COVID-19 Vaccine Hesitancy Among Health Care Workers
Tags: Covid 19, Covid Vaccine, Healthcare, Coronavirus

COVID-19 Vaccine Hesitancy Among Health Care Workers

How can we increase COVID-19 vaccine confidence among healthcare workers to boost confidence in their patients?

Photo by Kristine Wook on Unsplash

This year has been like no other, at least in most people’s lifetime, because of the COVID-19 crisis. Thankfully, it seems with the rolling out of the vaccine, we are at the end of the tunnel, and the light is peeking through the horizon. However, we now have to grapple with ensuring the vaccines result in vaccination, which really protects against the coronavirus.

Unfortunately, we still see so many people skeptical about the vaccine, even health care workers, who are certain to be one of the first sets of people in line for the vaccine.

A study by PLOS ONE reported finding that information and assurance from healthcare workers are important factors that encouraged laypeople to get vaccinated. Therefore, health care workers wield some power in increasing overall vaccine confidence among patients.

In September, the CDC reported results of a survey that showed 63% of health care workers reported that they would likely get a COVID-19 vaccine; the percentage is not bad, but you would think more health care workers will be interested in getting vaccinated. Another survey by the American Nurses Foundation Pulse on the Nation’s Nurses COVID-19 Series involving 12,939 nurses reported that only 15% were confident a COVID-19 vaccine would be safe and effective, 48% were somewhat confident, and 37% had no confidence. Only 34% would voluntarily receive the vaccine if not mandated by their employer.

In a cross-sectional survey of a preprint report, even though there was overwhelming confidence about vaccine safety, 66.5% of health care workers still intended to delay vaccination.

What are the reasons for COVID-19 vaccine hesitancy?

The speed of vaccine development has been a big concern, not only among health care workers but also among the public. Prior vaccine development took years to complete, but scientists have had to do this in less than a year. This raises concerns about due diligence being observed and the possibility of shortcuts that might weaken the vaccine’s safety and efficacy.

The novelty of messenger RNA (mRNA) COVID-19 vaccines is also a concern. CDC reports that research on mRNA has been ongoing for decades, so it is not completely unknown.

Political undertones in the process of vaccine development have raised concerns about possible dangerous shortcuts to vaccine development.

Fear that even though it may help prevent COVID-19 now, the unknown side effects in the future are a cause for concern.

How can we address these concerns?

First, we should acknowledge the concerns and address them transparently. If we cannot build vaccine confidence among healthcare workers, how will they persuade their patients to get vaccinated?.

We should address the novelty of the mRNA vaccine by explaining in simple terms what it is about for everyone. CDC explains that mRNA gives the body specific instructions to make parts of the spike protein similar to the proteins coronavirus uses to cause infection. The body learns to identify these proteins, and when exposed to the coronavirus, the immune system can develop antibodies to fight the virus. The mRNA does not interact with your DNA and is safe. Also, mRNA vaccines lack live viruses; therefore, they will not cause the disease in the vaccinated person.

Make safety data readily available and easy to understand. Even for some health care workers, decoding these kinds of documents can be a challenge. So make it easy to understand.

CDC has excellent information on its website about the new vaccine. Health care workers and the general population should familiarize themselves with the information provided.

Health care facilities should hold sessions to discuss the vaccine trial data findings with their health care workers.

Provide vaccine information sheets that explain everything about the vaccine.

Provide widespread public service announcements that encourage vaccination. This will help build confidence in the general populace.

Recognize the usefulness of mRNA vaccines beyond coronavirus. If we get more data on this vaccine’s safety and efficacy, mRNA-based vaccines may be potentially revolutionary in preventing many diseases in the future.

Our leaders should also be the first in line to get the vaccine and to do it publicly. Hopefully, this will also be reassuring.

Current evidence on the safety of mRNA vaccines

An ongoing multinational efficacy trial involving over 43,000 people, 16 years and older, with half receiving 2 doses of the mRNA vaccine and the other half receiving a placebo 21 days apart, reported that there were 10 cases of severe COVID-19 infection after the first injection dose and 9 were in the placebo group. Also, there were 8 cases of the infection within a week of the second dose of the mRNA vaccine, while there were 162 cases among the placebo group. They found that the vaccine in a two-dose regimen was 95% effective in protecting against COVID-19 infection. The safety over a median of 2 months was comparable to other viral vaccines.

In a preliminary report on a smaller mRNA vaccine trial involving 45 adults receiving 2 vaccine doses 28 days apart, researchers found that the vaccine caused an anti–SARS-CoV-2 immune responses in all participants, with no trial-limiting safety concerns.

Another small trial involving older adults reported that the mRNA vaccine's adverse events were not severe and included fatigue, chills, headache, myalgia, and pain at the injection site.

Take-home points