COVID-19 Vaccine Hesitancy Among Clinical Health Care Workers (HCWs) in Four Major Healthcare Systems in Metro Atlanta Open Access

Abstract

Background: Since COVID-19 vaccines were approved for emergency use in late 2020, they

remain the most effective known preventive measure for fighting the current pandemic. Several

studies have highlighted COVID-19 vaccine hesitancy in the general population; however, little

is known about the nature and extent of COVID-19 vaccine hesitancy in healthcare workers

(HCWs) in Georgia. This current study assessed the prevalence and risk factors of COVID-19

vaccine hesitancy among clinical HCWs in four healthcare systems in metro Atlanta.

Method: The study included demographic and COVID-19 vaccination-related data collected

from clinical HCWs. Data was collected through an anonymous cross-sectional survey using

Qualtrics via email to all HCWs in May-June 2021. We estimated the prevalence of vaccine hesitancy

across clinical healthcare roles and assessed the predictors using a logistic regression

model. We also examined the perception and reasons for vaccine hesitancy among vaccine-hesitant

HCWs. All analyses were done in SAS 9.4 and statistical significance was assumed at a

0.05 level.

Results: A total of 3373 clinical HCWs were surveyed in this study with a response rate of

approximately 18%. Overall, 9.7% of clinical HCWs were vaccine-hesitant. Physicians were the

least vaccine-hesitant (1.8%), whereas paramedics (29.1%), medical/nursing assistants (14.6%),

nurses (13.4%), and technologists (13.4%) were the most vaccine-hesitant groups. About half of

the vaccine-hesitant clinical HCWs were nurses. Factors that were positively associated with

vaccine-hesitancy included young age, previous COVID-19 infection, and children under 18

years at home. Higher education, Asian race, Hispanic ethnicity, and having a family member

with critical COVID-19 were negatively associated with vaccine-hesitancy. Among all

respondents, 54% doubted its effectiveness, 30% were concerned about side effects, and 40% did

not agree to mandatory COVID-19 vaccination for HCWs. Among the vaccine-hesitant HCWs,

the top concerns were side effects (45%), limited knowledge (18%), and wanting more people to

get vaccinated (26%).

Conclusion: Vaccine hesitancy among clinical HCWs was highest among younger and less

educated HCWs. A considerable proportion of HCWs had negative perceptions of COVID-19

vaccines and documented less confidence in getting this. Therefore, targeted interventions such

as information leaflets, posters, or regular plenary presentations are needed to improve vaccine

uptake among HCWs.

Table of Contents

Chapter-1: Introduction ..........................................................................................................1-6

Chapter-2: Literature review ....................................................................................................7-11

Chapter-3: Methodology .........................................................................................................12-26

Chapter-4: Results ................................................................................................................. 27-48

Chapter-5: Discussion ............................................................................................................ 49-51

References .............................................................................................................................52-55

Appendix ...............................................................................................................................56-71

About this Master's Thesis

Rights statement

• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Epidemiology - MPH & MSPH
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Epidemiology
Keyword	vaccine hesitancy healthcare workers COVID-19
Committee Chair / Thesis Advisor	Ambar Kulshreshtha, MD PhD, Emory University
Committee Members	Sheetal Kandiah, MD MPH, Emory University

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