Public Health Watch: Vaccine Hesitancy Among Healthcare Workers Differs Along Racial Lines

JAMA study highlights more reluctance among communities of color.

Earlier this summer, Houston Methodist Hospital fired more than 150 staffers who refused the COVID-19 vaccine after instituting a requirement that all personnel get inoculated against the virus.

The news came just weeks before a Delta variant-fueled surge in SARS-CoV-2 cases in the region.

Some 60 of the fired healthcare workers have since sued the hospital but it is far from the only institution nationally to institute vaccine requirements for patient-facing staff. In fact, publicly-run health systems in states from New York to California have implemented similar policies and, in August, President Biden signed an executive order mandating that all nursing home personnel be vaccinated against the coronavirus, over the objections of the American Health Care Association and National Center for Assisted Living, which fear a mass exodus of employees from facilities already struggling to maintain adequate staffing levels.

However, before dismissing those who refuse the COVID-19 vaccine “anti-vax, anti-science,” it’s possible that these incidents of vaccine hesitancy in healthcare reflect a larger issue in society as a whole—at least if the results of a study published on August 30th by JAMA Network Open are any indication.

For the study, researchers at the University of Pennsylvania surveyed 12,034 healthcare workers at 2 large academic hospitals, of whom 10,871 reported their race/ethnicity. Notably, vaccine hesitancy was highest among Black healthcare workers, at 732 of 882 respondents, or 83%, followed by Hispanic/Latinx staffers, at 195 of 307 respondents, or 63.5%. Black healthcare workers surveyed were nearly 5 times less likely to get vaccinated against SARS-CoV-2 compared with White respondents, while Hispanic/Latinx and Asian personnel were 50% and 47% less likely to do, respectively.

Among 5440 healthcare workers, or just over 50%, who indicated vaccine hesitancy, reasons given included concerns about side effects (87.1% of hesitant respondents), the fact the shots are new (79.2% of hesitant respondents), and lack of vaccine knowledge (75.2% of hesitant respondents).

“In addition to reasons for vaccine hesitancy reported here, it is possible that mistrust of the healthcare system owing to historical mistreatment in research and medical care, particularly in the Black community, may contribute to hesitancy,” wrote the researchers, who did not respond to requests for comment from Contagion. “[Our] results suggest that more work is needed to ensure confidence in COVID-19 vaccination, particularly among Black and Hispanic or Latino individuals, who are disproportionately impacted by the pandemic. Developing messaging emphasizing the individual, family, and community benefits of getting the vaccine and providing continued transparency on the safety profile of COVID-19 vaccines are simple approaches that may be rapidly disseminated across healthcare systems to improve vaccine acceptance among [staff].”

Indeed, this is hardly the first study to highlight differences in vaccine hesitancy along racial and ethnic lines. A survey of 3,479 staffers at 5 hospitals, published in February by Vaccines, found that 81% of Black and 70% of Hispanic/Latinx healthcare workers, respectively, were unwilling to take the COVID-19 vaccine. Although these trends are often pinned on historic mistrust of the medical profession among communities of color, dating back to the infamous Tuskegee experiments, recent reports suggest concerns run deeper than that.

Either way, healthcare systems are uniquely positioned to educate and advocate for their staff, and thus should be able to navigate the challenges posed by vaccine hesitancy. Given the scope of the ongoing COVID-19 crisis, the time for addressing them is long overdue. The safety of staff—and patients—is at stake.