COVID-19 vaccine perceptions and uptake in a national prospective cohort of essential workers |
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| Institution: | 1. Family & Community Medicine, College of Medicine – Tucson, University of Arizona, Tucson, AZ, 655 N Alvernon Way, Suite 228, Tucson, AZ, 85721, United States;2. Center for Health Research, Kaiser Permanente Northwest, Portland, OR, United States;3. Epidemiology Prevention Branch, Influenza Division, Centers of Disease Control and Prevention, Atlanta, GA, United States;4. Abt Associates, Atlanta, GA, United States;5. Baylor Scott and White Health, Texas A&M University College of Medicine, Temple, TX, United States;6. Family & Community Medicine, College of Medicine – Tucson, University of Arizona, Tucson, AZ, United States;7. Assessment Branch, Immunization Services Division, Centers for Disease Control and Prevention, Atlanta, GA, United States;8. Baylor Scott and White Health, Texas A&M University College of Medicine, Temple, TX, United States;9. Occupational and Environmental Health, School of Medicine, University of Utah, Salt Lake City, UT, United States;10. Epidemiology and Biostatistics, College of Public Health, University of Arizona, Tucson, AZ, United States;11. St. Luke’s Infectious Disease Associates, St. Luke’s Hospital, Duluth, MN, United States |
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| Abstract: | IntroductionIn a multi-center prospective cohort of essential workers, we assessed knowledge, attitudes, and practices (KAP) by vaccine intention, prior SARS-CoV-2 positivity, and occupation, and their impact on vaccine uptake over time.MethodsInitiated in July 2020, the HEROES-RECOVER cohort provided socio-demographics and COVID-19 vaccination data. Using two follow-up surveys approximately three months apart, COVID-19 vaccine KAP, intention, and receipt was collected; the first survey categorized participants as reluctant, reachable, or endorser.ResultsA total of 4,803 participants were included in the analysis. Most (70%) were vaccine endorsers, 16% were reachable, and 14% were reluctant. By May 2021, 77% had received at least one vaccine dose. KAP responses strongly predicted vaccine uptake, particularly positive attitudes about safety (aOR = 5.46, 95% CI: 1.4–20.8) and effectiveness (aOR = 5.0, 95% CI: 1.3–19.1). Participants’ with prior SARS-CoV-2 infection were 22% less likely to believe the COVID-19 vaccine was effective compared with uninfected participants (aOR 0.78, 95% CI: 0.64–0.96). This was even more pronounced in first responders compared with other occupations, with first responders 42% less likely to believe in COVID-19 vaccine effectiveness (aOR = 0.58, 95% CI 0.40–0.84). Between administrations of the two surveys, 25% of reluctant, 56% reachable, and 83% of endorser groups received the COVID-19 vaccine. The reachable group had large increases in positive responses for questions about vaccine safety (10% of vaccinated, 34% of unvaccinated), and vaccine effectiveness (12% of vaccinated, 27% of unvaccinated).DiscussionOur study demonstrates attitudes associated with COVID-19 vaccine uptake and a positive shift in attitudes over time. First responders, despite potential high exposure to SARS-CoV-2, and participants with a history of SARS-CoV-2 infection were more vaccine reluctant.ConclusionsPerceptions of the COVID-19 vaccine can shift over time. Targeting messages about the vaccine’s safety and effectiveness in reducing SARS-CoV-2 virus infection and illness severity may increase vaccine uptake for reluctant and reachable participants. |
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| Keywords: | U S Food and Drug Administration Centers for Disease Control and Prevention Emergency Use Authorization Knowledge attitudes and practices HEROES-RECOVER Health care personnel Frontline workers Personal protective equipment |
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