Vaccine Refusal Higher Among Health Workers Who Feel Pressured by Employers, According to New Research

New research suggests that health and social care workers who feel greater pressure from their employers to receive Covid vaccination are more likely to decline it. The study, not yet peer reviewed, was led by the London School of Hygiene & Tropical Medicine (LSHTM) and “emphasise[s] the importance of Covid vaccination remaining voluntary”, according to its primary author. Here are the key findings.

In a survey of nearly 2,000 [health and social care workers], participants were asked for their level of agreement with the statement “I feel/felt under pressure from my employer to get a Covid vaccine”. This was asked on a four-point scale from (one) strongly disagree to (four) strongly agree. For each additional point of agreement on the scale, participants were 75% more likely to have declined Covid vaccination.

Among unvaccinated participants, worrying concerns were raised about how their vaccination decision might impact their job security. For social care workers, pressure was exacerbated by hearing of care sector employers making Covid vaccination mandatory for staff, and the vulnerability of social care worker positions (e.g. employment on zero-hours contracts).

Feeling pressurised had damaging effects, eroding trust and negatively affecting relationships at work, and often exacerbated Covid vaccination concerns and hardened stances on declining vaccination…

Dr Sadie Bell, Research Fellow at LSHTM and lead author, said: “Our findings emphasise the importance of Covid vaccination remaining voluntary. Organisational factors and workplace culture play an important role in the likelihood of both being offered and getting vaccinated. Health and social care providers need to offer a space for their staff to have ‘conversations’ where they feel safe to ask about Covid vaccination, and not feel judged and stigmatised for having questions and/or concerns.”

The research team used a mixed-methods approach – involving an online cross-sectional survey and interviews – to find out U.K. health and social care workers’ views on Covid vaccination.  1,917 health and social care workers – 1658 healthcare workers and 261 social care workers – completed the survey. Twenty survey participants were interviewed…

The survey revealed common reasons for declining the vaccine were concerns about side effects and a lack of research on the vaccine. It revealed the main motivation for vaccine acceptance was protecting family members and friends, and self-protection from Covid…

Sandra Mounier-Jack, an Associate Professor in Health Policy at LSHTM and study author, said: “Our work shows a move towards mandating Covid vaccination is likely to harden stances and negatively affect trust in the vaccination, provider, and policymakers. Health and social care employers are in a pivotal position to facilitate Covid vaccination access, ensuring staff are aware of how to get vaccinated and promoting a workplace environment in which vaccination decisions are informed and voluntary.”

These findings echo SAGE member Stephen Reicher’s recent warning that the introduction of vaccine passports (that is, a step towards mandatory vaccination) could lead to people refusing to get vaccinated against Covid. If the Government’s aim really is to increase vaccine uptake among health workers (and in the general population) it should abandon any plans for mandatory vaccination.

The LSHTM report is worth reading in full.

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