“The vaccination is positive; I don’t think it’s the panacea”: A qualitative study on COVID-19 vaccine attitudes among ethnically diverse healthcare workers in the United Kingdom

Abstract

Background Globally, healthcare workers (HCWs) were prioritised for receiving vaccinations against the coronavirus disease-2019 (COVID-19). Previous research has shown disparities in COVID-19 vaccination uptake among HCWs based on ethnicity, job role, sex, age, and deprivation. However, vaccine attitudes underpinning these variations and factors influencing these attitudes are yet to be fully explored. Methods We conducted a qualitative study with 164 HCWs from different ethnicities, sexes, job roles, migration statuses, and regions in the United Kingdom (UK). Interviews and focus groups were conducted online or telephonically, and recorded with participants’ permission. Recordings were transcribed and a two-pronged analytical approach was adopted: content analysis for categorising vaccine attitudes and thematic analysis for identifying factors influencing vaccine attitudes. Findings We identified four different COVID-19 vaccine attitudes among HCWs: Active Acceptance, Passive Acceptance, Passive Decline, and Active Decline. Content analysis of the transcripts showed that HCWs from ethnic minority communities and female HCWs were more likely to either decline (actively/passively) or passively accept vaccination—reflecting hesitancy. Factors influencing these attitudes included: trust; risk perception; social influences; access and equity; considerations about the future. Interpretation Our data show that attitudes towards COVID-19 vaccine are diverse, and elements of hesitancy may persist even after uptake. This has implications for the sustainability of the COVID-19 vaccine programme, particularly as new components (for example boosters) are being offered. We also found that vaccine attitudes differed by ethnicity, sex and job role, which calls for an intersectional and dynamic approach for improving vaccine uptake among HCWs. Trust, risk perception, social influences, access and equity and future considerations all influence vaccine attitudes and have a bearing on HCWs’ decision about accepting or declining the COVID-19 vaccine. Based on our findings, we recommend building trust, addressing structural inequities and, designing inclusive and accessible information to address hesitancy.

COVID-19 vaccine knowledge, attitudes, and experiences of health care workers in Perth, Western Australia: A qualitative study

“…A study in the eastern Australian state of Queensland identified that participants' belief that close family and friends would want them to get vaccinated was significantly associated with uptake [28]. While we did not explore this directly, we saw mutuality flowing in the other direction: our participants felt that those closest to them would get vaccinated, and some were actively encouraging this, as also seen in HCWs in other global settings [24,26]. We note that "normal" for our participants was a world free from pandemic control measures which were successfully keeping the disease out of the community, whereas HCWs in countries such as the UK embraced vaccination as a way out of the pandemic because other prevention and control measures had failed [29].…”

“…They trusted the data on COVID-19 vaccine safety and efficacy, which was not the case for HCWs in all comparable global settings (e.g. the UK's ethnically diverse health workforce [24] and health workers in Hong Kong [25]). Our participants felt confident that vaccination would protect themselves and others around them, enabling the community to get back to "normal."…”

“…HCWs in other countries (e.g. Canada [26] and the UK [24]) and other Australian states [27,28] echoed similar drivers, particularly normality. A study in the eastern Australian state of Queensland identified that participants' belief that close family and friends would want them to get vaccinated was significantly associated with uptake [28].…”

Migrant healthcare workers during COVID-19: bringing an intersectional health system-related approach into pandemic protection. A German case study

“…Comparative data revealed strong social inequalities and discrimination against migrant HCWs and racialised groups in the HCWF. This was especially documented for BAME doctors in the UK (53,54,56,57,58,59,60) and ethnic minorities in Brazil (17,62,63).…”

Disparities in COVID-19 vaccination coverage in rural Romania

“…The category of passive acceptance includes respondents who had one or two doses of the vaccine, but still had doubts about its e cacy or safety. Declination of vaccine or passive acceptance has been identi ed more likely among ethnic minority communities and female healthcare workers (Gogoi, 2022).…”