Many Healthcare Workers Are Still Hesitant Toward COVID-19 Vaccines

Key TakeawaysMore than one-fifth of healthcare workers globally are COVID-19 vaccine-hesitant, according to a recent study.And nearly half of frontline healthcare workers in the U.S. haven’t received a COVID-19 vaccine, according to a recent survey.Younger, female healthcare workers with lower levels of education were more likely to be vaccine hesitancy.

Key Takeaways

More than one-fifth of healthcare workers globally are COVID-19 vaccine-hesitant, according to a recent study.And nearly half of frontline healthcare workers in the U.S. haven’t received a COVID-19 vaccine, according to a recent survey.Younger, female healthcare workers with lower levels of education were more likely to be vaccine hesitancy.

More than one-fifth of healthcare workers globally are hesitant about receiving a COVID-19 vaccine, according to a recent study. Researchers found that vaccine safety, efficacy, and potential side effects were the top reasons for concern, along with a host of misinformation about COVID-19 vaccines.

The researchers also discovered that younger female healthcare workers with a lower education level are more likely to be vaccine-hesitant. The April study was published in theJournal of Community Health.

“Most people spend eight waking hours in a full-time job,” co-study author Jagdish Khubchandani, PhD, professor of public health at New Mexico State University, tells Verywell. “Beyond that, they are a part of the society for 16 hours. So, the time spent around family and community is more, and the influence could be greater from community and family norms, perceptions, and misinformation.”

Study Explores Which Healthcare Workers Are Apprehensive of a COVID-19 Vaccine

In a scoping review, Khubchandani and fellow researchers looked at a pool of 35 studies on healthcare worker vaccine hesitancy worldwide. The studies encompassed more than 76,000 participants.

For the sake of the review, researchers considered participants hesitant if they declined or refused a COVID-19 vaccine, said they were unlikely to get one, or if indicated disagreement with vaccinating against the virus. Undecided participants were not counted.The researchers found that the prevalence of vaccine hesitancy worldwide ranged from about 4% to 72%, with an average of 22%.

“We have a misperception that healthcare workers practice better health behaviors and engage in healthier lifestyles,” Khubchandani says.

COVID-19 Healthcare Workers Are Becoming Long-Haulers

Khubchandani and colleagues looked at healthcare worker vaccine hesitancy globally, but the prevalence is potentially higher in the U.S. Frontline healthcare workers were among the first groups of people in the nation to be offered a vaccine last December, with rollout beginning at the end of 2020. But not all jumped at the chance when their turn came.

According to a Kaiser Family Foundation (KFF) and Washington Post survey of 1,327 frontline healthcare workers, as of early March, only 52% said they had received at least one dose. Of those surveyed, 18% said they didn’t plan to get a vaccine, while another 12% said they were undecided.

Factors That Correlate With Hesitancy

In their study, Khubchandani and fellow researchers found three factors among healthcare workers that correlated with more hesitancy toward the COVID-19 vaccines: being female, having a lower education level, and being young.

Gender

“Gender-related findings were initially surprising to me, as I have always written that women practice better health behaviors," Khubchandani says. “But the case of COVID vaccines is unique.”

In another preprint study part of the COVID States Project, researchers surveyed more than 21,000 individuals across the U.S. about their COVID-19 vaccine attitudes. The researchers also found that vaccine resistance was higher in female healthcare workers than in males in the industry. For those surveyed in February 2021, 27% of female and 18% of male healthcare workers said they would not get a COVID-19 vaccine.

Khubchandani says some women express concerns about vaccine side effects leaving them unable to care for their families or causing infertility. However, COVID-19 vaccine side effects tend to resolve within a few days, and experts have widely debunked concerns about the shots causing infertility.

Education

Khubchandani and his colleagues found a correlation between higher vaccine uptake among healthcare workers if they were doctoral degree holders or involved in patient-facing care. Those with lower education levels were more likely to be hesitant.Not all healthcare workers are doctors or have extensive training in medicine or research and not all have waded through the vaccine data, which may be inaccessible to some people, he explains.

Healthcare workers with lower levels of education may also be more vulnerable to misinformation on social media and elsewhere. Some participants expressed doubts on whether COVID-19 exists or didn’t believe it is a serious disease. Others cited false conspiracy theories about the vaccines actually serving as an “injection of microchips.”

5 Ways to Avoid COVID-19 Misinformation

The COVID States Project survey as well as the KFF and Washington Post survey both found that healthcare workers with higher education levels resisted the vaccine at lower rates.

“Healthcare workers around the world are not a monolithic group and have a variety of roles, types of training, and experiences in the field,” Khubchandani explains. “Those who are in patient care, know someone who died, or know infected or hospitalized clients are more likely to take the vaccine—as they understand the severity of the disease, have a higher perceived risk of getting infected or perceive greater benefits of the vaccine.”

Age

Younger healthcare workers were also more likely to be vaccine-hesitant. The researchers attribute this finding to a few possibilities. Older healthcare workers may have higher education levels and more experience in the field, and age may impact a person’s perceived vulnerability to a severe case of COVID-19.

This aligns with aVerywell Health surveythat found young people, in general, were more likely to reject the vaccines. Young respondents—individuals under 30—were more than twice as likely as older respondents to not want the vaccine.

Why Young Adults Say They Won’t Get a COVID-19 Vaccine

Unvaccinated Healthcare Workers Pose a Risk

Public health experts say COVID-19 vaccine hesitancy among healthcare workers poses a health threat to patients and the community at large. In their study, Khubchandani and fellow researchers write, “Healthcare workers regularly work with vulnerable populations and cannot rely solely on wearing masks or personal protective equipment to fulfill their professional obligations to their patients.”

An unvaccinated healthcare worker can unknowingly transmit SARS-CoV-2, the virus that causes COVID-19, to a patient or even cause an outbreak—as was the case at one Kentucky nursing home. The Centers for Disease Control and Prevention (CDC) confirms that an unvaccinated healthcare worker—who was offered a vaccine but turned it down—caused a COVID-19 outbreak in a skilled nursing facility that infected 26 residents (18 of whom were fully vaccinated) and 20 staff members (4 of whom were vaccinated). Three residents died from the outbreak. The unvaccinated healthcare worker transmitted a more infectious variant of the virus.

“One unvaccinated person infecting everyone around in a healthcare setting can have a major financial and social impact, apart from the toll on health, well-being, and life,” Khubchandani says.

7 Essential Vaccinations for Healthcare Workers

What This Means For YouIf someone in your life is unsure about getting the COVID-19 vaccine, try having a calm and collected conversation with them about their concerns. Try out ourHealthy Conversationscoach to learn about the best ways to encourage COVID-19 vaccination.

What This Means For You

If someone in your life is unsure about getting the COVID-19 vaccine, try having a calm and collected conversation with them about their concerns. Try out ourHealthy Conversationscoach to learn about the best ways to encourage COVID-19 vaccination.

Vaccine Mandates for Healthcare Workers

Some hospitals, like Houston Methodist, are beginning to implement COVID-19 vaccine mandates for healthcare workers—with certain exceptions in place. Employees who refuse will be terminated from staff.

Other hospitals may follow suit, especially if thePfizer-BioNTechvaccine receives full approval from the Food and Drug Administration (FDA) soon. All three vaccines are currently under emergency use authorization, but Pfizer is now under review for full approval. Legal experts are still trying to decipher what the EUA provision means for COVID-19 vaccine mandates.

If a COVID-19 vaccine reaches fullFDA approval, however, that means the agency vetted extensive research for the drug’s “safety, purity, potency, and effectiveness.” And such a classification places a vaccine squarely in the camp of other FDA-approved inoculations. Currently, 15 states mandate measles, mumps, and rubella (MMR) vaccines for healthcare workers. And states havevarying lawson healthcare worker flu shot requirements.

The History and Evolution of Vaccines

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit ourcoronavirus news page.

6 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Biswas N, Mustapha T, Khubchandani J, et al.The nature and extent of COVID-19 vaccination hesitancy in healthcare workers.J Community Health. 2021 Apr. doi:10.1007/s10900-021-00984-3Krizinger A, Kearney A, Hamel L, et al.KFF/The Washington Post frontline health care workers survey. April 6, 2021.Lazer D, Ognyanova K, Green J, et al.The COVID States Project #47: Update on COVID-19 vaccine attitudes among healthcare workers.OSF Preprints. 2021 Mar. doi:10.31219/osf.io/a352zEvans MB, Alexander C, Barnard E, et al.COVID-19 vaccine and infertility: baseless claims and unfounded social media panic. January 2021.Cavanaugh AM, Fortier S, Lewis P, et al. COVID-19Outbreak associated with a SARS-CoV-2 R.1 lineage variant in a skilled nursing facility after vaccination program — Kentucky, March 2021.MMWR Morb Mortal Wkly Rep2021;70:639-643. doi:10.15585/mmwr.mm7017e2Gooch K.Houston Methodist implements mandatory COVID-19 vaccinations. March 31, 2021.

6 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Biswas N, Mustapha T, Khubchandani J, et al.The nature and extent of COVID-19 vaccination hesitancy in healthcare workers.J Community Health. 2021 Apr. doi:10.1007/s10900-021-00984-3Krizinger A, Kearney A, Hamel L, et al.KFF/The Washington Post frontline health care workers survey. April 6, 2021.Lazer D, Ognyanova K, Green J, et al.The COVID States Project #47: Update on COVID-19 vaccine attitudes among healthcare workers.OSF Preprints. 2021 Mar. doi:10.31219/osf.io/a352zEvans MB, Alexander C, Barnard E, et al.COVID-19 vaccine and infertility: baseless claims and unfounded social media panic. January 2021.Cavanaugh AM, Fortier S, Lewis P, et al. COVID-19Outbreak associated with a SARS-CoV-2 R.1 lineage variant in a skilled nursing facility after vaccination program — Kentucky, March 2021.MMWR Morb Mortal Wkly Rep2021;70:639-643. doi:10.15585/mmwr.mm7017e2Gooch K.Houston Methodist implements mandatory COVID-19 vaccinations. March 31, 2021.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Biswas N, Mustapha T, Khubchandani J, et al.The nature and extent of COVID-19 vaccination hesitancy in healthcare workers.J Community Health. 2021 Apr. doi:10.1007/s10900-021-00984-3Krizinger A, Kearney A, Hamel L, et al.KFF/The Washington Post frontline health care workers survey. April 6, 2021.Lazer D, Ognyanova K, Green J, et al.The COVID States Project #47: Update on COVID-19 vaccine attitudes among healthcare workers.OSF Preprints. 2021 Mar. doi:10.31219/osf.io/a352zEvans MB, Alexander C, Barnard E, et al.COVID-19 vaccine and infertility: baseless claims and unfounded social media panic. January 2021.Cavanaugh AM, Fortier S, Lewis P, et al. COVID-19Outbreak associated with a SARS-CoV-2 R.1 lineage variant in a skilled nursing facility after vaccination program — Kentucky, March 2021.MMWR Morb Mortal Wkly Rep2021;70:639-643. doi:10.15585/mmwr.mm7017e2Gooch K.Houston Methodist implements mandatory COVID-19 vaccinations. March 31, 2021.

Biswas N, Mustapha T, Khubchandani J, et al.The nature and extent of COVID-19 vaccination hesitancy in healthcare workers.J Community Health. 2021 Apr. doi:10.1007/s10900-021-00984-3

Krizinger A, Kearney A, Hamel L, et al.KFF/The Washington Post frontline health care workers survey. April 6, 2021.

Lazer D, Ognyanova K, Green J, et al.The COVID States Project #47: Update on COVID-19 vaccine attitudes among healthcare workers.OSF Preprints. 2021 Mar. doi:10.31219/osf.io/a352z

Evans MB, Alexander C, Barnard E, et al.COVID-19 vaccine and infertility: baseless claims and unfounded social media panic. January 2021.

Cavanaugh AM, Fortier S, Lewis P, et al. COVID-19Outbreak associated with a SARS-CoV-2 R.1 lineage variant in a skilled nursing facility after vaccination program — Kentucky, March 2021.MMWR Morb Mortal Wkly Rep2021;70:639-643. doi:10.15585/mmwr.mm7017e2

Gooch K.Houston Methodist implements mandatory COVID-19 vaccinations. March 31, 2021.

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