key: cord-0833880-xtrvweut
authors: Jain, Vivek; Doernberg, Sarah B; Holubar, Marisa; Huang, Beatrice; Bollyky, Jenna; Sample, Hannah; Weng, Yingjie; Lu, Di; Desai, Manisha; Maldonado, Yvonne; Rutherford, George
title: High completion of COVID-19 vaccination among healthcare workers despite initial self-reported vaccine reluctance
date: 2021-09-06
journal: Open Forum Infect Dis
DOI: 10.1093/ofid/ofab446
sha: ba357933006257567fe073844e9ece986f78e61e
doc_id: 833880
cord_uid: xtrvweut

nan

A c c e p t e d M a n u s c r i p t 3 Dear Editor,

vaccination. [1] [2] The degree to which pre-vaccination opinions correlate with actual vaccination completion is unclear.

t We also describe emergent reasons for vaccine delay and non-completion among HCW. and Stanford Health Care. [3] On-site vaccinations were offered in staged fashion starting in December 2020; all HCW were invited before the second survey; HCW were also given materials about multiple community-based locations where they could receive vaccination. Both surveys were web/email-based and used REDCap electronic data capture tools hosted at Stanford University [4] (surveys included as Supplemental Appendices 1/2). We defined vaccine reluctance in the first survey as a 5-point Likert scale response of "definitely no" or "unlikely" to the question "If a vaccine received emergency use authorization but not formal FDA approval, would you get it?" We ascertained HCW vaccine completion via survey, and defined delay in receipt of vaccine as an individual receiving vaccination ≥2 weeks after their invitation for vaccination. included concerns about side effects, regulatory approval processes, vaccine efficacy, allergy to vaccine components or other agents, and pregnancy/breastfeeding. However, when asked if they would eventually receive COVID-19 vaccination, only 4/22 (18.2%) responded "definitely not" or "unlikely", while 11/22 (50%) responded "likely" or "definitely."

In a cohort of over 2000 California HCW, over 98% of HCWs self-reported completing COVID-19 vaccination despite 30% initially reporting reluctance. A small fraction of HCW delayed vaccination at the time they first became eligible but eventually sought vaccination. Among HCWs who remained unvaccinated in April 2021, months after initial eligibility, diverse reasons included concerns about side effects, vaccine efficacy, and a perception that there was insufficient data for women who were pregnant. Half of unvaccinated HCWs indicated a high likelihood of future vaccine completion.

A c c e p t e d M a n u s c r i p t 5 Our data add to an emerging picture of HCW vaccination. Our vaccination rates are higher than in other regions but align with California's overall high general population vaccine uptake, [5] and are very similar to a 96% vaccine completion recently reported among Los Angeles HCW. HCW vaccination is critical for ensuring the safety and stability of the workforce, and for promoting public confidence in the vaccines. Despite widespread availability for HCW vaccination rates are still below targets. Our data underscore the critical need for healthcare systems to (1) continue to maintain low-barrier access to vaccination at work sites and other venues (2) continue to inform HCW about the vaccine approval process and existing safety data.

Emerging COVID-19 vaccine safety data among pregnant/lactating individuals[7] should also be integrated into outreach campaigns. Given the high willingness of unvaccinated HCW to be vaccinated eventually, health systems should not view these HCW as having fixed opinions; rather they should be continually engaged in the process of vaccination offerings. 

This work was supported by a research grant from the Chan Zuckerberg Initiative.

We gratefully acknowledge the participation of healthcare worker participants in the CHART Study at UCSF Health and 

Assessment of U.S. health care personnel (HCP) attitudes towards COVID-19 vaccination in a large university health care system

Trends in Health Care Worker Intentions to Receive a COVID-19

Vaccine and Reasons for Hesitancy

Healthcare personnel knowledge, motivations, concerns and intentions regarding COVID-19 vaccines: a cross-sectional survey

Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support

Vaccination progress data

A c c e p t e d M a n u s c r i p t