Abstract
Since health professionals provide frontline care to COVID-19 patients, information on vaccine acceptance among healthcare workers is needed. We developed and implemented an anonymous internet-based cross-sectional survey with direct solicitation among employees of a safety net health system. Items queried demographic and health-related characteristics, experience with and knowledge of COVID-19, and determinants of decisions to vaccinate. COVID-19 vaccine acceptance groups (acceptors, hesitant, refusers) were defined; an adapted version of the WHO vaccine hesitancy scale was included. The survey demonstrated good reliability (Cronbach’s alpha = 0.92 for vaccine hesitancy scale; 0.93 for determinants). General linear and logistic regression methods examined factors which were univariately associated with vaccine hesitancy and vaccine acceptance, respectively. Multivariable models were constructed with stepwise model-building procedures. Race/ethnicity, marital status, job classification, immunocompromised status, flu vaccination and childhood vaccination opinions independently predicted hesitancy scale scores. Gender, education, job classification and BMI independently predicted acceptance, hesitancy, and refusal groups. Among hesitant employees, uncertainty was reflected in reports of motivating factors influencing their indecision. Despite a strong employee-support environment and job protection, respondents reported physical and mental health effects. The appreciation of varied reasons for refusing vaccination should lead to culturally sensitive interventions to increase vaccination rates amongst healthcare workers.
Highlights
The success of any vaccination program is dependent on a number of interconnected and interdependent actions
Respondents were predominantly female (79.2%), between the ages of 30–64 (83.7%), non-Hispanic white (37.7%) or Hispanic (36.8%) and had a self-reported education level of a college degree or higher (59.7%). Of those responding to the survey, 755 (95.6%) answered questions enabling a categorization into groups of vaccine acceptors, hesitant, or refusers
In our comprehensive survey of employees of a large safety net county health system conducted between March and April 2021 when COVID-19 vaccinations were being administered in the United States (US), we found that 9.4% overall were hesitant and 5.3% refused to be vaccinated, which is consistent with studies that have estimated 8–18% hesitancy [3,42]
Summary
The success of any vaccination program is dependent on a number of interconnected and interdependent actions. These include development of vaccine, testing for efficacy and safety, rapid distribution to the population and acceptance by recipients. The latter issue of vaccine uptake [1] is critical, and can be characterized as vaccine acceptance, refusal, or hesitancy. Factors that may influence vaccine acceptance include complacency, access to vaccination sources, confidence in the safety and efficacy and perceived intent of the agencies providing the vaccine [3]. Vaccine hesitancy is a global issue and it is not limited to the current COVID-19 pandemic; it has, in part, been blamed for international resurgences of infectious disease outbreaks such as measles, which had previously been brought under control [7]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
