Journal article
Modifiable social and structural factors influence COVID-19 vaccine intention among frontline workers in the Midwestern USA: a community-engaged survey study
BMJ public health, Vol.3(1), e000859
01/2025
DOI: 10.1136/bmjph-2023-000859
PMCID: PMC11956395
PMID: 40166606
Abstract
Introduction COVID-19 vaccines have been a crucial measure in the pandemic response, yet vaccine uptake has been variable across the population. We sought to identify social and structural factors associated with COVID-19 vaccine intention among adults in the Midwestern USA who worked in one or more frontline industries during the COVID-19 pandemic.
Methods A community-engaged, cross-sectional online survey study was conducted between May and July 2022 among 889 workers. Guided by Thomas and Penchasky’s 5As theory of access and Thomson et al’s 5As taxonomy of vaccine uptake, we assessed modifiable social and structural factors related to access (transportation and convenient locations), affordability (time and incentives), activation (reminders), acceptability (experiences in a healthcare setting, political confidence and vaccine confidence) and accommodation (language inclusion and flexible appointments). Multinomial logistic regression was used to identify potentially modifiable factors that may influence vaccine intention among more than 200 surveyed workers who had not yet been vaccinated.
Results Workers who intended not to receive the vaccine were at least three times more likely to report transportation challenges, limited time off work and inflexible vaccine appointments compared with those who intended to vaccinate. Interest in financial incentives was strongly endorsed among workers who did not intend to vaccinate and among those who were undecided. Concerns about vaccine safety or side effects did not influence intention, whereas concerns about vaccine effectiveness were more common among workers who did not intend to vaccinate. Mistrust in government leaders was associated with positive vaccine intention.
Conclusions Vaccine intention among frontline workers is strongly influenced by social and structural factors and not solely by hesitancy about the vaccine itself.
Details
- Title: Subtitle
- Modifiable social and structural factors influence COVID-19 vaccine intention among frontline workers in the Midwestern USA: a community-engaged survey study
- Creators
- Precious-Junia de-Winton Cummings - University of IowaCarolina Gonzalez Bravo - University of IowaKimberly C Dukes - University of IowaAloha D Wilks - University of IowaChristopher D Ahlers - University of IowaFernando E Casado Castillo - Department of Internal Medicine, The University of Iowa Roy J and Lucille A Carver College of Medicine, Iowa City, Iowa, USAAndrea Courtney - Akbay Mental Health Counseling Services, PLC, Iowa City, Iowa, USAAlaina N Elliott-Wherry - University of IowaJessica E Knobbe - University of IowaNatalie M Pineiro-Falcon - Department of Occupational and Environmental Health, The University of Iowa College of Public Health, Iowa City, Iowa, USASienna E Schaeffer - University of IowaSarai Tillinghast - Des Moines Public Schools, Des Moines, Iowa, USAEmilio F Tovar - The University of Iowa Roy J and Lucille A Carver College of Medicine, Iowa City, Iowa, USAAneli T Villa - University of IowaMartha L Carvour - Department of Internal Medicine, The University of Iowa Roy J and Lucille A Carver College of Medicine, Iowa City, Iowa, USA
- Resource Type
- Journal article
- Publication Details
- BMJ public health, Vol.3(1), e000859
- DOI
- 10.1136/bmjph-2023-000859
- PMID
- 40166606
- PMCID
- PMC11956395
- NLM abbreviation
- BMJ Public Health
- eISSN
- 2753-4294
- Publisher
- BMJ Publishing Group Ltd
- Grant note
- P3 Grant Program / University of Iowa Strategic Initiatives Fund K12 TR004403; KL2 TR002536; T32 AI007485; T32 GM139776 / National Institutes of Health (http://dx.doi.org/10.13039/100000002)
- Language
- English
- Date published
- 01/2025
- Academic Unit
- Infectious Diseases; Epidemiology; Institute for Public Health Practice, Research and Policy; Fraternal Order of Eagles Diabetes Research Center; General Internal Medicine; Community and Behavioral Health; Internal Medicine
- Record Identifier
- 9984802103702771
Metrics
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