DOI: 10.5061/dryad.cnp5hqc5h
title: COVID-19 Vaccination perceptions of HCWs

description: Objectives: This study aimed to identify COVID-19 vaccine perception,
 acceptance, confidence, hesitancy, and barriers among healthcare workers
 (HCW). Methods: An online national cross-sectional pilot-validated
 questionnaire was self-administered by HCW in Saudi Arabia, a nation with
 MERS-CoV experience. The main outcome variable was HCW’s acceptance of
 COVID-19 vaccine candidates. The associated factors of vaccination
 acceptance were identified through a logistic regression analysis and the
 level of anxiety using a validated instrument to measure general anxiety
 levels. Results: Out of 1512 HCWs who completed the study
 questionnaire—62.4% women, 70% were willing to receive COVID-19 vaccines.
 Logistic regression analysis revealed that male HCWs (ORa=1.551, 95% CI:
 1.122–2.144), HCWs who believe in vaccine safety (ORa=2.151; 95%
 CI:1.708–2.708), HCWs who believe that COVID vaccines are the most likely
 way to stop the pandemic (ORa=1.539; 95% CI: 1.259–1.881), and HCWs who
 rely on Centers for Disease Control and Prevention website for COVID 19
 updates (ORa=1.505, 95% CI: 1.125–2.013) were significantly associated
 with reporting willingness to be vaccinated. However, HCWs who believed
 vaccines were rushed without evidence-informed testing were found to be
 60% less inclined to accept COVID-19 vaccines (ORa=0.394, 95% CI:
 0.298–0.522). Conclusion: Most HCWs are willing to receive COVID-19
 vaccines once available; yet satisfactoriness of COVID-19 vaccination
 among HCWs is crucial because health professionals’ knowledge and
 confidence toward vaccines are important determining factors for their own
 vaccine acceptance and recommendation to their patients.
description: <b>Study Design and Study Population</b>
 This was a national cross-sectional survey among HCWs in KSA
 during the COVID-19 pandemic [30]. The survey was aimed at different
 categories of HCWs from various specialties working in public and private
 healthcare settings across KSA.  Participants were recruited from several
 social media platforms and email lists using a convenience sampling
 technique. <b>Data Collection</b>
 Data were collected from
 November 4 to November 14, 2020.  The survey employed a pilot-validated,
 self-administered questionnaire that was sent to HCW online through
 SurveyMonkey©, a platform
 that allows researchers to deploy and analyze surveys via the web
 [34]. The
 questionnaire was adapted from our previously published study [26] with
 modifications and additions related to COVID-19 vaccine
 candidates. The
 questions addressed the demographic characteristics of respondents (job
 category, age, gender, years of clinical experience, and work area),
 previous exposure to MERS-CoV or COVID-19 infected patients, and whether
 HCWs themselves were ever infected with COVID-19. We assessed HCW readiness to
 receive the COVID-19 vaccine as the main outcome. We also evaluated the
 timing of HCW acceptance to receive the vaccine, HCWs’ beliefs about
 COVID-19 vaccination, and the barriers and reasons for refusal of new
 vaccines for those who completely rejected receiving it.
 Additionally, we assessed the HCWs’ perceived worry about the
 COVID19 pandemic using a series of Likert-like scales (Scale 1–5) and
 their generalized anxiety level using the general anxiety disorder-7
 (GAD-7). This validated instrument is a seven-item tool that is used to
 assess the severity of generalized anxiety disorder, with each item asking
 the individual to rate the severity of his or her symptoms over the past
 two weeks [35]. GAD-7 was previously used to assess HCWs’ anxiety due to
 COVID-19 [36, 37]. In short,  the participants were asked to rate their
 worries on  a scale of 1 to 5, with 1 indicating “Not worried at all” and
 5 indicating “Extremely worried”.  The questions were: “Rate how much
 worry you experienced over the past two weeks: About contracting COVID-19
 infection yourself? About transmitting COVID19 Infection to your family
 members?”, “Over the last 2 weeks, how often have you been bothered by the
 following problems? GAD-7. Before participation, the purpose
 of the study was explained in English at the beginning of the online
 survey. The respondent was given the opportunity to ask questions via a
 dedicated email address for the study. The Institutional Review Board at
 the College of Medicine and King Saud University Medical City approved the
 study (approval # 20/0065/IRB). A waiver for signed consent was obtained
 since the survey presented no more than a minimal risk to subjects and
 involved no procedures for which written consent is usually required
 outside the study context. To maximize confidentiality, personal
 identifiers were not required. <b>Statistical
 analysis</b> Descriptive statistics approaches
 with mean and standard deviation were applied to continuous variables,
 while percentages were used for dichotomous variables. The two-sample t
 test was used to evaluate continuous scores, and the chi-squared test
 (χ<sup>2</sup>) of independence was used to compare
 proportions. A
 multivariate binary logistic regression model was used to explore the
 associations between the outcome variable of HCWs’ willingness to receive
 the COVID-19 vaccine and demographic characteristics of HCWs, HCW beliefs
 toward COVID-19 vaccines and anxiety from COVID-19 and levels of anxiety
 using the GAD-7. The associations between predictors and the outcome were
 expressed as adjusted odds ratio and 95% confidence interval. The SPSS IBM
 Version 21 [38] was used for data analysis, the Excel program was used for
 creating figures and depictions, and the p-value ≤ 0.050 was considered
 statistically significant.