Assignment 2: Journal Article Review

Vaccine 39 (2021) 1693–1700
Contents lists available at ScienceDirect

Vaccine

journal homepage: www.elsevier.com/locate/vaccine
Perspectives on the receipt of a COVID-19 vaccine: A survey
of employees in two large hospitals in Philadelphia
https://doi.org/10.1016/j.vaccine.2021.02.029
0264-410X/� 2021 Elsevier Ltd. All rights reserved.

⇑ Corresponding author at: Vaccine Education Center, Children’s Hospital of
Philadelphia, 3615 Civic Center Boulevard, Philadelphia, PA 19104, United States.

E-mail addresses: [email protected], [email protected] (B.J. Kuter).
Barbara J. Kuter a,⇑, Safa Browne a, Florence M. Momplaisir b, Kristen A. Feemster a, Angela K. Shen a,
Judith Green-McKenzie b, Walter Faig c, Paul A. Offit a

a Vaccine Education Center, Children’s Hospital of Philadelphia, United States
b Hospital of the University of Pennsylvania, United States
c Children’s Hospital of Philadelphia, United States

a r t i c l e i n f o a b s t r a c t
Article history:
Received 11 January 2021
Received in revised form 2 February 2021
Accepted 8 February 2021
Available online 16 February 2021

Keywords:
COVID-19
Vaccine
Health care workers
Risk factors
Vaccine safety
Vaccine acceptance
Vaccine hesitancy
Background: Health care personnel have been identified by the ACIP as a priority group for COVID-19 vac-
cination. We conducted a survey in November-December 2020 at two large, academic hospitals in
Philadelphia to evaluate the intention of hospital employees to be vaccinated.
Methods: The survey was sent electronically to all employees (clinical and nonclinical staff) at a chil-
dren’s hospital and an adult hospital. The survey was voluntary and confidential. Questions focused on
plans to receive a COVID-19 vaccine when available, reasons why employees would/would not get vac-
cinated, when employees planned to be vaccinated, vaccine safety and efficacy features that would be
acceptable, and past history of receipt of other vaccines by the employee and family. Responses were ana-
lyzed using univariate and multiple logistic regression methods.
Results: A total of 12,034 hospital employees completed the survey (a 34.5% response rate). Overall, 63.7%
of employees reported that they planned to receive a COVID-19 vaccine, 26.3% were unsure, and 10.0%
did not plan to be vaccinated. Over 80% of those unsure or unwilling to be vaccinated expressed concerns
about vaccine side effects and the vaccines’ newness. In multivariable logistic regression, persons plan-
ning to take a COVID-19 vaccine were more likely to be older, male, more educated, Asian or White,
up-to-date on vaccinations, without direct patient contact, and tested for COVID-19 in the past. No sig-
nificant difference in intention to be vaccinated was found between those with higher versus lower levels
of exposure to COVID-19 patients or the number of previous exposures to patients with COVID-19.
Conclusions: While the majority of hospital employees are planning to receive a COVID-19 vaccine, many
are unsure or not planning to do so. Further education of hospital employees about the safety, efficacy,
and value of the currently available COVID-19 vaccines is critical to vaccine acceptance in this population.

� 2021 Elsevier Ltd. All rights reserved.
1. Background

The coronavirus disease 2019 (COVID-19) pandemic continues
to aggressively spread throughout the United States with more
than 26.1 million cases and 441,831 deaths reported as of February
2, 2021 [1]. COVID-19 is now the leading cause of death in the US
[2]. The persistence of the pandemic and its increasing morbidity
and mortality, despite current mitigation efforts, underlines the
need for COVID-19 vaccines. COVID-19 vaccine development and
testing has progressed at rapid speed due to novel vaccine tech-
nologies, the unprecedented number of public–private partner-
ships, vaccine manufacturers, and regulatory agencies focused on
a solution, and significant funding from both government and pri-
vate industry.

A central strategy to mitigating the COVID-19 pandemic is
through vaccination. Although vaccination programs are well
underway in the US, vaccination can only curtail ongoing transmis-
sion of the SARS-CoV-2 virus and reduce the overall severity of the
disease if widespread uptake occurs and herd immunity is
achieved. Experts estimate that �67% of the population must be
immune against the SARS-CoV-2 virus to halt transmission [3–6].

Acceptance of vaccination against COVID-19 by the general
population has been reported to be less than optimal. Eight polls
conducted between May 2020 and October 2020 showed that the
percent of adults who planned to receive a COVID-19 vaccine
ranged from 35 to 75% with no clear trend over time [7–13].

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https://doi.org/10.1016/j.vaccine.2021.02.029

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https://doi.org/10.1016/j.vaccine.2021.02.029

http://www.sciencedirect.com/science/journal/0264410X

http://www.elsevier.com/locate/vaccine

B.J. Kuter, S. Browne, F.M. Momplaisir et al. Vaccine 39 (2021) 1693–1700
Acceptance rates varied by race/ethnicity with lower acceptance
among Blacks than Whites [8,9].

In anticipation of the imminent Emergency Use Authorization
(EUA) of several COVID-19 vaccine candidates, the CDC’s Advisory
Committee on Immunization Practices (ACIP) made recommenda-
tions for priority groups for vaccination at its December 1, 2020
meeting. Recommendations were made recognizing that supply
would be limited when a vaccine was first available. The ACIP rec-
ommended that health care personnel should be included in the
first group to be offered COVID-19 vaccination as they are on the
front lines of pandemic response. Health care settings were recog-
nized as high-risk locations for SARS-CoV-2 exposure and trans-
mission [14,15].

Health care personnel may not only be some of the first persons
to receive a COVID-19 vaccine, they will also play an important role
in the acceptance of the vaccine in the general population. Patients
turn to health care providers for expert medical advice and care,
including vaccine recommendations. It is well established that
patients are far more likely to receive an immunization when a
provider has recommended it [16–23].

In view of the low vaccine acceptance rate in the general popu-
lation and the priority given to vaccination of health care person-
nel, we conducted a survey among hospital employees in the
weeks prior to imminent COVID-19 vaccine introduction. The pur-
pose of the survey was to understand attitudes toward COVID-19
vaccines which will be new to them, their patients, and their fam-
ilies. We aimed to obtain a better understanding of how hospital
employees, both in clinical and nonclinical positions, perceive the
new COVID-19 vaccines and their intention to be vaccinated.
2. Methods

We conducted a confidential, voluntary survey between
November 13, 2020 and December 6, 2020 at two large, academic
hospitals in Philadelphia, one serving children and the other serv-
ing adults (henceforth referred to as hospital A and hospital B,
respectively). The survey was distributed to all hospital employees
regardless of clinical role using REDCAP, an electronic survey
instrument. The survey was announced by management at each
hospital 1–2 days before being distributed, and 3–4 reminders
were sent out over the course of the survey period.

The survey was developed based on results from other studies
related to COVID-19 vaccine acceptance in the general population
with inclusion of specific questions related to role in the hospital
and exposure to COVID-19. A pilot survey was conducted prior to
dissemination at the two hospitals to test for feasibility, length of
time to complete the survey, and clarity. The survey took 10–
15 minutes to complete. The survey questions focused on
employee plans to receive a COVID-19 vaccine, timing of vaccine
receipt once available, reasons for taking or not taking the vaccine,
safety and efficacy features of a vaccine that would or would not be
acceptable, who should be vaccinated first, history of exposure to
COVID-19 at work, at home or elsewhere, and past history of
receipt of other vaccines for the employee or their children. Demo-
graphic data collected included hospital of employment, age, gen-
der, race/ethnicity, education, position and area employed in the
hospital, duration of employment, and residential area. Assump-
tions that were communicated to the employees when completing
the survey included: 1) The vaccine would be at least 50% effective;
2) The vaccine would be authorized under Emergency Use Autho-
rization (EUA) by the Food and Drug Administration (FDA) and
would be recommended by the ACIP for health care workers; 3)
COVID-19 was expected to continue to circulate in the US for the
next few months; and 4) There would be no cost to receive the
vaccine.
1694
The protocol and survey were reviewed by the Institutional
Review Board at each hospital and determined to be exempt from
human subjects’ review.

Analysis included summary statistics (frequencies and percent-
ages) of employee characteristics (age, gender, race or ethnicity,
level of education, home residence type, and hospital position)
for the entire responding population (12,034 individuals). For each
survey question, the percent of individuals who responded to each
possible answer was tabulated, excluding those who did not
respond to the question along with 9 subjects who indicated they
had participated in a COVID-19 vaccine trial. Intention to receive a
COVID-19 vaccine (based on a response of yes, no, or unsure) was
further stratified by the employee characteristics noted above as
well as timing of vaccine receipt, self-health assessment,
employee/child vaccination status, number of COVID-19 expo-
sures, risk of exposure, prior COVID-19 testing status, hospital of
employment, and years employed (as categorized in Table 3). Dif-
ference in rates were determined by Chi square tests with signifi-
cance level 0.05. Variables shown to have significantly different
rates of intention to receive a COVID-19 vaccine in this univariate
analysis were included in multiple logistic regression analyses
[24]. Significance level 0.05 was used to determine a variable’s
overall significance in the model when controlling for all other
variables as well as a parameter’s odds ratio compared to its refer-
ence (as shown in Table 4).
3. Results

3.1. Response rate

The survey was sent to 34,865 health care employees at the two
hospitals. A total of 12,034 persons (7427 at hospital A and 4607 at
hospital B) responded to the survey. The overall response rate was
34.5% (36.8% at hospital A and 31.3% at hospital B).

3.2. Demographics

The demographics of the 12,034 survey respondents are shown
in Table 1. The age distribution and racial/ethnicity of the respon-
dents at the two hospitals was comparable. There were more
females at hospital A who responded to the survey while there
were more employees who lived in an urban setting, more staff
in clinical positions, and more employees with postgraduate edu-
cation who responded to the survey at hospital B.

3.3. Intention to be vaccinated

A total of 11,760 employees (7271 at hospital A and 4489 at
hospital B) responded to the survey question about their plans to
be vaccinated. Overall, 63.7% of these employees said they planned
to receive a COVID-19 vaccine when available under an EUA in the
US. The intention to receive a COVID-19 vaccine was 61.6% at hos-
pital A and 67.3% at hospital B. Approximately one quarter (26.3%)
of employees (27.6% at hospital A and 24.1% at hospital B) said they
were unsure if they would take the vaccine, and 10.0% said that
they did not plan to receive the vaccine (10.8% at hospital A and
8.7% at hospital B).

3.4. Vaccine characteristics of importance

Vaccine safety and efficacy were the two COVID-19 vaccine
characteristics of most importance to the employees (94.4%% and
82.8%, respectively). Only 28.3% of respondents said they would
be willing to receive a vaccine if the side effects they would
develop included a high fever, muscle aches, chills, and a headache

Table 1
Demographic Characteristics of 12,034 Hospital Employees who Completed the Survey.

Variable Parameter Hospital A (%) Hospital B (%) Combined (%)

Age <40 years 3732 (50.3) 2404 (52.2) 6136 (51.0) 40–64 years 3020 (40.7) 1692 (36.7) 4612 (39.2) 65 or older 224 (3.0) 208 (4.5) 432 (3.6) Unknown/NR 451 (6.1) 303 (6.6) 754 (6.3) Gender Female 5658 (76.2) 2969 (64.5) 8627 (71.7) Male 1241 (16.7) 1288 (28.0) 2529 (21.0) Other/Unknown/NR 528 (7.1) 350 (7.6) 878 (7.3) Race/Ethnicity White 5177 (69.7) 3216 (69.8) 8393 (69.7) Black 607 (8.2) 275 (6.0) 882 (7.3) Hispanic or Latino 209 (2.8) 99 (2.2) 308 (2.6) Asian 440 (5.9) 408 (8.9) 848 (7.1) Other/Unknown/NR 994 (13.4) 609 (13.2) 1603 (13.3) Education Less than Bachelor’s Degree 1108 (14.9) 404 (8.8) 1512 (12.6) Bachelor’s or Master’s Degree 4471 (60.2) 2324 (50.4) 6795 (56.5) Postgraduate Degree 1489 (20.1) 1621 (35.2) 3110 (25.8) Unknown 359 (4.8) 258 (5.6) 617(5.1) Home Residence Urban 2729 (36.7) 1971 (42.8) 4700 (39.1) Suburban 4153 (55.9) 2297 (49.9) 6450 (53.6) Rural 184 (2.5) 79 (1.7) 263 (2.2) Unknown 361 (4.9) 260 (5.6) 621 (5.2) Hospital Position Clinical – Direct patient contact 3365 (45.3) 3115 (67.6) 6480 (53.9) Some patient interaction 723 (9.7) 350 (7.6) 1073 (8.9) Nonclinical - No patient interaction 2371 (31.9) 672 (14.6) 3043 (25.3) Other/Unknown 968 (13.0) 470 (10.2) 1438 (11.9) NR – No response to this question. Table 2 Reasons Why Employees Would Not Receive a COVID-19 Vaccine Among The Subset who Indicated They Were Unsure or Did Not Plan to be Vaccinated. Reason Hospital A (N = 2791) Hospital B (N = 1470) Combined (N = 4261) Concern about side effects 2469 (88.5%) 1326 (90.2%) 3795 (89.1%) Vaccine is too new 2363 (84.7%) 1216 (82.7%) 3579 (84.0%) Don’t know enough about the vaccine 2201 (78.9%) 1117 (76.0%) 3318 (77.9%) It may not work 967 (34.6%) 435 (29.6%) 1402 (32.9%) Concern about getting infected with COVID-19 from the vaccine 753 (27.0%) 331 (22.5%) 1084 (25.4%) I do not like vaccines 132 (4.7%) 70 (4.8%) 202 (4.7%) COVID-19 outbreak is not as serious as some people say it is 73 (2.6%) 47 (3.2%) 120 (2.8%) I do not like needles 56 (2.0%) 22 (1.5%) 78 (1.8%) I won’t have time to get vaccinated 10 (0.4%) 10 (0.7%) 20 (0.5%) None of the above 16 (0.6%) 7 (0.5%) 23 (0.5%) Other (specify)1 247 (8.8%) 128 (8.7%) 375 (8.8%) Reasons listed were prespecified in the survey. Employees could select more than one reason why they would not receive a COVID-19 vaccine. 1 Other includes pregnant, want to get pregnant, breastfeeding, concern about fertility, concern about long term complications, duration of protection unknown, distrust government and pharma, want more data, underlying medical condition (autoimmune disorder, cancer, allergies, diabetes), vaccine development rushed, concern about fetal cell use, don’t trust the vaccine, too much conflicting information, no other mRNA vaccine on the market, religious reasons, need to see more data, too much political involvement. B.J. Kuter, S. Browne, F.M. Momplaisir et al. Vaccine 39 (2021) 1693–1700 after vaccination that resulted in loss of 2 days at work, while 33.2% of employees said they were unsure if they would take a vac- cine with this exact safety profile. Intention to be vaccinated increased with increasing vaccine effectiveness (35.8% willing to receive a vaccine with 50% effectiveness, 61.1% willing to receive a vaccine with 70% effectiveness, and 85.6% willing to receive a vaccine with 90% effectiveness). The number of prior persons vac- cinated was an important characteristic of a COVID-19 vaccine for 32.3% of employees. 3.5. Reasons to be vaccinated/reasons not to be vaccinated The reasons employees most frequently selected for receiving a COVID-19 vaccine included protection of one’s family (86.7%) and protecting themselves (82.9%). Other reasons for receiving a COVID-19 vaccine included protecting one’s community (68.8%), getting life ‘‘back to normal” (59.4%), and a belief that vaccination was the best measure to prevent becoming seriously ill from COVID-19 (58.3%). A desire to travel again was noted by 38.5% of employees. 1695 Table 2 presents the reasons employees selected for not taking a COVID-19 vaccine among those who indicated they were either not planning or unsure about taking the vaccine. The reasons most frequently selected for not wanting to be vaccinated included concern about side effects (89.1%), the vaccine being too new (84.0%), and not knowing enough about the vaccine (77.9%). Other reasons included concerns about the vaccine not working (32.9%) and getting infected with COVID-19 from the vaccine (25.4%). 3.6. Timing of vaccination Among the 7158 persons who said they planned to be vacci- nated and answered the question about timing of vaccination, 5661 (79.1%) said they would receive the vaccine as soon as it was recommended and made available to them, 1367 (19.1%) said they would take the vaccine after it had been administered to others for 3–6 months, and 130 (1.8%) said they would take the vaccine after it had been administered to others for 12 months. Table 3 Characteristics of Hospital Employees Planning to Receive a COVID-19 Vaccine (Hospitals A & B Combined)1. Category Variable Parameter Total Respondents2 N (%) Planning To Receive A COVID-19 Vaccine3 p-value Demographics Age <40 years 6131 3835 (62.6) <0.0001 40–64 years 4708 3073 (65.3) 65 or older 432 376 (87.0) Gender Male 2525 2064 (81.7) <0.0001 Female 8622 5181 (60.1) Other/Prefer Not to Answer 253 73 (28.9) Race/Ethnicity White 8388 5833 (69.5) <0.0001 Black 882 262 (29.7) Hispanic or Latino 307 167 (54.4) Asian 845 626 (74.1) Multiple/Other 449 264 (58.8) Education Less than Bachelor’s Degree 1511 618 (40.9) <0.0001 Bachelor’s or Master’s Degree 6792 4120 (60.7) Postgraduate Degree 3105 2583 (83.2) Area of Residence Urban 4696 3163 (67.4) <0.0001 Suburban 6445 4037 (62.6) Rural 263 121 (46.0) Work Location Hospital A 7271 4480 (61.6) <0.0001 Hospital B 4489 3019 (67.3) Years Employed at Hospital <1 year 984 670 (68.1) 0.0041 1–4 years 3682 2304 (62.6) 5 or more years 6733 4343 (64.5) Health of Individual Self-reported health status Excellent 3378 2442 (72.3) <0.0001 Good or Very Good 7753 4729 (61.0) Fair or Poor 393 208 (52.9) Vaccination History Employee Up-to-date on most or all vaccines 11,193 7220 (64.5) <0.0001 Up-to-date on some vaccines 180 99 (55.0) Unsure if up-to-date 89 38 (42.7) Not up-to-date 62 22 (35.5) Employee’s Children4 Up-to-date on most or all vaccines 6099 3883 (63.7) <0.0001 Up-to-date on some vaccines 110 63 (57.3) Unsure if up-to-date 108 65 (60.2) Not up-to-date 50 13 (26.0) Level of Patient Care Position in the Hospital Clinical - direct patient contact5 6473 4270 (66.0) <0.00018 Some patient interaction6 1073 536 (50.0) Nonclinical - no patient interaction7 3041 1995 (65.6) COVID Exposures & Testing Area of Employment in the Hospital High Exposure to COVID- 19 3042 2019 (66.4) 0.2642 Moderate Exposure to COVID-19 4883 3156 (64.6) Low Exposure to COVID- 19 2594 1705 (65.7) Confirmed COVID-19 exposures at work, home, elsewhere9 0 4142 2687 (64.9) 0.7962 1–4 3047 1954 (64.1) �5 2528 1627 (64.4) Previous COVID-19 test Yes 4290 2975 (69.4) <0.0001 No 7056 4317 (61.2) Unsure 234 113 (48.3) p value indicates significant difference among the parameters for each variable and were derived from tests of multiple proportions. 1 Excludes individuals who participated in a COVID-19 vaccine clinical trial. 2 Excludes individuals who did not respond to whether they plan to receive a COVID-19 vaccine. 3 Answered yes to survey question asking whether they planned to receive a COVID-19 vaccine. 4 Limited to those with children in the household. 5 Includes nursing staff, EMT, medical assistant, paramedic, phlebotomist, NP/MD/DO/PA, respiratory therapist, PT/OT/speech therapist. 6 Includes dietician/nutritionist, environmental services, security, radiology technician, visiting nurse, child life services, patient service representative, social worker, unit clerk, clergy. 7 Includes administrative, management staff, clinical laboratory personnel, IT support, maintenance, dietary staff, pharmacist, research personnel, volunteer. 8 p = 0.7452 when comparing those with direct patient contact to those with no patient interaction. 9 Excludes persons who were unsure of their number of exposures. The rate of persons planning to be vaccinated in this category was 61.0% (1137/1864). B.J. Kuter, S. Browne, F.M. Momplaisir et al. Vaccine 39 (2021) 1693–1700 1696 Table 4 Multiple Logistic Regression for Intention to Receive a COVID-19 Vaccine (Yes vs. No/Unsure) Across Those Variables Showing Differences in Univariate Analysis (Table 3). Category Variable Parameter OR (95% CI) P-Value Demographics Age Group (years) <40 Reference <0.0001 40–64 1.40 (1.26, 1.56) �65 3.50 (2.50, 4.90) Gender Female Reference <0.0001 Male 2.41 (2.12, 2.75) Other/Prefer Not To Answer 0.73 (0.42, 1.27) Race/Ethnicity White Reference <0.0001 Black 0.23 (0.19, 0.27) Hispanic or Latino 0.51 (0.39, 0.67) Asian 0.87 (0.73, 1.04) Multiple/Other 0.58 (0.47, 0.73) Education (Less than Bachelor’s Degree) Less than Bachelor’s Degree Reference <0.0001 Bachelor’s or Master’s Degree 1.84 (1.59, 2.13) Postgraduate Degree 4.59 (3.83, 5.50) Area of Residence Urban Reference <0.0001 Suburban 0.71 (0.65, 0.79) Rural 0.41 (0.30, 0.54) Hospital Hospital A Reference 0.7282 Hospital B 0.98 (0.89, 1.08) Years Employed at Hospital <1 Year Reference 0.2674 1 – 4 Years 0.87 (0.73, 1.03) �5 Years 0.89 (0.74, 1.06) Health of Individual Self-Reported Health Status Excellent Reference 0.0003 Good – Very Good 0.81 (0.73, 0.90) Poor - Fair 0.73 (0.56, 0.95) Vaccination History Employee Up-to date on most or all vaccines Reference 0.0023 Up-to-date on some vaccines 0.78 (0.54, 1.13) Not up-to-date 0.36 (0.18, 0.71) Unsure 0.56 (0.32, 0.96) Level of Patient Care Position in the Hospital Clinical – Direct Contact Reference <0.0001 Some Patient Interaction 1.12 (0.96, 1.31) Non-Clinical – No Patient Interaction 1.44 (1.29, 1.61) COVID-19 Testing Prior COVID-19 Test Yes Reference <0.0001 No 0.78 (0.71, 0.86) Unsure 0.69 (0.50, 0.95) The regression analysis was performed on 10,067 individuals who answered the question about their intention to be vaccinated as well as all included variables. Due to the limited number of responses, the category ‘‘Prefer Not to Answer” was excluded from both the race/ethnicity and age variables and the category ‘‘Other” was excluded from the level of patient care variable. Parameters with a significant odds ratio compared to the reference are in bold. B.J. Kuter, S. Browne, F.M. Momplaisir et al. Vaccine 39 (2021) 1693–1700 3.7. Intention to be vaccinated based on employee characteristics The difference in the intention of employees to be vaccinated was assessed based on their demographics, hospital of employ- ment, self-reported health status, vaccination history (their own and their children’s), level of patient care, level of exposure to COVID-19, and history of COVID-19 testing. A summary of the results and their corresponding statistical significance is shown in Table 3. 3.7.1. Demographic characteristics There was a significant difference in intention to be vaccinated by hospital of employment (61.6% at hospital A and 67.3% at hos- pital B) and gender (81.7% of males and 60.1% of females). A higher proportion of older compared with younger employees reported they planned to be vaccinated (87.0% for persons �65 year of age versus 65.3% in 40–64 year olds and 62.6% in those <40 years of age). Those employed <1 year at the hospital were more likely planning to be vaccinated than those employed 5 or more years (68.1% and 64.5%, respectively). A higher proportion of persons with a postgraduate degree were planning on being vaccinated than persons with a bachelor’s or master’s degree or those with less than a bachelor’s degree (83.2%, 60.7%, and 40.9%, respec- tively). Persons reporting that they lived in urban or suburban areas indicated they were more likely to be vaccinated than those living in rural areas (64.6% vs 46.0%). 1697 Significant differences in vaccine acceptance also were noted by race/ethnicity. The reported intention to receive a COVID-19 vac- cine was 74.1% in Asians, 69.5% in Whites, 54.4% in Hispanics, 29.7% in Blacks, and 58.8% in multiple/other races. 3.7.2. Personal health status/vaccination history Those who planned to be vaccinated were more likely to report being in excellent health. The intention to be vaccinated was 72.3% among employees who said their health was excellent versus 52.9% among those who said their health was poor or fair. History of vaccination among the employees and their children was assessed. Employees who reported that they were up-to-date on most or all routinely recommended vaccines for their age were more likely planning to be vaccinated compared with those employees who reported that they were up-to-date on some or no vaccines (64.5%, 55.0%, and 35.5%, respectively). Employees who intended to be vaccinated were also more likely to report hav- ing children who were up-to-date on most or all routinely recom- mended vaccines for their age compared to those who reported their children were up-to-date on some or no vaccines (63.7%, 57.3%, and 26.0%, respectively). 3.7.3. Exposure to COVID-19 Level of exposure to COVID-19 was assessed using three proxy measures – role in the hospital, area of employment within the hospital, and number of confirmed COVID-19 exposures at work, B.J. Kuter, S. Browne, F.M. Momplaisir et al. Vaccine 39 (2021) 1693–1700 home, and/or elsewhere. First, clinical roles involving direct patient care (including, but not limited to physicians, nurses, paramedics, phlebotomists, and emergency medical technicians) were com- pared to those with some patient interaction (such as dieticians, social workers, and environmental services) and nonclinical roles with no direct patient interaction (such as pharmacists, research staff, or administrative staff). Vaccine acceptance was similar for those in hospital roles with direct patient interaction and those in nonclinical roles with no patient interaction (66.0% and 65.6%, respectively), but declined significantly for those with some patient interactions (50.0%). Second, the area of employment within the hospital was assessed with those having a high level of exposure to COVID-19 (including persons working in a COVID- 19 unit, emergency room [ER], or intensive care unit [ICU]) com- pared with persons with a moderate or low level of exposure to COVID-19 in their daily work. The level of exposure to COVID-19 based on area of employment in the hospital played no role in intention to be vaccinated (66.4% of those with high level of expo- sure, 64.6% with moderate exposure, and 65.7% with low expo- sure). Third, there were no differences in the proportion of respondents intending to be vaccinated by number of reported exposures to persons with COVID-19 at work, home, or elsewhere (64.4% for those who reported �5 exposures, 64.1% for those reporting 1–4 exposures, and 64.9% for those who reported no exposures). A lower proportion (61.0%) of those who were unsure of their exposures planned to be vaccinated. Employees were also asked if they had ever been tested to see if they had an ongoing COVID-19 infection. Those who had been tested for COVID-19 were more likely planning on being vacci- nated compared to those who had never been tested (69.4% vs 61.2%, respectively). 3.8. Multiple logistic regression analysis - intention to be vaccinated Table 4 presents the results of the multiple logistic regression analysis that includes the 11 variables that were found to be signif- icantly associated with employee intention to be vaccinated in uni- variate analysis (as shown in Table 3). Several demographic characteristics (race/ethnicity, gender, age, education, and area of residence) as well as self-health assessment, vaccination history, level of patient care, and prior COVID-19 testing remained inde- pendently associated with an employee’s intention to be vacci- nated when controlling for all other variables. The likelihood of intending to be vaccinated was lower among Blacks (OR: 0.23, 95% CI 0.19, 0.27), Hispanics (OR: 0.51, 95% CI 0.39, 0.67), and those reporting multiple/other races (OR: 0.58, 95% CI 0.47, 0.73) com- pared to Whites. The likelihood of intending to be vaccinated was twice as high among males compared to females (OR: 2.41, 95% CI 2.12, 2.75). Adults � 65 years of age were 3.5 times more likely planning to be vaccinated compared with those <40 years of age (OR: 3.50, 95% CI 2.50, 4.90). Employees with a postgraduate degree were > 4 times more likely planning to be vaccinated than
persons with less than a bachelor’s degree (OR: 4.59, 95% CI 3.83,
5.50). The likelihood of intending to be vaccinated was lower
among persons in poor or fair health compared with those in excel-
lent …

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You have to be 100% sure of the quality of your product to give a money-back guarantee. This describes us perfectly. Make sure that this guarantee is totally transparent.

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Zero-plagiarism guarantee

The Product ordered is guaranteed to be original. Orders are checked by the most advanced anti-plagiarism software in the market to assure that the Product is 100% original. The Company has a zero tolerance policy for plagiarism.

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Free-revision policy

The Free Revision policy is a courtesy service that the Company provides to help ensure Customer’s total satisfaction with the completed Order. To receive free revision the Company requires that the Customer provide the request within fourteen (14) days from the first completion date and within a period of thirty (30) days for dissertations.

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Privacy policy

The Company is committed to protect the privacy of the Customer and it will never resell or share any of Customer’s personal information, including credit card data, with any third party. All the online transactions are processed through the secure and reliable online payment systems.

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Fair-cooperation guarantee

By placing an order with us, you agree to the service we provide. We will endear to do all that it takes to deliver a comprehensive paper as per your requirements. We also count on your cooperation to ensure that we deliver on this mandate.

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Calculate the price of your order

550 words
We'll send you the first draft for approval by September 11, 2018 at 10:52 AM
Total price:
$26
The price is based on these factors:
Academic level
Number of pages
Urgency

Order your paper today and save 15% with the discount code HAPPY

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Feel free to ask questions, clarifications, or discounts available when placing an order.