Leonard Davis Institute, Division of Occupational Medicine, Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia.
Epidemiology and Biostatistics Research, Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia.
JAMA Netw Open. 2021 Dec 1;4(12):e2136582. doi: 10.1001/jamanetworkopen.2021.36582.
Several COVID-19 vaccines have been authorized in the US, yet preliminary evidence suggests high levels of vaccine hesitancy and wide racial, ethnic, and socioeconomic disparities in uptake.
To assess COVID-19 vaccine acceptance among health care personnel (HCP) during the first 4 months of availability in a large academic hospital, compare acceptance with previously measured vaccine hesitancy, and describe racial, ethnic, and socioeconomic disparities in vaccine uptake.
DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study included 12 610 HCP who were offered COVID-19 vaccination at a major academic hospital in Philadelphia between December 16, 2020, and April 16, 2021.
For each HCP, data were collected on occupational category, age, sex, race and ethnicity (Asian or Pacific Islander, Black or African American [Black], Hispanic, White, and multiracial), and social vulnerability index (SVI) at the zip code of residence.
Vaccine uptake by HCP at the employee vaccination clinic.
The study population included 4173 men (34.8%) and 7814 women (65.2%) (623 without data). A total of 1480 were Asian or Pacific Islander (12.4%); 2563 (21.6%), Black; 452 (3.8%), Hispanic; 7086 (59.6%), White; and 192 (1.6%), multiracial; 717 had no data for race and ethnicity. The mean (SD) age was 40.9 (12.4) years, and 9573 (76.0%) received at least 1 vaccine dose during the first 4 months of vaccine availability. Adjusted for age, sex, job position, and SVI, Black (relative risk [RR], 0.69; 95% CI, 0.66-0.72) and multiracial (RR, 0.80; 95% CI, 0.73-0.89) HCP were less likely to receive vaccine compared with White HCP. When stratified by job position, Black nurses (n = 189; 62.8%), Black HCP with some patient contact (n = 466; 49.9%), and Black HCP with no patient contact (n = 636; 56.3%) all had lower vaccine uptake compared with their White and Asian or Pacific Islander counterparts. Similarly, multiracial HCP with some (n = 26; 52.0%) or no (n = 48; 58.5%) patient contact had lower vaccine uptake. In contrast, Black physicians were just as likely to receive the vaccine as physicians of other racial and ethnic groups.
In this cross-sectional study, more than two-thirds of HCP at a large academic hospital in Philadelphia received a COVID-19 vaccine within 4 months of vaccine availability. Although racial, ethnic, and socioeconomic disparities were seen in vaccine uptake, no such disparities were found among physicians. Better understanding of factors driving these disparities may help improve uptake.
几种 COVID-19 疫苗已在美国获得授权，但初步证据表明，疫苗接种犹豫率较高，且在接受程度上存在广泛的种族、民族和社会经济差异。
评估在一家大型学术医院 COVID-19 疫苗可获得的头 4 个月期间，医护人员（HCP）对 COVID-19 疫苗的接受程度，将其与之前测量的疫苗犹豫程度进行比较，并描述疫苗接种率的种族、民族和社会经济差异。
设计、设置和参与者：本横断面研究纳入了 2020 年 12 月 16 日至 2021 年 4 月 16 日期间在费城一家主要学术医院接受 COVID-19 疫苗接种的 12610 名 HCP。
对于每一位 HCP，数据收集了职业类别、年龄、性别、种族和民族（亚裔或太平洋岛民、黑人和非裔美国人[黑人]、西班牙裔、白人和多种族）以及居住邮政编码的社会脆弱性指数（SVI）。
HCP 在员工疫苗接种诊所的疫苗接种率。
研究人群包括 4173 名男性（34.8%）和 7814 名女性（65.2%）（623 人无数据）。共有 1480 人是亚裔或太平洋岛民（12.4%）；2563 人（21.6%）是黑人；452 人（3.8%）是西班牙裔；7086 人（59.6%）是白人；192 人（1.6%）是多种族；717 人没有种族和民族数据。平均（SD）年龄为 40.9（12.4）岁，在疫苗可获得的头 4 个月期间，9573 人（76.0%）至少接种了 1 剂疫苗。调整年龄、性别、职位和 SVI 后，与白人 HCP 相比，黑人（相对风险 [RR]，0.69；95%CI，0.66-0.72）和多种族（RR，0.80；95%CI，0.73-0.89）HCP 接种疫苗的可能性较低。按职位分层时，黑人护士（n=189；62.8%）、有一定患者接触的黑人 HCP（n=466；49.9%）和无患者接触的黑人 HCP（n=636；56.3%）与白人及亚裔或太平洋岛民相比，疫苗接种率均较低。同样，有一定（n=26；52.0%）或无（n=48；58.5%）患者接触的多种族 HCP 疫苗接种率也较低。相比之下，黑人医生接种疫苗的可能性与其他种族和民族的医生一样。
在这项横断面研究中，费城一家大型学术医院的大多数 HCP 在疫苗可获得的头 4 个月内接种了 COVID-19 疫苗。尽管在疫苗接种率上存在种族、民族和社会经济差异，但在医生中并未发现这种差异。更好地了解推动这些差异的因素可能有助于提高接种率。
