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Article

Correlates of COVID-19 Vaccine Acceptance, Hesitancy and Refusal among Employees of a Safety Net California County Health System with an Early and Aggressive Vaccination Program: Results from a Cross-Sectional Survey

by
Nicole M. Gatto
1,*,
Jerusha E. Lee
2,
Donatella Massai
1,
Susanna Zamarripa
3,
Bijan Sasaninia
3,
Dhruv Khurana
3,
Kelsey Michaels
3,
Deborah Freund
1,2,
Judi Nightingale
3 and
Anthony Firek
3 on behalf of the Riverside University Health System (RUHS) Comparative Effectiveness and Clinical Outcomes Research Center (CECORC)-Claremont Graduate University (CGU) COVID-19 Research Group
1
School of Community and Global Health, Claremont Graduate University, 150 E 10th St, Claremont, CA 91711, USA
2
Department of Economic Sciences, Claremont Graduate University, 150 E 10th St, Claremont, CA 91711, USA
3
Comparative Effectiveness and Clinical Outcomes Research Center, Riverside University Health System, 26520 Cactus Avenue, Moreno Valley, CA 92555, USA
*
Author to whom correspondence should be addressed.
Vaccines 2021, 9(10), 1152; https://doi.org/10.3390/vaccines9101152
Submission received: 12 September 2021 / Revised: 4 October 2021 / Accepted: 5 October 2021 / Published: 9 October 2021
(This article belongs to the Collection Factors Associated with Vaccine Hesitancy)
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Abstract

Since health professionals provide frontline care to COVID-19 patients, information on vaccine acceptance among healthcare workers is needed. We developed and implemented an anonymous internet-based cross-sectional survey with direct solicitation among employees of a safety net health system. Items queried demographic and health-related characteristics, experience with and knowledge of COVID-19, and determinants of decisions to vaccinate. COVID-19 vaccine acceptance groups (acceptors, hesitant, refusers) were defined; an adapted version of the WHO vaccine hesitancy scale was included. The survey demonstrated good reliability (Cronbach’s alpha = 0.92 for vaccine hesitancy scale; 0.93 for determinants). General linear and logistic regression methods examined factors which were univariately associated with vaccine hesitancy and vaccine acceptance, respectively. Multivariable models were constructed with stepwise model-building procedures. Race/ethnicity, marital status, job classification, immunocompromised status, flu vaccination and childhood vaccination opinions independently predicted hesitancy scale scores. Gender, education, job classification and BMI independently predicted acceptance, hesitancy, and refusal groups. Among hesitant employees, uncertainty was reflected in reports of motivating factors influencing their indecision. Despite a strong employee-support environment and job protection, respondents reported physical and mental health effects. The appreciation of varied reasons for refusing vaccination should lead to culturally sensitive interventions to increase vaccination rates amongst healthcare workers.
Keywords: vaccine hesitancy; COVID-19; pandemic; SARS-CoV-2; healthcare workers; vaccine acceptance; physicians; nurses; determinants vaccine hesitancy; COVID-19; pandemic; SARS-CoV-2; healthcare workers; vaccine acceptance; physicians; nurses; determinants

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MDPI and ACS Style

Gatto, N.M.; Lee, J.E.; Massai, D.; Zamarripa, S.; Sasaninia, B.; Khurana, D.; Michaels, K.; Freund, D.; Nightingale, J.; Firek, A., on behalf of the Riverside University Health System (RUHS) Comparative Effectiveness and Clinical Outcomes Research Center (CECORC)-Claremont Graduate University (CGU) COVID-19 Research Group. Correlates of COVID-19 Vaccine Acceptance, Hesitancy and Refusal among Employees of a Safety Net California County Health System with an Early and Aggressive Vaccination Program: Results from a Cross-Sectional Survey. Vaccines 2021, 9, 1152. https://doi.org/10.3390/vaccines9101152

AMA Style

Gatto NM, Lee JE, Massai D, Zamarripa S, Sasaninia B, Khurana D, Michaels K, Freund D, Nightingale J, Firek A on behalf of the Riverside University Health System (RUHS) Comparative Effectiveness and Clinical Outcomes Research Center (CECORC)-Claremont Graduate University (CGU) COVID-19 Research Group. Correlates of COVID-19 Vaccine Acceptance, Hesitancy and Refusal among Employees of a Safety Net California County Health System with an Early and Aggressive Vaccination Program: Results from a Cross-Sectional Survey. Vaccines. 2021; 9(10):1152. https://doi.org/10.3390/vaccines9101152

Chicago/Turabian Style

Gatto, Nicole M., Jerusha E. Lee, Donatella Massai, Susanna Zamarripa, Bijan Sasaninia, Dhruv Khurana, Kelsey Michaels, Deborah Freund, Judi Nightingale, and Anthony Firek on behalf of the Riverside University Health System (RUHS) Comparative Effectiveness and Clinical Outcomes Research Center (CECORC)-Claremont Graduate University (CGU) COVID-19 Research Group. 2021. "Correlates of COVID-19 Vaccine Acceptance, Hesitancy and Refusal among Employees of a Safety Net California County Health System with an Early and Aggressive Vaccination Program: Results from a Cross-Sectional Survey" Vaccines 9, no. 10: 1152. https://doi.org/10.3390/vaccines9101152

APA Style

Gatto, N. M., Lee, J. E., Massai, D., Zamarripa, S., Sasaninia, B., Khurana, D., Michaels, K., Freund, D., Nightingale, J., & Firek, A., on behalf of the Riverside University Health System (RUHS) Comparative Effectiveness and Clinical Outcomes Research Center (CECORC)-Claremont Graduate University (CGU) COVID-19 Research Group. (2021). Correlates of COVID-19 Vaccine Acceptance, Hesitancy and Refusal among Employees of a Safety Net California County Health System with an Early and Aggressive Vaccination Program: Results from a Cross-Sectional Survey. Vaccines, 9(10), 1152. https://doi.org/10.3390/vaccines9101152

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