Nearly Half of Frontline Healthcare Workers Not Vaccinated: Survey

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Despite being prioritized for COVID-19 vaccination, 48% of frontline healthcare workers have not yet gotten one or more vaccine doses, according to a survey conducted by the Washington Post and the Kaiser Family Foundation February 11–March 7.

The researchers conducted online or phone interviews with 1327 frontline healthcare workers, who were defined as anyone who had direct exposure to patients and their bodily fluids.

Nearly seven in 10 (68%) of the workers responsible for diagnosis and treatment, including doctors and nurses, reported having received a COVID-19 vaccine. In contrast, 44% of workers who perform administrative duties and 37% of those who assist with patient care, such as those involved in bathing, eating, cleaning, exercising, and housekeeping, reported having been vaccinated.

There were also big differences in the percentages of vaccinated respondents in various care settings. Sixty-six percent of workers in hospitals and 64% of those in hospital outpatient clinics said they’d been vaccinated, compared with 52% of those who work in doctors’ offices, 50% of workers in nursing home and assisted living facilities, and 26% of home health workers.

Overall, 52% of the survey participants had received at least one dose of vaccine. The percentages of those vaccinated was higher among men than in women and higher among whites than among Blacks or Hispanics.

Vaccine Hesitancy

The unvaccinated group of frontline health workers included people who either had scheduled their vaccination (3%) or planned to get vaccinated but hadn’t scheduled it yet (15%). Twelve percent of respondents said they hadn’t decided whether or not to get vaccinated, and 18% said they didn’t plan to receive a COVID-19 vaccine.

Together, the last two groups — the vaccine-hesitant and those opposed to being vaccinated — comprised three in 10 of the surveyed healthcare workers.

Of the workers in those categories, a large majority were concerned about potential side effects (82%) and the newness of the vaccine (81%).

Among frontline healthcare workers, half of Black workers, 45% of workers without a college degree, and 40% of Republican and Republican-leaning workers said they were not confident that the COVID-19 vaccines available in the United States had been properly tested for safety and effectiveness. About 20% of those in each of these groups said they would not get vaccinated.

The vaccine hesitancy among survey participants was fairly similar to that of the general public, as revealed in an accompanying poll of 971 US adults who were not frontline healthcare workers.

For example, 21% of healthcare workers and 17% of the public were “not too confident” that the vaccines had been properly tested. Fifteen percent of healthcare workers and 18% of the public were “not at all confident” that this was the case.

Access to Vaccination

Access to a COVID-19 vaccine from an employer was a key aspect of vaccination rates among frontline healthcare workers. Six in 10 healthcare workers who were not self-employed said they were either offered or received a COVID-19 vaccine from their employer (including 84% of vaccinated healthcare workers).

The share of workers who were offered a COVID-19 vaccine by their employer was much lower among those working in patients’ homes (34%).

Among workers who planned to get vaccinated but had not yet made an appointment, just over 6 in 10 said they planned to do so through their employer. Approximately 3 in 10 said their employer had not offered them a shot.

Sixty percent of survey participants who treated or provided assistance to COVID-19 patients had received their first vaccine dose; only 42% of those who didn’t treat or provide assistance to patients had gotten their first shot.

Of workers who identified as Democratic voters or Democratic-leaning independents, 58% had gotten their first shot; this was true of only 48% of those identifying as Republicans or Republican-leaning independents. Twelve percent of the Democratic group had decided not to get vaccinated, and 24% of the Republican group had made the same decision.

Pandemic Politicized

The politicization of the pandemic is one reason why so many minority healthcare workers have declined to be vaccinated, said Halee Fischer-Wright, MD, president of the Medical Group Management Association, in an interview with Medscape Medical News.

“It reinforced for Black and brown communities their mistrust of the government. Then, that government created Operation Warp Speed, which was terrible branding, because it connected with the fears that this vaccine was produced without all due care and safety. In addition, this population has a historical reason to be distrustful of the medical community and of the government. All of that has played into why we see a low immunization rate in those populations, even if they’re healthcare workers,” she said

Michael J. Wright, director of the Health, Safety and Environment Department at United Steelworkers (USW), told Medscape Medical News that the healthcare workers represented by USW have a higher vaccination rate than the workers in the Washington Post-KFF survey.

One reason, he said, is that the union has pushed vaccination. “We’ve done webinars and have put out educational materials,” he said.

Also, Wright noted, the healthcare workers trust the union more than they trust their employers or the government. Hospitals and other employers “have not always acted with appropriate concern for healthcare workers. For example, some hospitals are still not providing N95 respirators to some workers even though they’re now widely available. Or if they do make them available, the hospitals want the workers to use the same masks numerous times.”

Hospital Workers First

On the other hand, Fischer-Wright pointed out, hospitals prioritized their own workers (including those in hospital-owned practices) when they initially administered the vaccines they received from the government. Only recently have they begun to transfer their excess supplies to physician practices in the community, she said.

Besides this supply chain problem, she also cited the requirement that the Pfizer vaccine be stored at ultra-cold temperatures. Although the Moderna vaccine can be stored in a normal freezer, she noted, “only hospitals and large practices with research-grade freezers could store the Pfizer vaccine.”

Because few practices had access to the vaccines in the early going, she explained, many of their staff members had to seek vaccination appointments along with members of the public who were eligible to be immunized at the same time. That proved to be a barrier to many healthcare workers.

These factors largely explain why a significantly higher percentage of hospital employees than of physician office staff have been vaccinated so far, she said.

Going forward, she maintained, a massive public education campaign will be required to overcome vaccine hesitancy. Physicians can serve as role models by getting vaccinated themselves, she said, and they should do their part to educate their own staffs. However, she noted, “There’s a little bit of reluctance to confront people about their tightly held beliefs.”

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