25 Mar COVID-19: Steady Increase in Health Care Workers Acceptance of Vaccine
MedicalResearch.com Interview with:
Michelle N. Meyer, PhD, JD
Assistant Professor & Associate Director, Research Ethics, Center for Translational Bioethics & Health Care Policy
Faculty Co-Director, Behavioral Insights Team, Steele Institute for Health Innovation
Assistant Professor of Bioethics
Geisinger Commonwealth School of Medicine
MedicalResearch.com: What is the background for this study?
Response: Earlier research had found people are less likely to say they’ll receive a COVID-19 vaccine offered to them under an Emergency Use Authorization (EUA) than one offered to them following full FDA approval. Earlier surveys had also found that only around 30% of health care workers intended to receive a COVID-19 vaccine. Because the public often looks to local health care workers for health advice, and in most prioritization schemes they were slated to be offered vaccines first, this was quite concerning for the prospect of achieving population immunity. Commenters had warned that if the FDA chose to make COVID-19 vaccines available under EUAs, that substantial efforts would need to be made to ensure trust. On Dec. 4, 2020, an announcement about anticipated vaccine availability was emailed to all 23,784 Geisinger employees, who were asked to indicate their intention to receive a vaccine when one was available to them and the reasons for any hesitation they might have.
MedicalResearch.com: What are the main findings?
Response: More than two-thirds of employees responded to the survey. Of those who completed the survey before the Dec. 10 livestreamed vote by an independent FDA advisory committee to recommend emergency use authorization (EUA) of the first COVID-19 vaccine, 53.2% said they would receive a COVID-19 vaccine; by contrast, 80.2% of those who completed the survey after that date said they planned to receive a vaccine. Several additional significant vaccine-related events followed the Dec. 10 Pfizer-BioNTech vote, including an EUA vote recommending authorization of the Moderna vaccine, recommendations for both vaccines by the Centers for Disease Control and Prevention, and news coverage of prominent members of both political parties receiving the vaccine.
Because many more employees completed the survey prior to the first authorization, only 55.3% of employees overall said they intended to receive a vaccine, with 16.3% saying they would decline and 28.4% saying they were undecided. But the substantial trends towards greater intent to receive a vaccine that the researchers observed is consistent with 67.2% of Geisinger employees having received at least one COVID-19 vaccine dose as of Feb. 18, 2021, a higher percentage than had initially indicated they would receive the vaccine.
Of those employees who indicated they would not receive the vaccine or were unsure, most (90.3%) said they worried about unknown risks of COVID-19 vaccines or felt there was insufficient data.
MedicalResearch.com: What should readers take away from your report?
Response: We found a steady increase in health care workers’ intentions to receive a COVID-19 vaccine as the EUA processes for the first two vaccines unfolded. This suggests that these efforts to build trust—such as independent agency review of trial data and independent FDA and CDC advisory committee votes livestreamed for all to see—paid off. This ascendant trend is consistent with 67.2% of Geisinger employees having received at least one COVID-19 vaccine dose as of Feb. 18, 2021, a higher percentage than had initially indicated they would receive the vaccine (53.2% of those who took the survey before the first EUA and 55.3% of respondents overall, the majority of whom took the survey prior to the first EUA).
A secondary message is that it matters how we ask people whether they want a COVID-19 vaccine. Even the much lower acceptance rate of those who took our survey prior to the first EUA was much higher than previous surveys (55.3% vs. ~30%). Part of this is no doubt due to the fact that by early December, we knew more about specific vaccines than had been known during earlier surveys. But in addition, most previous surveys of health care workers had been administered by pollsters and neutrally worded. Ours was administered by the health system’s Division Chief of Infectious Diseases, who emphasized that supplies would be very limited and that they were 90-95% effective, substantially more effective than the flu vaccines that most employees take, and who strongly encouraged employees to take a COVID-19 vaccine as soon as one was offered to them. “Gain-framed” messages about how the recipient stands to benefit, portraying a good as scarce—i.e., coveted, and appeals to authority are all well known “nudges” that can increase uptake.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Further research should investigate the effectiveness of different ways of encouraging other groups to get vaccinated. Part of this research should be investigating how to most effectively respond to the main reasons why people are hesitant to receive a COVID-19 vaccine.
Meyer MN, Gjorgjieva T, Rosica D. Trends in Health Care Worker Intentions to Receive a COVID-19 Vaccine and Reasons for Hesitancy. JAMA Netw Open. 2021;4(3):e215344. doi:10.1001/jamanetworkopen.2021.5344
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