COVID-19 Vaccine Hesitancy Among Healthcare Providers

Objective
Vaccine hesitancy among healthcare providers can compromise public confidence in vaccination during the ongoing COVID-19 global epidemic and increase susceptibility to life-threatening disease. We sought to investigate predictors of openness to vaccination among healthcare workers who choose not to be vaccinated against COVID-19 in order to explore potential solutions.
Methods
Physicians, physician assistants, and nurses who chose not to be vaccinated were surveyed to decipher reasons for vaccine refusal and personal loss due to the virus along with demographic variables. Multivariate logistic regression analysis evaluated whether provider role, parenthood, and death of family or friends were associated with strong versus relative vaccine refusal.
Results
The predominant reasons for vaccine hesitancy in this cohort of health care workers who had access to, but chose not to be vaccinated (n=500) were a concern for vaccine side effects (69.6%) and the belief that the vaccines are inadequately studied (61.6%). Being a physician, a parent, and having no experience of death in the family or friends had 2.64 times (95% CI: 1.65-4.23, p < 0.001), 1.72 times (95% CI: 1.05-2.81, p = 0.032), and 1.70 times (95% CI: 1.06-2.72, p = 0.028) the odds of strong vaccine refusal, respectively. Older age (35 and up) respondents were 1.83 times (95% CI: 1.24-2.68, p = 0.002) more likely to be open to vaccination.
1. Dror AA, Eisenbach N, Taiber S, et al. Vaccine hesitancy: the next challenge in the fight against COVID-19. Eur J Epidemiol. 2020;35(8):775-779. doi:10.1007/s10654-020-00671-y
2. Carvalho T, Krammer F, Iwasaki A. The first 12 months of COVID-19: a timeline of immunological insights. Nat Rev Immunol. 2021;21(4):245-256. doi:10.1038/s41577-021-00522-1
3. Tobaiqy M, Elkout H, MacLure K. Analysis of Thrombotic Adverse Reactions of COVID-19 AstraZeneca Vaccine Reported to EudraVigilance Database. Vaccines (Basel). 2021;9(4):393. doi:10.3390/vaccines9040393
4. Lopez Bernal J, Andrews N, Gower C, et al. Effectiveness of the Pfizer-BioNTech and Oxford-AstraZeneca vaccines on covid-19 related symptoms, hospital admissions, and mortality in older adults in England: test negative case-control study. BMJ. Published online May 13, 2021: n1088. doi:10.1136/bmj.n1088
5. BNT162b2 mRNA Covid-19 Vaccine in a Nationwide Mass Vaccination Setting. N Engl J Med. 2021;384(20):1968-1970. doi:10.1056/nejmc2104281
6. Zhou W, Wang W. Fast-spreading SARS-CoV-2 variants: challenges to and new design strategies of COVID-19 vaccines. Signal Transduct Target Ther. 2021;6(1). doi:10.1038/s41392-021-00644-x
7. Omer SB, Salmon DA, Orenstein WA, deHart MP, Halsey N. Vaccine Refusal, Mandatory Immunization, and the Risks of Vaccine-Preventable Diseases. N Engl J Med. 2009;360(19):1981-1988. doi:10.1056/nejmsa0806477
8. Dubé E. Addressing vaccine hesitancy: the crucial role of healthcare providers. Clinical Microbiology and Infection. 2017;23(5):279-280. doi:10.1016/j.cmi.2016.11.007
9. Kose S, Mandiracioglu A, Sahin S, Kaynar T, Karbus O, Ozbel Y. Vaccine hesitancy of the COVID-19 by health care personnel. Int J Clin Pract. 2020;75(5). doi:10.1111/ijcp.13917
10. 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. doi:10.1016/j.ijnurstu.2020.103854
11. Paterson P, Meurice F, Stanberry LR, Glismann S, Rosenthal SL, Larson HJ. Vaccine hesitancy and healthcare providers. Vaccine. 2016;34(52):6700-6706. doi:10.1016/j.vaccine.2016.10.042
12. Rothschild D, Konitzer T. Random Device Engagement (RDE) With Organic Samples. Pollfish Inc; 2020. https://www.pollfish.com/lp/files/organic-sampling-survey-method.pdf
13. Verger P, Fressard L, Collange F, et al. Vaccine Hesitancy Among General Practitioners and Its Determinants During Controversies: A National Cross-sectional Survey in France. EBioMedicine. 2015;2(8):891-897. doi:10.1016/j.ebiom.2015.06.018
14. Verger P, Collange F, Fressard L, et al. Prevalence and correlates of vaccine hesitancy among general practitioners: a cross-sectional telephone survey in France, April to July 2014. Eurosurveillance. 2016;21(47). doi:10.2807/1560-7917.es.2016.21.47.30406
15. Dubé E, Laberge C, Guay M, Bramadat P, Roy R, Bettinger JA. Vaccine hesitancy. Hum Vaccin Immunother. 2013;9(8):1763-1773. doi:10.4161/hv.24657
16. Troiano G, Nardi A. Vaccine hesitancy in the era of COVID-19. Public Health. 2021;194:245-251. doi:10.1016/j.puhe.2021.02.025
17. Chou WYS, Budenz A. Considering Emotion in COVID-19 Vaccine Communication: Addressing Vaccine Hesitancy and Fostering Vaccine Confidence. Health Commun. 2020;35(14):1718-1722. doi:10.1080/10410236.2020.1838096
18. Physician COVID-19 Vaccination Study (Topline Report). Accessed February 22, 2022. https://www.ama-assn.org/system/files/2021-06/physician-vaccination-study-topline-report.pdf
19. Dubé E, Gagnon D, MacDonald NE. Strategies intended to address vaccine hesitancy: review of published reviews. Vaccine. 2015;33(34):4191-4203. doi:10.1016/j.vaccine.2015.04.041
20. Jarrett C, Wilson R, O'Leary M, Eckersberger E, Larson HJ. Strategies for addressing vaccine hesitancy - a systematic review. Vaccine. 2015;33(34):4180-4190. doi:10.1016/j.vaccine.2015.04.040