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. 2023 Jan-Dec:14:21501319231159814.
doi: 10.1177/21501319231159814.

Characterization of COVID-19 Vaccine Hesitancy Among Essential Workforce Members of a Large Safety Net Urban Medical Center

Deborah Kupferwasser  1   2 , Evelyn A Flores  1 , Prudencio Merino  1 , Donna Phan Tran  1 , Michael Bolaris  1 , Mildred Gonzales  3 , Megan H Nguyen  4 , Arlene Balo  1 , Angel Abueg  1 , Wellington Da Silva  5 , Leslie Astorga-Cook  5 , Honghu Liu  6 , Holli Mason  1 , Deborah Freund  2 , Judi Nightingale  7 , Jay Orr  2 , Bin Xie  2 , Loren G Miller  1   6
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Characterization of COVID-19 Vaccine Hesitancy Among Essential Workforce Members of a Large Safety Net Urban Medical Center

Deborah Kupferwasser et al. J Prim Care Community Health. 2023 Jan-Dec.

Abstract

Objectives: Vaccine hesitancy among essential workers remains a significant public health challenge. We examined psychological constructs of perceived susceptibility, threat, and self-efficacy and their associations with COVID-19 vaccine hesitancy among a racially and ethnically diverse essential workforce population.

Methods: We performed a cross-sectional survey of essential workers from September-December 2020 at a large Los Angeles safety-net medical center as part of a program offering free COVID-19 serology testing. Program participants completed a standardized survey at the time of phlebotomy. Hierarchical logistic regression was utilized to determine factors independently associated with vaccine hesitancy.

Results: Among 1327 persons who had serology testing, 1235 (93%) completed the survey. Of these, 958 (78%) were healthcare workers. Based on expressed intent, 22% were vaccine-hesitant 78% were vaccine acceptors. In our multivariate model, vaccine hesitancy was associated with female gender [aOR = 2.09; 95% CI (1.44-3.05)], African American race [aOR = 4.32; (2.16-8.62)], LatinX ethnicity [aOR = 2.47; 95% CI (1.51-4.05)] and history of not/sometimes receiving influenza vaccination [aOR = 4.39; 95% CI (2.98-6.48)]. Compared to nurses, vaccine hesitancy was lower among physicians [aOR = 0.09; 95% CI (0.04-0.23)], non-nursing/non-physician healthcare workers [aOR = 0.55; 95% CI (0.33-0.92)], and non-healthcare care workers [aOR = 0.53; 95% CI (0.36-0.78)].

Conclusions: Among a racially/ethnically diverse group of safety net medical center essential workers, COVID-19 vaccine hesitancy was associated with racial/ethnic minority groups, employment type, and prior influenza vaccination hesitancy. Interestingly, we found no association with the Health Belief Model construct measures of perceived susceptibility, threat, and self-efficacy. Psychological constructs not assessed may be drivers of vaccine hesitancy in our population.

Keywords: COVID-19; behavioral health; community health; prevention; vaccine hesitancy.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Distribution of Likert-type response items for health belief model based vaccine hesitancy questions. (A) Panel A: vaccine-acceptors, (B) Panel B: vaccine-hesitant, and (C) Mean response scores for vaccine-acceptors and vaccine-hesitant persons.
See this image and copyright information in PMC

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