Exploring healthcare workers' opinions on mandatory COVID-19 vaccination in the UK

By Shanet Susan AlexJan 13 2022Reviewed by Aimee Molineux

In a recent study posted to the medRxiv* preprint server, researchers determined healthcare workers' (HCWs) views on mandatory severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination in the United Kingdom (UK). The study concluded that most HCWs did not support the implementation of the compulsory coronavirus disease 2019 (COVID-19) vaccination policy.

Background

This news article was a review of a preliminary scientific report that had not undergone peer-review at the time of publication. Since its initial publication, the scientific report has now been peer reviewed and accepted for publication in a Scientific Journal. Links to the preliminary and peer-reviewed reports are available in the Sources section at the bottom of this article. View Sources

Since the emergency approval of COVID-19 vaccination in the UK in December 2020, a staggering vaccine uptake was observed across the population, those aged 12 years or older. However, low vaccination rates were reported among females, younger age groups, certain ethnic groups, and HCWs.

In England, the surge of the COVID-19 cases and the emergence of the Omicron variant of concern (VOC) had led to the SARS-CoV-2 vaccination being made compulsory for social care workers in November 2021, and it will become mandatory for HCWs employed in other healthcare sectors from April 2022.

Numerous HCW representatives and regulatory bodies in the UK were concerned about the workforce shortage and loss of employees' trust towards the organization associated with the mandatory COVID-19 vaccination for HCWs.

Previous studies have reported HCWs' opinions about compulsory vaccination against diseases like influenza. However, sufficient information regarding the HCW views on mandatory COVID-19 vaccination is not yet available.

The study

In the present study, researchers evaluated HCWs' opinions on mandatory vaccination policy in the UK for the general public and HCWs. The analysis used 17,891 HCWs data from the baseline and the first follow-up questionnaires of the United Kingdom Research study into Ethnicity And COVID-19 outcomes in healthcare workers (UK-REACH) nationwide prospective cohort study. The participants filled the baseline and the first follow-up questionnaires online between December 2020-March 2021 and April 21, 2021-June 26, 2021.

The study included individuals aged 16 years or older, healthcare or social care workers, registered to any of the seven UK professional regulatory bodies, and residing in the UK.

The participant responses were asked a free-text question, “What should society do if people don't get vaccinated against COVID-19?” using the qualitative method of manifest content analysis.

The categories were pooled into a binary outcome variable: 'favors mandatory vaccination'. Thus, those who favor compulsory vaccination for the general public or HCWs are scored one and all others scored zero. Further, the binary variables' demographic predictors, and health, occupational, and attitudinal predictors adjusted for demographics were calculated using logistic regression.

Results

The results indicated that among the 5633 questionnaire respondents, the free-text question was answered by 3235. While 578 respondents favored mandatory vaccination, 1047 respondents suggested education and support as a vaccine coverage strategy.

The number of females and participants from ethnic minority groups was 2405 and 897, respectively. The proportion of HCWs employed in an allied health profession, medical, and nursing or midwifery was 40.3%, 23.9%, and 21.6%, respectively.

Non-responders of the free-text question were younger than responders with a median age of 43 years and 47 years, respectively. Among responders and non-responders, no significant differences by gender, ethnicity, or occupation were observed. 

Responses favoring the seven codes - mandatory vaccination for the general public; mandatory vaccination for the HCWs; specific restrictions for unvaccinated people; do nothing; educate, increase access, incentivize; maintenance of social restrictions; and don't know - were observed in 12%, 6%, 17%, 18%, 32%, 10%, and 5% of HCWs respectively. 

HCWs who are old, those with more positive vaccination attitudes, and those vaccinated against influenza were more likely to favor compulsory vaccination. On the contrary, HCWs who were allied health professionals, females, young, those reluctant about SARS-CoV-2 vaccination and all vaccination on a general basis, trusted their organization, and the Black ethnic group was less likely to favor mandatory vaccination approach. 

Conclusions

The study concluded that most HCWs in the UK were not in favor of compulsory COVID-19 vaccination as a strategy for dealing with suboptimal vaccination coverage. Only one in six HCWs in this large, diverse, UK-wide sample supported the mandatory vaccination policy. Almost a third of participants suggested education and support as a vaccine coverage strategy.

While the implementation of mandatory vaccination is likely to boost vaccination coverage, a substantial amount of HCWs may still remain unvaccinated. Hence, further studies are required to identify the effect of the mandatory vaccination policies on trust among certain minority groups, and staff health and shortages in England. Moreover, according to the authors, vaccine education and building trust of HCWs might influence the overall vaccine coverage to a greater extent.

This news article was a review of a preliminary scientific report that had not undergone peer-review at the time of publication. Since its initial publication, the scientific report has now been peer reviewed and accepted for publication in a Scientific Journal. Links to the preliminary and peer-reviewed reports are available in the Sources section at the bottom of this article. View Sources