Young Females Dubbed Most Likely Health Care Workers to be Vaccine Hesitant

The problem of COVID-19 vaccine hesitancy among health care workers (HCWs) concerned health care experts even before there were COVID-19 vaccines, and it recently surfaced in a headline-grabbing manner as more hospitals make employment contingent on getting the vaccine, cheered on by medical associations whose members often have to deal with infectious diseases. This issue especially resonates with infection preventionists (IPs) because they’re often the ones who oversee vaccination efforts in hospitals and other health care institutions.

But where to begin? The term “health care workers” encompasses about 18 million people in the United States, according to the Centers for Disease Control and Prevention (CDC). If HCWs comprised a state, it would be the fifth most populous state in the country.

Start COVID-19 vaccination efforts first among female health care workers under 30 years old, says a study published online yesterday in the American Journal of Infection Control (AJIC).

Investigators with Hangzhou Medical College conclude that “targeted strategies of COVID-19 vaccination need to be formulated and implemented for female health care workers under the age of 30 years who have no history of influenza vaccination in order to address the issue of vaccine hesitancy among HCWs.”

Investigators note that their meta-analysis focuses on HCWs who say they intend to get the vaccine, as opposed to those who actually get the vaccine, and while for the most part intention predicts behavior, that’s not always the case.

What they did find gives pause: only 51% of overall COVID-19 vaccine acceptance among HCWs. “One possible contributor for this finding is that HCWs are exposed to more professional information, and therefore [have] more concerns about the effectiveness and safety of COVID-19 vaccine, which may affect their decision to get vaccinated and hinder their recommendation of vaccination to patients,” the study states.

This finding dovetails with a study in early May by investigators with McGill University Faculty of Medicine, Montreal, Canada, that says HCWs want to see more data on the COVID-19 vaccines, and may want to see how the vaccines affect fellow workers before they themselves take the plunge. In the U.S., some medical experts have argued that full approval of the COVID-19 vaccines by the Food and Drug Administration—that is moving them out of the emergency use authorization (EUA) silo—would help lessen vaccine hesitancy among the entire population, including HCWs.

Hangzhou Medical College investigators in the AJIC study conclude: “In the case of newly-available COVID-19 vaccine, little is known regarding its efficacy and safety at this moment for most individuals. Thus, global governments should expand and intensify their health education efforts urgently to improve knowledge, attitude and practice regarding COVID-19 vaccination that are beneficial to promotion of COVID-19 vaccination.”

Investigators collected their data from English databases PubMed, EMBASE, Web of Science, and the Cochrane Library. They also collected data from Chinese databases the Chinese National Knowledge Infrastructure, the Chongqing VIP Chinese Science, the Wanfang Database and the China Biomedical Literature Database.

“Nine records with a total of 24,952 subjects were included in this meta-analysis,” the study states. “The results of this meta-analysis revealed that the pooled effect value of COVID-19 vaccination willingness among HCWs using a random-effects model was 51% (95% confidence interval (CI) 0.41-0.62). Male, aged 30 years or older, having a history of prior influenza vaccination were facilitators for HCWs’ intention to vaccinate against COVID-19 (odds ratio (OR) 1.82, 95% CI 1.37-2.41, P=0.000, I2=59.4%; OR 1.32, 95% CI 1.16-1.51, P=0.000, I2=31.7%; OR 2.97, 95% CI 1.82-4.84, P=0.000, I2=88.1%). The impact of occupation on HCWs’ intention to get vaccinated could not yet be definitively confirmed (OR 0.85, 95% CI 0.69-1.06, P=0.160, I2=85.5%).”

The investigators also touch on the subject of mandatory COVID-19 vaccination for HCWs. They note that while most countries recommend that HCWs get vaccinated, Italy—"after suffering from the most severe effects of COVID-19 among European countries”—mandates it. They cite another study that suggests that a majority of HCWs would get the vaccine if mandated to do so.

Also, a “free vaccination policy may also contribute to increase vaccination rates and the result has been validated by a study conducted in China.”