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Nearly a Third of Hospital Personnel Remained Unvaccinated in COVID-19 Study

For hospital pharmacists, who have worked tirelessly to make sure as many Americans are vaccinated against COVID-19 as possible, one of the most difficult cohorts to convince might be their own co-workers. A new study points out that nearly a third of hospital-based healthcare workers remained unvaccinated as of mid-September. Here are more details.

ATLANTA – Nearly a third of healthcare personnel in more than 2,000 U.S. hospitals weren’t vaccinated by mid-September, according to a new study.

The analysis from the national Centers for Disease Control and Prevention includes data from 3.3 million HCP and is considered the most comprehensive assessment of vaccination rates in that cohort as of now.

Past research has found that pharmacists, as well as physicians, have very high vaccination rates, but the rates among nurses, and especially aides, are considerably lower.

The report in the American Journal of Infection Control found that vaccination rates increased from 36% to 60% in just four months between January and April 2021, but then decelerated, at least until August, only reaching 70% by September 2021. The highest vaccination rates were among HCP in children’s hospitals and metropolitan counties.

“Our analysis revealed that vaccine coverage among U.S. hospital-based HCP stalled significantly after initial uptake,” said lead author Hannah Reses, MPH, a member of the CDC team that conducted the analysis. “Additional efforts are needed now to improve HCP vaccine coverage and reduce the risk of SARS-CoV-2 transmission to patients and other hospital staff.”

Data used in the study were voluntarily reported to the Department of Health and Human Services (HHS) Unified Hospital Data Surveillance System on COVID-19 vaccination coverage among hospital-based HCP between Jan. 20, 2021, and Sept.15, 2021.

Of the 5,085 children’s hospitals, short-term acute care hospitals (ACH), long-term ACH, and critical access hospitals in the system, 2,086 reported data on HCP vaccination coverage and total personnel numbers and met specific analysis validation checks.

Because of the number and variety of facilities in the data, researchers were able to assess vaccination rates by hospital type and the characteristics of the county in which the hospitals are located, such as rural vs. metropolitan.

“Highest vaccination coverage was observed among HCP in children's hospitals (77.0%; 95% CI: 76.8, 77.3) followed by HCP in short-term ACH (70.1%; 95% CI: 70.1, 70.2), long-term ACH (68.8%; 95% CI: 68.2, 69.3), and critical access hospitals (64.0%; 95% CI: 63.8, 64.3),” the authors write. “Coverage was higher among HCP working in facilities located in metropolitan counties (71.0%; 95% CI: 70.9, 71.0), followed by HCP working in facilities located in rural counties (65.1%; 95% CI: 64.8, 65.3), and HCP working in non–metropolitan urban counties (63.3%; 95% CI: 63.1, 63.5).”

The study points out that, while vaccination coverage increased just 5% from April to August 2021, it jumped another 5% in just one month from August to September. The authors posit that the notable increase likely was related to rising COVID-19 rates associated with the Delta variant or vaccination mandates implemented at some facilities.

The authors suggest that the higher COVID-19 vaccination coverage among children's hospital-based HCP, even after controlling for the effects of urbanicity and state, might relate to stronger expectations around employee vaccination or greater emphasis placed on preventing transmission to patients in children's hospitals because patients 12 and younger remained ineligible for vaccination then.

“Additional efforts are needed to improve COVID-19 vaccine coverage among HCP, such as educational and promotional activities, communication efforts to address misinformation, and providing paid time off to receive the vaccine,” the authors conclude.