COVID-19 Vaccine Uptake Among Health Care Workers

Last Updated: January 22, 2021

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This Briefing Note was completed by the Research, Analysis, and Evaluation Branch (Ministry of Health) based on information provided by members of the COVID-19 Evidence Synthesis Network. Please refer to the Methods section for further information.

Purpose

This note provides a summary of Canadian and international experiences with vaccination hesitancy among health care workers (HCW) during the novel coronavirus disease (COVID-19) pandemic, and interventions used to increase vaccination uptake.

*The full version of the Briefing Note including the Appendix can be accessed in the PDF file at the top of the page*

Key Findings

Limitations

Analysis for Ontario

Supporting Evidence

This section below summarizes published and grey literature on vaccine hesitancy among health care workers (HCWs) during the COVID-19 pandemic, and interventions to increase vaccination uptake.

Scientific Evidence

COVID-19 Vaccination Acceptance

  • An emerging body of evidence has begun to document HCWs’ willingness to receive a COVID-19 vaccine and the factors underlying their willingness.
    • Nine single studies conducted across the globe (United States, France, Egypt, Saudi Arabia, China, Hong Kong) and two systematic reviews (international) reported HCWs willingness to receive a COVID-19 vaccine varied greatly; one systematic review suggested the overall proportion of HCWs positively inclined towards receiving a COVID-19 vaccine ranged from 27.7% to 81.5%.

Barriers and Enablers of Vaccine Uptake

  • Overall, knowledge of the factors that affect intention of HWCs to accept COVID-19 vaccination is limited. Overall attitudes toward vaccination were positive but specific concerns regarding the COVID-19 vaccine are prevalent. Differences in vaccine acceptance were noted between individual and group characteristics.
    • Barriers: Selected barriers include: female gender; Black, Latinx, Conservative/ Republican HCWs; rural work setting; concerns regarding COVID-19 vaccine safety (e.g., unknown risks, insufficient data, known side effects); concerns about vaccine effectiveness; and concerns about expedited development/approval process; experience with racial discrimination.
    • Enablers: Selected enablers include: male gender; older age; physician profession; presence of comorbidities or chronic diseases; fear of COVID-19; perceived risk; stronger vaccine confidence; belief that COVID-19 vaccine will likely to stop the pandemic; social contacts’ decisions to have vaccine; and reliance on CDC website for COVID 19 updates.
      • After an FDA advisory committee voted to recommend an emergency use authorization, the proportion of HCWs in a Pennsylvania health system intending to receive a COVID-19 vaccine increased (i.e., 79% of HCWs [n = 1,155].

Interventions to Increase COVID-19 Uptake

  • No identified studies reported interventions for increasing COVID-19 vaccination uptake among HCWs. Since the distribution of vaccinations began in early December 2020, there likely has been little opportunity to examine interventions to address COVID-19 vaccine hesitancy.
    • Key interventions to increase HCW uptake of other vaccines (i.e., influenza, hepatitis B, other vaccines) included: Provision of free vaccine; easy access to the vaccine; educational activities and/or reminders and/or incentives; management or organizational changes; and long-term implementation of the strategy, such as mandatory vaccination policies

International Scan

Recommendations to Increase COVID-19 Vaccine Confidence

  • The US Centers for Disease Control and Prevention (CDC) outlined six steps to build COVID-19 vaccine confidence among HCWs: 1) encourage senior leaders to be vaccine champions; 2) host discussions where personnel at different levels can provide input and ask questions; 3) share key messages with staff through emails, breakroom posters, and other channels; 4) educate health care teams about COVID-19 vaccines, how they are developed and monitored for safety, and how teams can talk to other about the vaccines; 5) educate non-medical staff about the importance of getting vaccinated; and, 6) make the decision to get vaccinated visible, and celebrate it.

Canadian Scan

  • Recent preliminary survey data of a long-term care home staff from British Columbia found that 57% intended to get the COVID-19 vaccine when it became available.

Methods

The COVID-19 Evidence Synthesis Network is comprised of groups specializing in evidence synthesis and knowledge translation. The group has committed to provide their expertise to provide high-quality, relevant, and timely synthesized research evidence about COVID-19 to inform decision makers as the pandemic continues. The following members of the Network provided evidence synthesis products that were used to develop this Evidence Synthesis Briefing Note:

  • Ontario Health
  • McMaster Health Forum