Objectives To examine factors associated with COVID-19 vaccine receipt among healthcare workers, including healthcare worker job type, race, and gender, as well as the role of vaccine confidence in decisions to vaccinate, and to better understand specific concerns related to COVID-19 vaccination among healthcare workers.
Design Cross-sectional anonymous survey among front-line, support service, and administrative healthcare workers.
Setting Two large integrated healthcare systems (one private and one public) in New York City during the initial rollout of the COVID-19 vaccine among healthcare workers.
Participants 1,933 healthcare workers, including nurses, physicians, allied health professionals, environmental services staff, researchers, and administrative staff.
Main Outcome Measures The primary outcome was COVID-19 vaccine receipt during the initial rollout of the vaccine among healthcare workers.
Results Among 1,933 healthcare workers who had been offered the vaccine, 81% had received the vaccine at the time of the survey. Receipt was lower among Black (58%) compared with White (91%) healthcare workers; and lower among Hispanic (69%) compared with non-Hispanic (84%) healthcare workers. Among healthcare workers with concerns about COVID-19 vaccine safety, 65% received the vaccine. Among healthcare workers who agreed with the statement that the vaccine is important to protect family members, 86% were vaccinated. Of those who disagreed, 25% received the vaccine. Across all participants, 27% expressed concern about being experimented on with the COVID-19 vaccine. In a multivariable analysis, concern about being experimented on with the COVID-19 vaccine, concerns about COVID-19 vaccine safety, lack of influenza vaccine receipt, disagreeing that COVID-19 vaccination is important to protect family members, and Black race were independently associated with COVID-19 vaccine non-receipt. Over 70% of all healthcare workers responded that they had been approached for vaccine advice multiple times by family, community members, and patients.
Conclusions Our data demonstrated high overall receipt among healthcare workers. Even among healthcare workers with concerns about COVID-19 vaccine safety, side effects, or being experimented on, over 50% received the vaccine. Attitudes around the importance of COVID-19 vaccination to protect others played a large role in healthcare workers' decisions to vaccinate. We observed striking inequities in COVID-19 vaccine receipt, particularly affecting Black and Hispanic workers. Further research is urgently needed in developing strategies with healthcare workers to address issues related to vaccine equity and uptake in the context of systemic racism and barriers to care. This is particularly important given the influence healthcare workers have in vaccine decision-making conversations in their communities.