COVID-19 Vaccine Hesitancy Among Healthcare Personnel Who Generally Accept Vaccines

Abstract

To identify psychological antecedents of COVID-19 vaccine hesitancy among healthcare personnel (HCP). We surveyed 4603 HCP to assess psychological antecedents of their vaccination decisions (the ‘5 Cs’) for vaccines in general and for COVID-19 vaccines. Most HCP accept vaccines, but many expressed hesitancy about COVID-19 vaccines for the psychological antecedents of vaccination: confidence (vaccines are effective), complacency (vaccines are unnecessary), constraints (difficult to access), calculation (risks/benefits), collective responsibility (need for vaccination when others vaccinate). HCP who were hesitant only about COVID-19 vaccines differed from HCP who were consistently hesitant: those with lower confidence were more likely to be younger and women, higher constraints were more likely to have clinical positions, higher complacency were more likely to have recently cared for COVID-19 patients, and lesser collective responsibility were more likely to be non-white. These results can inform interventions to encourage uptake of COVID-19 vaccines in HCP.

COVID-19 Vaccination Hesitancy among Healthcare Workers—A Review

“…One study noted that a majority of unvaccinated participants considered themselves at low risk [103]. Furthermore, exposure to COVID-19 might actually make HCWs more complacent toward COVID-19 and decrease their sense of personal risk, possibly due to having "survivorship bias" from direct exposure to COVID-19 [104].…”

“…However, HCWs that work several part-time jobs at multiple facilities have reported finding time to vaccinate more difficult [132]. During the early phase of vaccine rollout when distribution was limited, some HCWs who were not employed by a major hospital or healthcare organization may have lived a significant distance from these sites [104]. Financial barriers to receiving the vaccine are unlikely to be an issue in areas where the vaccine is freely available and where employers will allow for HCWs to be vaccinated.…”

“…For example, one study of French HCWs found that some HCWs in French Guiana and the French West Indies had a greater distrust of mainland France, possibly due to the historical treatment of these regions [212]. Still, some HCWs who are skeptical of governments and other institutions may have received other vaccines, possibly due to direct personal experience with these vaccines rather than due to government approval [104].…”

“…This may be because HCWs classify the seasonal influenza vaccine as less necessary than childhood or adolescent vaccinations, creating thus another category by which vaccines can be perceived. Indeed, one study found that HCWs with specific COVID-19 vaccine hesitancy (generally accepting of vaccines) typically had high confidence in vaccines and exhibited low complacency and a high level of collective responsibility [104]. Some HCWs may be more resistant to vaccine mandates than the vaccine itself and may refuse to vaccinate out of protest.…”

Higher Collective Responsibility, Higher COVID-19 Vaccine Uptake, and Interaction with Vaccine Attitude: Results from Propensity Score Matching

“…This calls into question whether collective responsibility is an independent predictor of vaccine uptake or whether it interacts with other predictors in the extended version of TPB. Additionally, vaccination willingness or behaviors are influenced by many factors [3,9,[24][25][26][27][28], and there are potential self-selection or confounding biases when studying vaccination intention or behaviors based on observational samples or data. For example, someone who has higher collective responsibility may also have a more positive attitude or higher subjective norm on vaccination.…”