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Published in: BMC Medicine 1/2022

Open Access 01-12-2022 | Influenza Vaccination | Research article

Hesitancy for receiving regular SARS-CoV-2 vaccination in UK healthcare workers: a cross-sectional analysis from the UK-REACH study

Authors: Neyme Veli, Christopher A. Martin, Katherine Woolf, Joshua Nazareth, Daniel Pan, Amani Al-Oraibi, Rebecca F. Baggaley, Luke Bryant, Laura B. Nellums, Laura J. Gray, Kamlesh Khunti, Manish Pareek, The UK-REACH Study Collaborative Group

Published in: BMC Medicine | Issue 1/2022

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Abstract

Background

Regular vaccination against SARS-CoV-2 may be needed to maintain immunity in ‘at-risk’ populations, which include healthcare workers (HCWs). However, little is known about the proportion of HCWs who might be hesitant about receiving a hypothetical regular SARS-CoV-2 vaccination or the factors associated with this hesitancy.

Methods

Cross-sectional analysis of questionnaire data collected as part of UK-REACH, a nationwide, longitudinal cohort study of HCWs. The outcome measure was binary, either a participant indicated they would definitely accept regular SARS-CoV-2 vaccination if recommended or they indicated some degree of hesitancy regarding acceptance (probably accept or less likely). We used logistic regression to identify factors associated with hesitancy for receiving regular vaccination.

Results

A total of 5454 HCWs were included in the analysed cohort, 23.5% of whom were hesitant about regular SARS-CoV-2 vaccination. Black HCWs were more likely to be hesitant than White HCWs (aOR 2.60, 95%CI 1.80–3.72) as were those who reported a previous episode of COVID-19 (1.33, 1.13–1.57 [vs those who tested negative]). Those who received influenza vaccination in the previous two seasons were over five times less likely to report hesitancy for regular SARS-CoV-2 vaccination than those not vaccinated against influenza in either season (0.18, 0.14–0.21). HCWs who trusted official sources of vaccine information (such as NHS or government adverts or websites) were less likely to report hesitancy for a regular vaccination programme. Those who had been exposed to information advocating against vaccination from friends and family were more likely to be hesitant.

Conclusions

In this study, nearly a quarter of UK HCWs were hesitant about receiving a regular SARS-CoV-2 vaccination. We have identified key factors associated with hesitancy for regular SARS-CoV-2 vaccination, which can be used to identify groups of HCWs at the highest risk of vaccine hesitancy and tailor interventions accordingly. Family and friends of HCWs may influence decisions about regular vaccination. This implies that working with HCWs and their social networks to allay concerns about SARS-CoV-2 vaccination could improve uptake in a regular vaccination programme.

Trial registration

ISRCTN Registry, ISRCTN11811602.
Appendix
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Literature
1.
go back to reference Liu YC, Kuo RL, Shih SR. COVID-19: the first documented coronavirus pandemic in history. Biomedical Journal. 2020;43(4):328–33.CrossRef Liu YC, Kuo RL, Shih SR. COVID-19: the first documented coronavirus pandemic in history. Biomedical Journal. 2020;43(4):328–33.CrossRef
2.
go back to reference Polack FP, Thomas SJ, Kitchin N, Absalon J, Gurtman A, Lockhart S, et al. Safety and efficacy of the BNT162b2 mRNA COVID-19 vaccine. N Engl J Med. 2020;383(27):2603–15.CrossRef Polack FP, Thomas SJ, Kitchin N, Absalon J, Gurtman A, Lockhart S, et al. Safety and efficacy of the BNT162b2 mRNA COVID-19 vaccine. N Engl J Med. 2020;383(27):2603–15.CrossRef
3.
go back to reference Agrawal U, Katikireddi SV, McCowan C, Mulholland RH, Azcoaga-Lorenzo A, Amele S, et al. COVID-19 hospital admissions and deaths after BNT162b2 and ChAdOx1 nCoV-19 vaccinations in 2·57 million people in Scotland (EAVE II): a prospective cohort study. Lancet Respir Med. 2021;9(12):1439–49.CrossRef Agrawal U, Katikireddi SV, McCowan C, Mulholland RH, Azcoaga-Lorenzo A, Amele S, et al. COVID-19 hospital admissions and deaths after BNT162b2 and ChAdOx1 nCoV-19 vaccinations in 2·57 million people in Scotland (EAVE II): a prospective cohort study. Lancet Respir Med. 2021;9(12):1439–49.CrossRef
4.
go back to reference Nguyen LH, Drew DA, Graham MS, Joshi AD, Guo CG, Ma W, et al. Risk of COVID-19 among front-line health-care workers and the general community: a prospective cohort study. Lancet Public Health. 2020;5(9):e475–83.CrossRef Nguyen LH, Drew DA, Graham MS, Joshi AD, Guo CG, Ma W, et al. Risk of COVID-19 among front-line health-care workers and the general community: a prospective cohort study. Lancet Public Health. 2020;5(9):e475–83.CrossRef
5.
go back to reference Eyre DW, Taylor D, Purver M, Chapman D, Fowler T, Pouwels KB, et al. Effect of COVID-19 vaccination on transmission of alpha and delta variants. N Engl J Med. 2022;386(8):744–56.CrossRef Eyre DW, Taylor D, Purver M, Chapman D, Fowler T, Pouwels KB, et al. Effect of COVID-19 vaccination on transmission of alpha and delta variants. N Engl J Med. 2022;386(8):744–56.CrossRef
6.
go back to reference Nguyen LH, Drew DA, Graham MS, Joshi AD, Guo C-G, Ma W, et al. Risk of COVID-19 among front-line health-care workers and the general community: a prospective cohort study. Lancet Public Health. 2020;5(9):e475–83.CrossRef Nguyen LH, Drew DA, Graham MS, Joshi AD, Guo C-G, Ma W, et al. Risk of COVID-19 among front-line health-care workers and the general community: a prospective cohort study. Lancet Public Health. 2020;5(9):e475–83.CrossRef
7.
go back to reference Hall V, Foulkes S, Insalata F, Kirwan P, Saei A, Atti A, et al. Protection against SARS-CoV-2 after COVID-19 vaccination and previous infection. N Engl J Med. 2022;386(13):1207–20.CrossRef Hall V, Foulkes S, Insalata F, Kirwan P, Saei A, Atti A, et al. Protection against SARS-CoV-2 after COVID-19 vaccination and previous infection. N Engl J Med. 2022;386(13):1207–20.CrossRef
8.
go back to reference Nordström P, Ballin M, Nordström A. Risk of SARS-CoV-2 reinfection and COVID-19 hospitalisation in individuals with natural and hybrid immunity: a retrospective, total population cohort study in Sweden. Lancet Infect Dis. 2022;22(6):781–90.CrossRef Nordström P, Ballin M, Nordström A. Risk of SARS-CoV-2 reinfection and COVID-19 hospitalisation in individuals with natural and hybrid immunity: a retrospective, total population cohort study in Sweden. Lancet Infect Dis. 2022;22(6):781–90.CrossRef
9.
go back to reference Nemet I, Kliker L, Lustig Y, Zuckerman N, Erster O, Cohen C, et al. Third BNT162b2 vaccination neutralization of SARS-CoV-2 omicron infection. N Engl J Med. 2022;386(5):492–4.CrossRef Nemet I, Kliker L, Lustig Y, Zuckerman N, Erster O, Cohen C, et al. Third BNT162b2 vaccination neutralization of SARS-CoV-2 omicron infection. N Engl J Med. 2022;386(5):492–4.CrossRef
11.
go back to reference Iacobucci G. COVID-19: NHS trusts declare “critical incidents” because of staff shortages. BMJ. 2022;376:o3.CrossRef Iacobucci G. COVID-19: NHS trusts declare “critical incidents” because of staff shortages. BMJ. 2022;376:o3.CrossRef
12.
go back to reference Mahase E. COVID-19: booster dose will be needed in autumn to avoid winter surge, says government adviser. BMJ. 2021;372:n664.CrossRef Mahase E. COVID-19: booster dose will be needed in autumn to avoid winter surge, says government adviser. BMJ. 2021;372:n664.CrossRef
13.
go back to reference Wise J. COVID-19: JCVI advises further booster for vulnerable adults and health and care workers. BMJ. 2022;377:o1277.CrossRef Wise J. COVID-19: JCVI advises further booster for vulnerable adults and health and care workers. BMJ. 2022;377:o1277.CrossRef
14.
go back to reference Iacobucci G. COVID-19: England is preparing to offer annual booster vaccination, says NHS boss. BMJ. 2021;375:n2824.CrossRef Iacobucci G. COVID-19: England is preparing to offer annual booster vaccination, says NHS boss. BMJ. 2021;375:n2824.CrossRef
15.
go back to reference Woolf K, McManus IC, Martin CA, Nellums LB, Guyatt AL, Melbourne C, et al. Ethnic differences in SARS-CoV-2 vaccine hesitancy in United Kingdom healthcare workers: results from the UK-REACH prospective nationwide cohort study. Lancet Reg Health Eur. 2021;9:100180.CrossRef Woolf K, McManus IC, Martin CA, Nellums LB, Guyatt AL, Melbourne C, et al. Ethnic differences in SARS-CoV-2 vaccine hesitancy in United Kingdom healthcare workers: results from the UK-REACH prospective nationwide cohort study. Lancet Reg Health Eur. 2021;9:100180.CrossRef
16.
go back to reference Martin CA, Marshall C, Patel P, Goss C, Jenkins DR, Ellwood C, et al. SARS-CoV-2 vaccine uptake in a multi-ethnic UK healthcare workforce: a cross-sectional study. PLoS Med. 2021;18(11):e1003823.CrossRef Martin CA, Marshall C, Patel P, Goss C, Jenkins DR, Ellwood C, et al. SARS-CoV-2 vaccine uptake in a multi-ethnic UK healthcare workforce: a cross-sectional study. PLoS Med. 2021;18(11):e1003823.CrossRef
17.
go back to reference Martin CA, Woolf K, Bryant L, Carr S, Gray LJ, Gupta A, et al. Persistent hesitancy for SARS-CoV-2 vaccines among healthcare workers in the United Kingdom: analysis of longitudinal data from the UK-REACH cohort study. Lancet Reg Health Eur. 2022;13:100299.CrossRef Martin CA, Woolf K, Bryant L, Carr S, Gray LJ, Gupta A, et al. Persistent hesitancy for SARS-CoV-2 vaccines among healthcare workers in the United Kingdom: analysis of longitudinal data from the UK-REACH cohort study. Lancet Reg Health Eur. 2022;13:100299.CrossRef
18.
go back to reference Pal S, Shekhar R, Kottewar S, Upadhyay S, Singh M, Pathak D, et al. COVID-19 vaccine hesitancy and attitude toward booster doses among US healthcare workers. Vaccines. 2021;9(11):1358.CrossRef Pal S, Shekhar R, Kottewar S, Upadhyay S, Singh M, Pathak D, et al. COVID-19 vaccine hesitancy and attitude toward booster doses among US healthcare workers. Vaccines. 2021;9(11):1358.CrossRef
19.
go back to reference Woolf K, Melbourne C, Bryant L, Guyatt AL, McManus IC, Gupta A, et al. The United Kingdom Research study into Ethnicity and COVID-19 outcomes in Healthcare workers (UK-REACH): protocol for a prospective longitudinal cohort study of healthcare and ancillary workers in UK healthcare settings. BMJ Open. 2021;11(9):e050647.CrossRef Woolf K, Melbourne C, Bryant L, Guyatt AL, McManus IC, Gupta A, et al. The United Kingdom Research study into Ethnicity and COVID-19 outcomes in Healthcare workers (UK-REACH): protocol for a prospective longitudinal cohort study of healthcare and ancillary workers in UK healthcare settings. BMJ Open. 2021;11(9):e050647.CrossRef
20.
go back to reference Woolf K, McManus IC, Martin CA, Nellums LB, Guyatt AL, Melbourne C, et al. Ethnic differences in SARS-CoV-2 vaccine hesitancy in United Kingdom healthcare workers: results from the UK-REACH prospective nationwide cohort study. Lancet Reg Health Eur. 2021;9:100180.CrossRef Woolf K, McManus IC, Martin CA, Nellums LB, Guyatt AL, Melbourne C, et al. Ethnic differences in SARS-CoV-2 vaccine hesitancy in United Kingdom healthcare workers: results from the UK-REACH prospective nationwide cohort study. Lancet Reg Health Eur. 2021;9:100180.CrossRef
21.
go back to reference Woolf K, Gogoi M, Martin CA, Papineni P, Lagrata S, Nellums LB, et al. Healthcare workers’ views on mandatory SARS-CoV-2 vaccination in the UK: a cross-sectional, mixed-methods analysis from the UK-REACH study. EClinicalMedicine. 2022;46:101346.CrossRef Woolf K, Gogoi M, Martin CA, Papineni P, Lagrata S, Nellums LB, et al. Healthcare workers’ views on mandatory SARS-CoV-2 vaccination in the UK: a cross-sectional, mixed-methods analysis from the UK-REACH study. EClinicalMedicine. 2022;46:101346.CrossRef
22.
go back to reference Martin CA, Pan D, Melbourne C, Teece L, Aujayeb A, Baggaley RF, et al. Risk factors associated with SARS-CoV-2 infection in a multiethnic cohort of United Kingdom healthcare workers (UK-REACH): a cross-sectional analysis. PLoS Med. 2022;19(5):e1004015.CrossRef Martin CA, Pan D, Melbourne C, Teece L, Aujayeb A, Baggaley RF, et al. Risk factors associated with SARS-CoV-2 infection in a multiethnic cohort of United Kingdom healthcare workers (UK-REACH): a cross-sectional analysis. PLoS Med. 2022;19(5):e1004015.CrossRef
23.
go back to reference Martin CA, Marshall C, Patel P, Goss C, Jenkins DR, Ellwood C, et al. SARS-CoV-2 vaccine uptake in a multi-ethnic UK healthcare workforce: a cross-sectional study. PLoS Med. 2021;18(11):e1003823.CrossRef Martin CA, Marshall C, Patel P, Goss C, Jenkins DR, Ellwood C, et al. SARS-CoV-2 vaccine uptake in a multi-ethnic UK healthcare workforce: a cross-sectional study. PLoS Med. 2021;18(11):e1003823.CrossRef
26.
29.
go back to reference Thompson HS, Manning M, Mitchell J, Kim S, Harper FWK, Cresswell S, et al. Factors associated with racial/ethnic group-based medical mistrust and perspectives on COVID-19 vaccine trial participation and vaccine uptake in the US. JAMA Netw Open. 2021;4(5):e2111629.CrossRef Thompson HS, Manning M, Mitchell J, Kim S, Harper FWK, Cresswell S, et al. Factors associated with racial/ethnic group-based medical mistrust and perspectives on COVID-19 vaccine trial participation and vaccine uptake in the US. JAMA Netw Open. 2021;4(5):e2111629.CrossRef
30.
go back to reference Warren RC, Forrow L, Hodge DA Sr, Truog RD. Trustworthiness before Trust - COVID-19 vaccine trials and the Black community. N Engl J Med. 2020;383(22):e121.CrossRef Warren RC, Forrow L, Hodge DA Sr, Truog RD. Trustworthiness before Trust - COVID-19 vaccine trials and the Black community. N Engl J Med. 2020;383(22):e121.CrossRef
31.
go back to reference Giuffrida A. Italy makes COVID vaccinations compulsory for over-50s. The Guardian. 2022;2022:5. Giuffrida A. Italy makes COVID vaccinations compulsory for over-50s. The Guardian. 2022;2022:5.
32.
go back to reference Iacobucci G. COVID-19: government abandons mandatory vaccination of NHS staff. BMJ. 2022;376:o269.CrossRef Iacobucci G. COVID-19: government abandons mandatory vaccination of NHS staff. BMJ. 2022;376:o269.CrossRef
33.
go back to reference Khunti K, Kamal A, Pareek M, Griffiths A. Should vaccination for healthcare workers be mandatory? J R Soc Med. 2021;114(5):235–6.CrossRef Khunti K, Kamal A, Pareek M, Griffiths A. Should vaccination for healthcare workers be mandatory? J R Soc Med. 2021;114(5):235–6.CrossRef
35.
go back to reference Lytras T, Kopsachilis F, Mouratidou E, Papamichail D, Bonovas S. Interventions to increase seasonal influenza vaccine coverage in healthcare workers: a systematic review and meta-regression analysis. Hum Vaccin Immunother. 2016;12(3):671–81.CrossRef Lytras T, Kopsachilis F, Mouratidou E, Papamichail D, Bonovas S. Interventions to increase seasonal influenza vaccine coverage in healthcare workers: a systematic review and meta-regression analysis. Hum Vaccin Immunother. 2016;12(3):671–81.CrossRef
37.
go back to reference Rhead RD, Chui Z, Bakolis I, Gazard B, Harwood H, MacCrimmon S, et al. Impact of workplace discrimination and harassment among National Health Service staff working in London trusts: results from the TIDES study. BJPsych Open. 2021;7(1):e10.CrossRef Rhead RD, Chui Z, Bakolis I, Gazard B, Harwood H, MacCrimmon S, et al. Impact of workplace discrimination and harassment among National Health Service staff working in London trusts: results from the TIDES study. BJPsych Open. 2021;7(1):e10.CrossRef
40.
go back to reference Garcia L, Firek A, Freund D, Massai D, Khurana D, Lee JE, et al. Decisions to choose COVID-19 vaccination by health care workers in a Southern California Safety Net Medical Center vary by sociodemographic factors. Vaccines. 2022;10(8):1247.CrossRef Garcia L, Firek A, Freund D, Massai D, Khurana D, Lee JE, et al. Decisions to choose COVID-19 vaccination by health care workers in a Southern California Safety Net Medical Center vary by sociodemographic factors. Vaccines. 2022;10(8):1247.CrossRef
41.
go back to reference Pacella-LaBarbara ML, Park YL, Patterson PD, Doshi A, Guyette MK, Wong AH, et al. COVID-19 vaccine uptake and intent among emergency healthcare workers: a cross-sectional survey. J Occup Environ Med. 2021;63(10):852–6.CrossRef Pacella-LaBarbara ML, Park YL, Patterson PD, Doshi A, Guyette MK, Wong AH, et al. COVID-19 vaccine uptake and intent among emergency healthcare workers: a cross-sectional survey. J Occup Environ Med. 2021;63(10):852–6.CrossRef
42.
go back to reference Nguyen LH, Joshi AD, Drew DA, Merino J, Ma W, Lo C-H, et al. Self-reported COVID-19 vaccine hesitancy and uptake among participants from different racial and ethnic groups in the United States and United Kingdom. Nat Commun. 2022;13(1):636.CrossRef Nguyen LH, Joshi AD, Drew DA, Merino J, Ma W, Lo C-H, et al. Self-reported COVID-19 vaccine hesitancy and uptake among participants from different racial and ethnic groups in the United States and United Kingdom. Nat Commun. 2022;13(1):636.CrossRef
Metadata
Title
Hesitancy for receiving regular SARS-CoV-2 vaccination in UK healthcare workers: a cross-sectional analysis from the UK-REACH study
Authors
Neyme Veli
Christopher A. Martin
Katherine Woolf
Joshua Nazareth
Daniel Pan
Amani Al-Oraibi
Rebecca F. Baggaley
Luke Bryant
Laura B. Nellums
Laura J. Gray
Kamlesh Khunti
Manish Pareek
The UK-REACH Study Collaborative Group
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Medicine / Issue 1/2022
Electronic ISSN: 1741-7015
DOI
https://doi.org/10.1186/s12916-022-02588-7

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