US healthcare workers hesitant to get COVID-19 vaccines. New England Journal of Medicine Journal Watch website. https://www.jwatch.org/fw117633/2021/03/21/nearly-one-third-us-healthcare-workers-hesitant-get-covid. Published 2021. Accessed August 25, 2021.Google Scholar
Kuter, BJ, Browne, S, Momplaisir, FM, et al. Perspectives on the receipt of a COVID-19 vaccine: a survey of employees in two large hospitals in Philadelphia. Vaccine 2021;39: 1693–1700.Google ScholarPubMed
Report of the Sage Working Group on Vaccine Hesitancy. World Health Organization website. https://www.who.int/immunization/sage/meetings/2014/october/1_Report_WORKING_GROUP_vaccine_hesitancy_final.pdf. Published 2014. Accessed August 25, 2021.Google Scholar
Shaw, J, Stewart, T, Anderson, KB, et al. Assessment of US healthcare personnel (HCP) attitudes towards COVID-19 vaccination in a large university health care system. Clin Infect Dis 2021. doi: 10.1093/cid/ciab054.Google Scholar
Reiter, PL, Pennell, ML, Katz, ML. Acceptability of a COVID-19 vaccine among adults in the United States: how many people would get vaccinated? Vaccine 2020;38:6500–6507.CrossRefGoogle ScholarPubMed
Callaghan, T, Moghtaderi, A, Lueck, JA, et al. Correlates and disparities of COVID-19 vaccine hesitancy. Soc Sci Med 2021; 272:113638.CrossRefGoogle Scholar
Owen, WF Jr, Carmona, R, Pomeroy, C. Failing another national stress test on health disparities. JAMA 2020;323:1905–1906.CrossRefGoogle ScholarPubMed
Larson, HJ, Jarrett, C, Schulz, WS, et al. Measuring vaccine hesitancy: the development of a survey tool. Vaccine 2015;33:4165–4175.Google ScholarPubMed
Egede, LE, and Walker, RJ. Structural racism, social risk factors, and COVID-19—a dangerous convergence for Black Americans. N Engl J Med 2020;383(12):e77.Google ScholarPubMed
Momplaisir, F, Haynes, N, Nkwihoreze, H, Nelson, M, Werner, RM, Jemmott, J. Understanding drivers of COVID-19 vaccine hesitancy among blacks. Clin Infect Dis 2021. doi: 10.1093/cid/ciab102.Google ScholarPubMed
Kahn, C, Beasley, D. More women than men in US nervous about fast rollout of COVID vaccine, and that’s a problem: Reuters/Ipsos poll. Reuters website. https://www.reuters.com/article/uk-health-coronavirus-vaccine-poll-idUKKBN28L0FI. Published December 2020. Accessed August 25, 2021.Google Scholar
Matoff-Stepp, S, Applebaum, B, Pooler, J, Kavanagh, E. Women as health care decision-makers: implications for health care coverage in the United States. J Health Care Poor Underserved 2014;25:1507–1513.Google ScholarPubMed
Shimabukuro, TT, Kim, SY, Myers, TR, et al. CDC v-safe COVID-19 pregnancy registry team. preliminary findings of mRNA COVID-19 vaccine safety in pregnant persons. N Engl J Med 2021;384:2273–2282.CrossRefGoogle ScholarPubMed
Kilich, E, Dada, S, Francis, MR, et al. Factors that influence vaccination decision-making among pregnant women: a systematic review and meta-analysis. PloS One 2020;15(7):e0234827.Google ScholarPubMed
Kempe, A, Saville, AW, Albertin, C, et al. Parental hesitancy about routine childhood and influenza vaccinations: a national survey. Pediatrics 2020;146(1):e20193852.CrossRefGoogle ScholarPubMed
Annenberg Public Policy Center of the University of Pennsylvania. Vaccine misinformation and social media: people exposed to vaccine content on social media more likely misinformed than those exposed to it on traditional media. ScienceDaily website. www.sciencedaily.com/releases/2020/02/200217163004.htm. Published February 2020. Accessed August 25, 2021.Google Scholar
McGloin, R, Richards, K, Embacher, K. Examining the potential gender gap in online health information-seeking behaviors among digital natives. Commun Res Repts 2016;33:370–375.Google Scholar
Social media fact sheet. Pew Research Center Internet and Technology website. https://www.pewresearch.org/internet/fact-sheet/social-media/?menuItem=45b45364-d5e4-4f53-bf01-b77106560d4c. Published April 2021. Accesssed August 25, 2021.Google Scholar
Kwok, KO, Li, KK, Wei, WI, Tang, A, Wong, S, Lee, SS. Editor’s Choice: Influenza vaccine uptake, COVID-19 vaccination intention and vaccine hesitancy among nurses: A survey. Int J Nurs Stud 2021;114:103854.Google ScholarPubMed
Nguyen, KH, Srivastav, A, Razzaghi, H, et al. COVID-19 vaccination intent, perceptions, and reasons for not vaccinating among groups prioritized for early vaccination—United States, September and December 2020. Morbid Mortal Wkly Rept 2021;70:217–222.CrossRefGoogle ScholarPubMed
Wang, K, Wong, E, Ho, KF, et al. Intention of nurses to accept coronavirus disease 2019 vaccination and change of intention to accept seasonal influenza vaccination during the coronavirus disease 2019 pandemic: a cross-sectional survey. Vaccine 2020;38:7049–7056.CrossRefGoogle ScholarPubMed
Guidry, J, Laestadius, LI, Vraga, EK, et al. Willingness to get the COVID-19 vaccine with and without emergency use authorization. Am J Infecton Control 2021;49:137–142.Google ScholarPubMed
Henriksen Hellyer, JM, DeVries, AS, Jenkins, SM, et al. Attitudes toward and uptake of H1N1 vaccine among health care workers during the 2009 H1N1 pandemic. PloS One 2011;6(12):e29478.CrossRefGoogle ScholarPubMed
Li, M, Luo, Y, Watson, R, et al. Healthcare workers’ (HCWs) attitudes and related factors towards COVID-19 vaccination: a rapid systematic review Postgrad Med J 2021. doi: 10.1136/postgradmedj-2021-140195.CrossRefGoogle ScholarPubMed
Chen, X, Hay, JL, Waters, EA, et al. Health literacy and use and trust in health information. J Health Commun 2018;23:724–734.CrossRefGoogle ScholarPubMed
Altay, S, Mercie, H. Framing messages for vaccination supporters. J Exper Psychol Appl 2020;26:567–578.Google ScholarPubMed