Predictors of COVID-19 Vaccine Acceptance and Hesitancy among Healthcare Workers in Southern California: Not Just “Anti” vs. “Pro” Vaccine

Abstract

In this study, we evaluated the status of and attitudes toward COVID-19 vaccination of healthcare workers in two major hospital systems (academic and private) in Southern California. Responses were collected via an anonymous and voluntary survey from a total of 2491 participants, including nurses, physicians, other allied health professionals, and administrators. Among the 2491 participants that had been offered the vaccine at the time of the study, 2103 (84%) were vaccinated. The bulk of the participants were middle-aged college-educated White (73%), non-Hispanic women (77%), and nursing was the most represented medical occupation (35%). Political affiliation, education level, and income were shown to be significant factors associated with vaccination status. Our data suggest that the current allocation of healthcare workers into dichotomous groups such as “anti-vaccine vs. pro-vaccine” may be inadequate in accurately tailoring vaccine uptake interventions. We found that healthcare workers that have yet to receive the COVID-19 vaccine likely belong to one of four categories: the misinformed, the undecided, the uninformed, or the unconcerned. This diversity in vaccine hesitancy among healthcare workers highlights the importance of targeted intervention to increase vaccine confidence. Regardless of governmental vaccine mandates, addressing the root causes contributing to vaccine hesitancy continues to be of utmost importance.

COVID-19 Vaccination Hesitancy among Healthcare Workers—A Review

“…This likely occurs to some degree for most individuals, as people tend to interact with those who share similar values and ideas; however, behavioral studies have shown that suspicion and fear decrease, and a more meaningful exchange of ideas between opposing sides can be facilitated by ex-tended contact. Family or household size was also related to vaccine hesitancy, with larger households being associated with higher rates of hesitancy [110]. Interestingly, HCWs with children were more likely to vaccinate themselves [124,125].…”

“…Hesitancy has also been noted among HCWs in the military [108] and at rural hospitals [109]. One study found that the only hospital department or setting associated with higher rates of vaccination worked in the intensive care unit (ICU) [110]. Thus, direct exposure to the severe COVID-19 illness, such as in the ICU, may be a stronger motivator for vaccination.…”

“…Media consumption, particularly social media, has been a major source of speculation and even misinformation regarding the pandemic and vaccination [119]. Some HCWs feel that the media has exaggerated the severity of the pandemic or COVID-19 [110]. A study of Ethiopian healthcare found that social media was more frequently viewed by HCWs as the best source of COVID-19 vaccine information (53.4%) compared to government websites (19.0%) [84].…”

“…Some contend that natural immunity is preferable to immunization [82,198]. Others contend that vaccination should not be required or is not necessary for those who have already contracted COVID-19 [110,142]. This may be due to feeling protected from COVID-19 due to previous illness or because those who are more likely to contract COVID-19 had fewer health-protective behaviors in the first place [157].…”

Impact of COVID-19 vaccine-associated side effects on health care worker absenteeism and future booster vaccination

“…We designed the survey to achieve two distinct goals: 1) analyze HCW attitudes toward COVID-19 vaccination to identify clusters or groupings predisposed to vaccine hesitancy, which in turn might aid in tailoring vaccine education programs (reported in another manuscript); [40] and 2) assess the practical work-related impacts of vaccine-associated side effects, which might assist health employers in planning future vaccination booster schedules (the focus of the present report). A working group developed the measures, and the survey was based on previous questionnaires conducted amongst the 2009 H1N1 flu pandemic.…”