COVID-19 Vaccination Acceptance and Hesitancy among Healthcare Workers in Germany

  1. Christopher Holzmann-Littig
  2. Matthias Braunisch
  3. Peter Kranke
  4. Maria Popp
  5. Christian Seeber
  6. Falk Fichtner
  7. Bianca Littig
  8. Javier Carbajo-Lozoya
  9. Christine Allwang
  10. Tamara Frank
  11. Joerg Meerpohl
  12. Bernhard Haller
  13. Christoph Schmaderer

Reviewed by

Read the full article See related articles

Listed in

Log in to save this article

Abstract

Vaccination hesitancy is a threat to herd immunity. Healthcare workers (HCWs) play a key role in promoting Coronavirus disease 2019 (COVID-19) vaccination in the general population. We therefore aimed to provide data on COVID-19 vaccination acceptance/hesitancy among German HCWs. For this exploratory, cross-sectional study, an online survey was conducted in February 2021. The survey included 54 items on demographics; previous vaccination behavior; trust in vaccines, physicians, the pharmaceutical industry and health politics; fear of adverse effects; assumptions regarding the consequences of COVID-19; knowledge about vaccines; and information seeking behavior. Odds ratios with 95% confidence intervals were calculated and chi-square tests were performed. Four thousand five hundred surveys were analyzed. The overall vaccination acceptance was 91.7%. The age group ≤20 years showed the lowest vaccination acceptance. Factors associated with vaccination hesitancy were lack of trust in authorities and pharmaceutical companies. Attitudes among acquaintances were associated with vaccination hesitancy too. Participants with vaccination hesitancy more often obtained information about COVID-19 vaccines via messenger services or online video platforms and underperformed in the knowledge test. We found high acceptance amongst German HCWs. Several factors associated with vaccination hesitancy were identified which could be targeted in HCW vaccination campaigns.

Article activity feed

  1. Version published to 10.3390/vaccines9070777
  2. ScreenIT

    SciScore for 10.1101/2021.04.20.21255794: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: Approval by the local ethics committee of the medical faculty of Technical University of Munich (41/21 S), data protection officer, hospital board and staff counsel were obtained.
    Consent: Every participant gave informed consent by clicking a checkbox after the information on the study and data protection prior to the survey.
    Sex as a biological variablenot detected.
    RandomizationThe items were not randomized.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    The subgroup of participants working in outpatient nursing services was stronger associated with a COVID-19 vaccination hesitancy with the caveat of a low number of participants in this subgroup. This might be due to the fact that most vaccine campaigns took place in hospitals and by health care providers, leading to the assumption that these workers were better informed. Working with COVID-19 patients was not associated with acceptance to receive a COVID-19 vaccine, except in HCW with less than 50% occupation with COVID-19 patients. This might be explained by the consideration of a perceived higher transmission risk in the family setting than in the professional setting where personal protective equipment and strict testing of patients and staff is used routinely, especially in COVID-19 treatment units, where HCWs treat COVID-19 patients on a daily basis. Also, it could be speculated that HCW in German hospitals were sufficiently supplied with professional protective equipment and therefore the threat of becoming infected with COVID-19 was judged lower (41). The number of correct answers in the four COVID-19 vaccine knowledge questions was significantly associated with vaccination acceptance providing a direct starting point for informational campaigns. To test whether improving knowledge about COVID-19 vaccines is a modifiable risk factor leading to higher vaccination acceptance is recommended for further studies. It is not surprising that prior adverse effects to vaccines ...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2021.04.20.21255794v1 on medRxiv