"Characterization of COVID-19 Vaccine Hesitancy among Essential Workfor" by Deborah Kupferwasser

Date of Award

Fall 2022

Degree Type

Restricted to Claremont Colleges Dissertation

Degree Name

Public Health, DPH

Program

School of Community and Global Health

Advisor/Supervisor/Committee Chair

Deborah Freund

Dissertation or Thesis Committee Member

Jay Orr

Dissertation or Thesis Committee Member

Bin Xie

Dissertation or Thesis Committee Member

Judi Nightingale

Terms of Use & License Information

Terms of Use for work posted in Scholarship@Claremont.

Rights Information

© 2022 Deborah Kupferwasser

Keywords

COVID-19, Vaccine Hesitancy

Abstract

Background: Essential workforce members such as those employed by hospitals were among the first populations to be offered the Emergency Use Authorized COVID-19 vaccines. Factors and the psychological drivers associated with vaccine hesitancy have not been well characterized for this population pre-vaccine rollout. Methods: To this extent, we performed a cross-sectional survey conducted from September through December 2020 at Los Angeles County USC Hospital to assess vaccine hesitancy. Adult employees with both non-patient roles and patient roles were included in this study. A total of 1327 participants were enrolled in the study with 1235(96%) completing the survey. Hierarchical logistic regression models were constructed to predict our outcome variable of vaccine hesitancy. Demographic factors and attitudes about the hypothetical COVID-19 vaccine were included in our hierarchical logistic models. Attitudes were assessed based on 7-point Likert-type questions developed utilizing the Health Belief Model constructs of perceived susceptibility, threat, and self-efficacy. We included the California-based Healthy Places Index as a community-level variable to assess the influence Social Determinates of Health have on vaccine hesitancy. Results: A total of 1327 healthcare workers participated. Based on expressed COVID-19 vaccine intent, 78% were categorized as vaccine acceptors and 22% as vaccine-hesitant. In our multivariable model, factors associated with vaccine hesitancy are Female gender [OR = 2.09; (CI 1.44–3.05, p = 0.001)], African American [OR = 4.32; (CI 2.16–8.62, p ≤ 0.001)] or LatinX [OR = 2.47; (CI 1.51–4.05, p = 0.01)] race, and a history of not or sometimes receiving Influenza vaccination (OR = 4.39; (CI 2.98–6.48), p ≤ 0.001). Conclusions: Vaccine hesitancy was associated with unique factors. These factors are female gender, identifying as African American or LatinX, and a history of not or sometimes receiving the Influenza vaccination. Among employees of a large urban safety net hospitable, COVID-19 vaccine hesitancy was associated with demographic factors and Influenza vaccination history but was not associated with the psychological based constructs of perceived susceptibility, threat, and self-efficacy. The results of our study contribute to a better understanding of drivers of vaccine hesitancy that can be targeted for public health initiatives designed to increase vaccine uptake.

ISBN

9798368412269

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