Coronavirus disease 2019 (COVID-19) vaccine intentions and uptake in a tertiary-care healthcare system: A longitudinal study

Objectives: Healthcare workers (HCWs) are a high-priority group for coronavirus disease 2019 (COVID-19) vaccination and serve as sources for public information. In this analysis, we assessed vaccine intentions, factors associated with intentions, and change in uptake over time in HCWs. Methods: A prospective cohort study of COVID-19 seroprevalence was conducted with HCWs in a large healthcare system in the Chicago area. Participants 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. Results: Of 4,180 HCWs who responded to a survey, 77.1% indicated that they intended to get the vaccine. In this group, 23.2% had already received at least 1 dose of the vaccine, 17.4% were unsure, and 5.5% reported that they would not get the vaccine. Factors associated with intention or vaccination were being exposed to clinical procedures (vs no procedures: adjusted odds ratio [AOR], 1.39; 95% confidence interval [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). Nurses (vs physicians: AOR, 0.24; 95% CI, 0.17-0.33), non-Hispanic Black (vs Asians: AOR, 0.35; 95% CI, 0.21-0.59), and women (vs men: AOR, 0.38; 95% CI, 0.30-0.50) had lower odds of intention to get vaccinated. By 6-months follow-up, >90% of those who had previously been unsure were vaccinated, whereas 59.7% of those who previously reported no intention of getting vaccinated, were vaccinated. Conclusions: COVID-19 vaccination in HCWs was high, but variability in vaccination intention exists. Targeted messaging coupled with vaccine mandates can support uptake.

Automated summary

Most healthcare workers (HCWs) expressed intentions to receive the COVID-19 vaccine, but some remained unsure or unwilling. Factors such as exposure to clinical procedures and negative serology tests for COVID-19 were predictive of vaccine intention and behavior. Targeted messaging and vaccine mandates can help increase vaccine uptake.