Impact of Local and Demographic Factors on Early COVID-19 Vaccine Hesitancy among Health Care Workers in New York City Public Hospitals

Abstract

Despite the development of several effective vaccines, SARS-CoV-2 continues to spread, causing serious illness among the unvaccinated. Healthcare professionals are trusted sources of information about vaccination, and therefore understanding the attitudes and beliefs of healthcare professionals regarding the vaccines is of utmost importance. We conducted a survey-based study to understand the factors affecting COVID-19 vaccine attitudes among health care professionals in NYC Health and Hospitals, at a time when the vaccine was new, and received 3759 responses. Machine learning and chi-square analyses were applied to determine the factors most predictive of vaccine hesitancy. Demographic factors, education, role at the hospital, perceptions of the pandemic itself, and location of work and residence were all found to significantly contribute to vaccine attitudes. Location of residence was examined for both borough and neighborhood, and was found to have a significant impact on vaccine receptivity. Interestingly, this borough-level data did not correspond to the number or severity of cases in the respective boroughs, indicating that local social or other influences likely have a substantial impact. Local and demographic factors should be strongly considered when preparing pro-vaccine messages or campaigns.

Keywords: COVID-19; healthcare workers; vaccine attitudes.

Figure 1

Reasons for vaccine attitudes and behaviors. (A). Unvaccinated respondents who indicated that they would not be vaccinated in the next three months (refusers) were asked why (n = 231). (B). Those HCW who did not receive the first dose of the vaccine but indicated they were unsure if they would or not (hesitant) were asked what would help them to make a decision (n = 490).

Figure 2

Neighborhoods within boroughs show different vaccination rates between health professionals who live there. (A) Vaccination rates in the Bronx are significantly different based on neighborhood (p < 0.001, n = 479) and range from 87.75% to 48.33%. (B) Vaccination rates for health professionals in Brooklyn are dependent on neighborhood (p = 0.00028 n = 762). Vaccination rates in Brooklyn range from 45.24% to 84.62%. (C) Manhattan has overall high vaccination rates but they are significantly dependent on neighborhoods (p = 0.0169 n = 593). Health professionals vaccinated in Manhattan range from 65.57% to 85.59%. (D) Queens was more homogenous in HCW vaccination rate by neighborhood, with no overall significant difference found (n = 624). Rates in Queens range from 63.33% to 83.63%. (E) Staten Island vaccination rates significantly differed by neighborhood (p = 0.022, n = 89).