Health and social care workers who felt under greater pressure from their employers to get a COVID-19 vaccine were more likely to decline it, according to preliminary new research.
The government has recently confirmed that it is considering making vaccinations a condition of work for care staff, but a new study led by the London School of Hygiene & Tropical Medicine (LSHTM) suggests that this could hinder take-up.
In a survey of nearly 2,000 people, participants were asked for their level of agreement with the statement ‘I feel/felt under pressure from my employer to get a COVID-19 vaccine’. This was asked on a four-point scale from (1) strongly disagree to (4) strongly agree. For each additional point of agreement on the scale, participants were 75% more likely to have declined COVID-19 vaccination.
Amongst unvaccinated participants, 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-19 vaccination mandatory for staff.
LSHTM, working in collaboration with NHS Race and Health Observatory, Public Health England and the Royal College of Nursing, found that feeling pressurised had damaging effects, eroding trust and negatively affecting relationships at work, and often exacerbated COVID-19 vaccination concerns and hardened stances on declining vaccination.
The study also identified structural barriers to vaccination uptake: Black African and Mixed Black African workers were not offered vaccination at the same rates as White British and White Irish participants (8.9% not offered as compared to 5.5%).
When additional demographic and situational factors were controlled for, Black African and Mixed Black African participants were around twice as likely not to be offered the vaccine as White British and White Irish participants, and social care workers were around 50% more likely to not be offered COVID-19 vaccination than health care workers.
Dr Sadie Bell, Research Fellow at LSHTM and lead author said: “Our findings emphasise the importance of COVID-19 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-19 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 UK health and social care workers’ views on COVID-19 vaccination. 1,917 health and social care workers – 1658 healthcare workers (HCWs) and 261 social care workers (SCWs) – completed the survey. Twenty survey participants were interviewed.
Commenting on the findings, UNISON general secretary Christina McAnea said: “This study makes plain any talk of compulsory vaccination could damage take-up severely.
“Care workers need clear, accurate information from their employers about when and how they get their jabs.
“If achieving maximum coverage is the goal, employers and policymakers will get better results through encouragement, reassurance and removal of any practical barriers for staff. Forced injections simply aren’t the answer.”