Chicago—Initial hesitancy to get COVID-19 vaccines at first availability diminished over time at a large urban healthcare system where a vaccination rate of 95% was achieved by spring 2021.

A new study published in Infection Control & Hospital Epidemiology suggests that many of those HCWs had a change of heart quickly.

The study found that only three-fourths of the 4,180 HCWs in the study planned to get in winter 2021. Among the HCWs who were unsure about getting vaccinated then, 90% had been vaccinated by spring 2021. Of the HCWs who took a harder line—indicating no intention to get vaccinated in winter 2021—nearly 60% had changed their minds and received vaccines by spring 2021.

"This study found healthcare workers' attitudes about COVID-19 vaccination could change in a very short period of time," stated lead study author Charlesnika Evans, professor of preventive medicine in epidemiology at Northwestern University Feinberg School of Medicine. "It shows there is opportunity to change people's decisions about not getting vaccinated."

The study pointed out that HCWs are a high-priority group for COVID-19, partly because they serve as sources for public information. The Northwestern University—led study team assessed vaccine intentions, factors associated with intentions, and changes in uptake over time in HCWs.

For the prospective cohort study, HCWs in a large healthcare system in the Chicago area completed surveys from November 25, 2020, to January 9, 2021, and from April 24 to July 12, 2021, on COVID-19 exposures, diagnosis and symptoms, demographics, and vaccination status.

Researchers report that of the—4,180 HCWs who responded to the survey—77.1% indicated that they intended to receive the vaccine. In that group, 23.2% had already received at least one dose of the vaccine, 17.4% were unsure, and 5.5% reported that they would not receive the vaccine.

Factors associated with intention or vaccination were being exposed to clinical procedures (vs. no procedures: adjusted odds ratio [AOR], 1.39; 95% CI, 1.16-1.65) and having a negative serology test for COVID-19 (vs. no test: AOR, 1.46; 95% CI, 1.24-1.73).

Among those with lower odds of intention to get vaccinated were:

• nurses (vs. physicians: AOR, 0.24; 95% CI, 0.17-0.33)
• non-Hispanic Blacks (vs. Asians: AOR, 0.35; 95% CI, 0.21-0.59) and
• women (vs. men: AOR, 0.38; 95% CI, 0.30-0.50).

By the 6-month follow-up, however, more than 90% of those who had previously been unsure were vaccinated, and 59.7% of those who previously reported no intention of getting vaccinated were vaccinated.

"COVID-19 vaccination in HCWs was high, but variability in vaccination intention exists," the authors wrote. "Targeted messaging coupled with vaccine mandates can support uptake."

Dr. Evans suggested that multiple factors helped HCWs change their minds. They include clear messaging about the vaccine safety and convenient access to vaccinations at the hospital, awareness of upcoming workplace mandates, as well as the granting of Emergency Use Authorization (EUA) for the vaccines by the FDA. “We saw a significant change in the number of people who said they would get the vaccine after the EUA was issued. People may have felt, ‘OK, this might be safe for me to take’,” she stated.

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