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. 2022 Jan 24;40(3):494-502.
doi: 10.1016/j.vaccine.2021.11.094. Epub 2021 Dec 11.

COVID-19 vaccine perceptions and uptake in a national prospective cohort of essential workers

Karen Lutrick  1 , Holly Groom  2 , Ashley L Fowlkes  3 , Kimberly D Groover  4 , Manjusha Gaglani  5 , Patrick Rivers  6 , Allison L Naleway  7 , Kimberly Nguyen  8 , Meghan Herring  9 , Kayan Dunnigan  10 , Andrew Phillips  11 , Joel Parker  12 , Julie Mayo Lamberte  13 , Khaila Prather  14 , Matthew S Thiese  15 , Zoe Baccam  16 , Harmony Tyner  17 , Sarang Yoon  18
Affiliations

COVID-19 vaccine perceptions and uptake in a national prospective cohort of essential workers

Karen Lutrick et al. Vaccine. .

Abstract

Introduction: In 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.

Methods: Initiated 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.

Results: A 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).

Discussion: Our 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.

Conclusions: Perceptions 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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Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Allison L. Naleway reported funding from Pfizer for a meningococcal B vaccine study unrelated to the submitted work.

References

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    1. Centers for Disease Control and Prevention. Interim List of Categories of Essential Workers Mapped to Standardized Industry Codes and Titles. https://www.cdc.gov/vaccines/covid-19/categories-essential-workers.html. Accessed June 1, 2021.

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