Study: COVID-19 vaccine hesitancy in healthcare workers remains a concern

A new study from New Mexico State University researchers reveals the prevalence of vaccine hesitancy among health care workers across the world.

The study is the first comprehensive and worldwide assessment of published evidence on COVID-19 vaccine hesitancy among health care workers. It comes as countries around the globe race to vaccinate their populations to slow transmission of the virus that causes COVID-19 and blunt the ongoing pandemic, now in its second year.

NMSU researchers, led by Jagdish Khubchandani, analyzed 35 studies that assessed vaccine hesitancy in health care workers from more than a dozen different countries. Their findings, published in the Journal of Community Health, show an average hesitancy rate of 22.5 percent among the 76,471 healthcare workers who participated in the studies.

Khubchandani, professor of public health sciences in the College of Health and Social Services at NMSU, said the study shows vaccine hesitancy among health care workers is more prevalent than otherwise perceived and may be similar to the vaccine hesitancy rate among the general population.

"Many people would assume health care workers would have no hesitancy to take the COVID-19 vaccine, given the nature of their work," Khubchandani said. "However, we must not forget that health care workers are not a homogenous group, may differ based on education and knowledge, and they are a part of the broader society with similar concerns and fears."

Khubchandani wrote the paper with James Price of the University of Toledo and two NMSU graduate students, Nirbachita Biswas and Toheeb Mustapha.

Among the studies reviewed by the researchers, Middle Eastern health care workers had the highest rates of vaccine hesitancy, Khubchandani said. Nine studies conducted in the U.S. found hesitancy rates ranging from 8 percent to 18 percent among American health care workers.

The top three reasons for vaccine hesitancy among health care workers included concerns over safety, efficacy and potential side effects—similar worries shared by the general public, Khubchandani said.

The prevalence of vaccine hesitancy among health care workers is a growing concern for Khubchandani and other public health professionals. That's because separate studies have found lower rates of vaccination hesitancy among the general public when health care providers recommend immunization.

"If health care workers continue to remain hesitant toward COVID-19 vaccines, it is unlikely they would recommend these vaccines to the general public and ensure mass vaccinations with the available COVID-19 vaccines. Health care workers have the potential to be infected or infect others and should try and get vaccinated," Khubchandani said.

The review of studies found health care workers who were male, older and had a doctoral degree or postgraduate education had a higher willingness to get the COVID-10 vaccine. A higher perceived risk of getting infected with COVID-19, a history of influenza vaccination and direct care for patients were factors that increased vaccine probability in this group.

Khubchandani noted that the health care industry may have a large representation of female workers from lower income levels or educational backgrounds.

"This could have been a reason for high hesitancy in health care workers, similar to what we have shown in our studies from the general population," he said. "Frequently, these populations are overrepresented in the health care workforce as frontline, essential or direct care workers. Vaccinations will ensure that this population at greater risk can continue to help patients without a risk of serious infection from COVID-19."

Certain strategies and interventions may help increase COVID-19 immunization rates among the health care population, Khubchandani said. These strategies include incentives to get vaccinated; role models and community leaders encouraging vaccinations; educational interventions; hospital-based protocols and mandates; prioritizing vaccination for these groups and making vaccine access easy; and giving time off or sick leave benefits to enable vaccination. Some health care facilities around the world are testing such initiatives, he added.

"Given the high rates of COVID-19 vaccination hesitancy in this population, education and policy-based interventions should be implemented to ensure that health care workers are vaccinated with the available COVID-19 vaccines," he said. "Without high compliance for COVID-19 vaccination among health care workers, there are enormous risks to the general public as well as health care workers."