Lutrick, Karen; Groom, Holly; Fowlkes, Ashley L; Groover, Kimberly D; Gaglani, Manjusha; Rivers, Patrick; Naleway, Allison L; ... Yoon, Sarang; + view all Lutrick, Karen; Groom, Holly; Fowlkes, Ashley L; Groover, Kimberly D; Gaglani, Manjusha; Rivers, Patrick; Naleway, Allison L; Nguyen, Kimberly; Herring, Meghan; Dunnigan, Kayan; Phillips, Andrew; Parker, Joel; Lamberte, Julie Mayo; Prather, Khaila; Thiese, Matthew S; Baccam, Zoe; Tyner, Harmony; Yoon, Sarang; - view fewer (2022) COVID-19 vaccine perceptions and uptake in a national prospective cohort of essential workers. Vaccine , 40 (3) pp. 494-502. 10.1016/j.vaccine.2021.11.094.

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Abstract

INTRODUCTION: In a multi-center prospective cohort of essential workers, we assessed knowledge, attitudes, and practices (KAP) by vaccine intention, prior SARS-CoV-2 positivity, and occupation, and their impact on vaccine uptake over time. METHODS: Initiated in July 2020, the HEROES-RECOVER cohort provided socio-demographics and COVID-19 vaccination data. Using two follow-up surveys approximately three months apart, COVID-19 vaccine KAP, intention, and receipt was collected; the first survey categorized participants as reluctant, reachable, or endorser. RESULTS: A total of 4,803 participants were included in the analysis. Most (70%) were vaccine endorsers, 16% were reachable, and 14% were reluctant. By May 2021, 77% had received at least one vaccine dose. KAP responses strongly predicted vaccine uptake, particularly positive attitudes about safety (aOR = 5.46, 95% CI: 1.4-20.8) and effectiveness (aOR = 5.0, 95% CI: 1.3-19.1). Participants' with prior SARS-CoV-2 infection were 22% less likely to believe the COVID-19 vaccine was effective compared with uninfected participants (aOR 0.78, 95% CI: 0.64-0.96). This was even more pronounced in first responders compared with other occupations, with first responders 42% less likely to believe in COVID-19 vaccine effectiveness (aOR = 0.58, 95% CI 0.40-0.84). Between administrations of the two surveys, 25% of reluctant, 56% reachable, and 83% of endorser groups received the COVID-19 vaccine. The reachable group had large increases in positive responses for questions about vaccine safety (10% of vaccinated, 34% of unvaccinated), and vaccine effectiveness (12% of vaccinated, 27% of unvaccinated). DISCUSSION: Our study demonstrates attitudes associated with COVID-19 vaccine uptake and a positive shift in attitudes over time. First responders, despite potential high exposure to SARS-CoV-2, and participants with a history of SARS-CoV-2 infection were more vaccine reluctant. CONCLUSIONS: Perceptions of the COVID-19 vaccine can shift over time. Targeting messages about the vaccine's safety and effectiveness in reducing SARS-CoV-2 virus infection and illness severity may increase vaccine uptake for reluctant and reachable participants.

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