Racial Differences in COVID-19 Vaccine Hesitancy Among Health Care Workers in Two Large Academic Hospitals

Background: Significant racial differences in hesitancy to receive COVID-19 vaccination has been observed in several settings. This hesitancy among healthcare workers (HCWs), who face both occupational and community exposure to COVID-19, has not been well described across racial and ethnic groups.Methods: This cross-sectional survey of HCWs from two large academic hospitals, measured hesitancy to receive a COVID-19 vaccine, defined as not planning on, being unsure about, or planning to delay vaccination. A three-step hierarchical multivariable logistic regression evaluated associations between race and vaccine hesitancy controlling for demographic characteristics, employment characteristics and COVID-19 exposure risk, and being up-to-date with routine vaccines.Findings: Among 10,871 HCWs who completed the survey and reported race, 77.2% were White, 8.1% Black, 7.8% Asian, 4.1% other/mixed race and 2.8% Hispanic. Vaccine hesitancy was highest among Black (83.0%) and Hispanic HCWs (63.5%). Reasons for hesitancy included concerns about side effects, newness of the vaccine, and lack of vaccine knowledge. The adjusted odds ratio (AOR) for vaccine hesitancy was 4.98 (95% CI 4.11-6.03) for Blacks, 2.10 (95% CI 1.63-2.70) for Hispanics, 1.48 (95% CI 1.21-1.82) for other/mixed race respondants, and 1.47 (95% 1.26-1.71) for Asian compared to White HCWs. When adjusting for employment characteristics, COVID-19 exposure risk, and being up-to-date with prior vaccines, AORs were slightly diminished for Black HCWs, but remained stable for HCWs of other racial/ethnic groups.Interpretation: Hesitancy to receive the COVID-19 vaccine is high among HCWs, especially among Black and Hispanic HCWs. Interventions focused on addressing trust in COVID-19 vaccination among HCWs are needed.Funding Statement: The study was funded by the Vaccine Education Center of the Children’s Hospital of Philadelphia.Declaration of Interests: Ms. Browne, Dr. Shen, Dr. Momplaisir, Dr. Green-McKenzie, Dr. Faig, Dr. Frank, and Dr. Offit have no conflicts of interest. Dr. Kuter is a consultant for Moderna. Dr. Feemster is an employee of Merck Research Laboratories.Ethics Approval Statement: The Institutional Review Board at each hospital reviewed the protocol and determined the study was exempt from human subjects’ review.