Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-11-10T05:08:27.185Z Has data issue: false hasContentIssue false

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

Published online by Cambridge University Press:  14 February 2022

Mandy C. Swann
Affiliation:
Infection Prevention and Control, Carilion Clinic, Roanoke, Virginia
Jesse Bendetson
Affiliation:
Virginia Tech Carilion School of Medicine, Roanoke, Virginia
Alexis Johnson
Affiliation:
Infection Prevention and Control, Carilion Clinic, Roanoke, Virginia
Maimuna Jatta
Affiliation:
Infection Prevention and Control, Carilion Clinic, Roanoke, Virginia
Charles J. Schleupner
Affiliation:
Virginia Tech Carilion School of Medicine, Roanoke, Virginia Infectious Diseases, Carilion Clinic, Roanoke, Virginia Department of Medicine, Carilion Clinic, Roanoke, Virginia
Anthony Baffoe-Bonnie*
Affiliation:
Infection Prevention and Control, Carilion Clinic, Roanoke, Virginia Virginia Tech Carilion School of Medicine, Roanoke, Virginia Infectious Diseases, Carilion Clinic, Roanoke, Virginia Department of Medicine, Carilion Clinic, Roanoke, Virginia
*
Author for correspondence: Anthony Baffoe-Bonnie, E-mail: awbaffoebonnie@carilionclinic.org

Abstract

Objective:

To assess characteristics and perceptions associated with vaccine hesitancy among healthcare workers to increase coronavirus disease 2019 (COVID-19) vaccine uptake in this population.

Design:

Cross-sectional quantitative survey.

Setting:

A not-for-profit healthcare system in southwestern Virginia.

Participants:

A convenience sample of 2,720 employees of a not-for-profit healthcare system.

Methods:

Between March 15 and 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, the 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 HCW characteristics and vaccine-related perceptions.

Results:

Overall, 18% of respondents were classified as vaccine hesitant. Characteristics significantly associated with hesitancy included Black race, younger age, not having a high-risk household member, and prior personal experience with COVID-19 illness. Vaccine 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 vaccine-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 sources of information about COVID-19 among both vaccine-hesitant and vaccine-acceptant respondents.

Conclusions:

Educational interventions to decrease vaccine hesitancy among 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.

Type
Original Article
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abelson, R. COVID overload: US hospitals are running out of beds for patients. New York Times website. https://www.nytimes.com/2020/11/27/health/covid-hospitals-overload.html. Published November 28, 2020. Accessed February 10, 2022.Google Scholar
Dooling, K, McClung, N, Chamberland, M, et al. The Advisory Committee on Immunization Practices’ interim recommendation for allocating initial supplies of COVID-19 vaccine—United States. Morb Mortal Wkly Rep 2020;69:18571859.CrossRefGoogle ScholarPubMed
Lazer, D, Perlis, RH, Ognyanova, K et al. The COVID states project #40: COVID-19 vaccine attitudes among healthcare workers. OSFPreprints 2021. doi: 10.31219/osf.io/p4q9h.CrossRefGoogle Scholar
Lucia, VC, Kelekar, A, Afonso, NM. COVID-19 vaccine hesitancy among medical students. J Public Health 2021;43:445449.CrossRefGoogle ScholarPubMed
Dror, AA, Eisenbach, N, Taiber, S, et al. Vaccine hesitancy: the next challenge in the fight against COVID-19. Eur J Epidemiol 2020;35:775779.CrossRefGoogle ScholarPubMed
Gadoth, A, Halbrook, M, Martin-Blais, R, et al. Assessment of COVID-19 vaccine acceptance among healthcare workers in Los Angeles. medRxiv 2020. doi: 10.1101/2020.11.18.20234468.CrossRefGoogle Scholar
Grech, V, Gauci, C, Agius, S. Vaccine hesitancy among Maltese healthcare workers toward influenza and novel COVID-19 vaccination. Early Hum Dev 2020. doi: 10.1016/j.earlhumdev.2020.105213.CrossRefGoogle Scholar
Barry, M, Temsah, MH, Alhuzaimi, A, et al. COVID-19 vaccine confidence and hesitancy among healthcare workers: a cross-sectional survey from a MERS-CoV experienced nation. medRxiv 2020. doi: 10.1101/2020.12.09.20246447.CrossRefGoogle Scholar
Kwok, KO, Li, KK, WEI, WI, Tang, A, Wong, SYS, Lee, SS. Influenza vaccine uptake, COVID-19 vaccination intention and vaccine hesitancy among nurses: a survey. Int J Nurs Stud 2021;114:103854.CrossRefGoogle ScholarPubMed
MacDonald, NE. Vaccine hesitancy: definition, scope and determinants. Vaccine 2015;33:41614164.Google ScholarPubMed
Benjamini, Y, Hochberg, Y. Controlling the false discovery rate: a practical and powerful approach to multiple testing. J R Stat Soc Ser B 1995;57:289300.Google Scholar
The SAS system for Windows. SAS Institute website. http://www.sas.com. Published 2013. Accessed February 10, 2022.Google Scholar
Intent to get a COVID-19 vaccine rises to 60% as confidence in research and development process increases. Pew Research Center website. https://www.pewresearch.org/science/2020/12/03/intent-to-get-a-covid-19-vaccine-rises-to-60-as-confidence-in-research-and-development-process-increases/. Published 2020. Accessed February 10, 2022.Google Scholar
Ndugga, N, Hill, L, Artiga, S, Haldar, S. Latest data on COVID-19 vaccinations by race/ethnicity. Kaiser Family Foundation website. https://www.kff.org/coronavirus-covid-19/issue-brief/latest-data-on-covid-19-vaccinations-by-race-ethnicity/. Published 2022. Accessed February 10, 2022.Google Scholar
Dada, D, Djiometio, JN, McFadden, SM, et al. Strategies that promote equity in COVID-19 vaccine uptake for black communities: a review. J Urban Health 2022. doi: 10.1007/s11524-021-00594-3.CrossRefGoogle Scholar
Boulware, LE, Cooper, LA, Ratner, LE, LaVeist, TA, Powe, NR. Race and trust in the healthcare system. Public Health Rep 2003;118:358365.CrossRefGoogle Scholar
Njoku, A, Joseph, M, Felix, R. Changing the narrative: structural barriers and racial and ethnic inequities in COVID-19 vaccination. Int J Environ Res Public Health 2021;18:9904.CrossRefGoogle ScholarPubMed
COVID data tracker. Centers for Disease Control and Prevention website. https://covid.cdc.gov/covid-data-tracker/#vaccination-demographics-trends. Published 2021. Accessed May 14, 2021.Google Scholar
Wesselink, AK, Hatch, EE, Rothman, KJ, et al. A prospective cohort study of COVID-19 vaccination, SARS-CoV-2 infection, and fertility. Am J Epidemiol 2022. doi: 10.1093/aje/kwac011.CrossRefGoogle Scholar
Hillson, K, Clemens, SC, Madhi, SA, Voysey, M, Pollard, AJ, Minassian, AM. Fertility rates and birth outcomes after ChAdOx1 nCoV-19 (AZD1222) vaccination. Lancet 2021;398:16831684.CrossRefGoogle ScholarPubMed
Hamel, L, Lopes, L, Sparks, G, et al. KFF COVID-19 vaccine monitor: October 2021. Kaiser Family Foundation website. https://www.kff.org/coronavirus-covid-19/poll-finding/kff-covid-19-vaccine-monitor-october-2021/. Published October 2021. Accessed February 10, 2022.Google Scholar
Monod, M, Blenkinsop, A, Xi, X, et al. Age groups that sustain resurging COVID-19 epidemics in the United States. Science 2021;371(6536):eabe8372.CrossRefGoogle ScholarPubMed
Latkin, CA, Dayton, L, Yi, G, Colon, B, Kong, X. Mask usage, social distancing, racial, and gender correlates of COVID-19 vaccine intentions among adults in the US. PLoS One 2021;16(2):e0246970.CrossRefGoogle ScholarPubMed
Thompson, D. How mRNA technology could change the world. The Atlantic website. https://www.theatlantic.com/ideas/archive/2021/03/how-mrna-technology-could-change-world/618431/. Published 2021. Accessed February 10, 2022.Google Scholar
Frequently asked questions about COVID-19 vaccination. Centers for Disease Control and Prevention website. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/faq.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fvaccines%2Fkeythingstoknow.html. Updated February 2, 2022. Accessed February 10, 2022.Google Scholar
Kuru, O, Stecula, D, Lu, H, et al. The effects of scientific messages and narratives about vaccination. PLoS One 2021;16(3):e0248328.CrossRefGoogle ScholarPubMed
Elwy, AR, Clayman, ML, LoBrutto, L, et al. Vaccine hesitancy as an opportunity for engagement: a rapid qualitative study of patients and employees in the US Veterans’ Affairs healthcare system. Vaccine X 2021. doi: 10.1016/j.jvacx.2021.100116.CrossRefGoogle Scholar
Wiysonge, CS, Ndwandwe, D, Ryan, J, et al. Vaccine hesitancy in the era of COVID-19: could lessons from the past help in divining the future? Hum Vaccin Immunother 2021. doi: 10.1080/21645515.2021.1893062.CrossRefGoogle Scholar
Thompson, D. The surprising key to combatting vaccine refusal. The Atlantic website. https://www.theatlantic.com/ideas/archive/2021/02/vaccine-hesitancy-isnt-just-one-thing/618164/. Published online February 2021. Accessed February 10, 2022.Google Scholar
Krumpal, I. Determinants of social desirability bias in sensitive surveys: a literature review. Qual Quant 2013;47:20252047.CrossRefGoogle Scholar