ANALYSIS: It’s essential to understand why some health care workers are putting off vaccination

It’s essential to understand why some health care workers are putting off vaccination Early data on why health care workers are delaying the Covid-19 vaccine could help us end the pandemic sooner. Katherine Harmon Courage Vox

Some hospitals around the country are reporting that 40 percent or more of their health care workers who could be getting a Covid-19 vaccine are not immediately signing up for it. Other health facilities have had so many extra doses from employees who declined the vaccine that people outside the first priority group — including a sheriff’s deputy and a Disney employee — have ended up getting shots.

It’s a troubling development, especially since health care workers are at higher risk of contracting the virus and are essential in our efforts to treat record numbers of Covid-19 patients. Some public health experts also hoped this group would be relatively easy to vaccinate — and could help pave the way for broader vaccine acceptance.

“I am definitely concerned that health care workers are electing to wait to get vaccinated,” Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases at the US Centers for Disease Control and Prevention, said in a briefing last week. “We want them not only to protect themselves, but we also want them to be educating their patients so that everyone across the United States understands that these vaccines are available, that they have a good safety profile, that they are working.”

A December survey by the Kaiser Family Foundation found health care workers overall were about as likely to be hesitant about getting the vaccine as the general population (29 percent and 27 percent, respectively), with these respondents saying they would probably not or definitely not get the vaccine.

Another December survey of workers in the Yale Medicine and Yale New Haven Health systems described in a commentary in NEJM Catalyst found that of the 3,500-plus respondents, 85 percent said they would be “extremely likely” or “somewhat likely” to get a Covid-19 vaccine. But so far, about 53 percent of their workers have gotten the vaccine when it was offered to them.

Understanding what’s holding this group back could help us improve vaccine uptake in the wider population later. What’s clear is that we will need the vast majority of people in the US to get vaccinated against Covid-19 in order to stop the pandemic.

But we also have to be careful. Using the wrong language or approach to encourage vaccination could backfire, increasing hesitancy overall, says Alison Buttenheim, a faculty member at Penn Nursing and the Perelman School of Medicine, and scientific director for the Center for Health Incentives and Behavioral Economics. “If we go about it in the wrong way, we could miss the window and blow it,” she says.

Here’s what we know about vaccine hesitancy among health care workers — and what we can learn from it.  ...