CDC Study Might Nudge Vaccine Hesitant Health Care Workers

One of the more frustrating roadblocks for infection preventionists (IPs) and medical experts in a return to normal in the United States—vaccine hesitancy among health care professionals—was met head-on in a study by the Centers for Disease Control and Prevention (CDC) that demonstrates just how much protection vaccination affords those workers.

The study states that mRNA COVID-19 vaccines reduced the risk of getting sick with COVID-19 by 94% among health care personnel who were fully vaccinated. “This report provided the most compelling information to date that COVID-19 vaccines were performing as expected in the real world,” CDC Director Rochelle Walensky, MD, MPH, said in a press release. “This study, added to the many studies that preceded it, was pivotal to CDC changing its recommendations for those who are fully vaccinated against COVID-19.”

The assessment compared vaccination status of health care professional (HCP) participants who tested positive for SARS-CoV-2, the virus that causes COVID-19 (cases) with vaccination status of those HCPs who tested negative (controls). Among the 1843 participants, there were 623 cases and 1220 controls. Vaccine effectiveness estimates were calculated by comparing the odds of COVID-19 vaccination in cases and controls.

The press release announcing the study underscores why vaccination of HCPs remains an important step in society’s return to normal. “Understanding vaccine effectiveness among HCP is important because they are at higher risk for exposure to SARS-CoV-2 through patient interactions,” the CDC press release states. “Vaccination of HCP protects them and their patients against COVID-19 and ensures continuation of critical health care services.”

The study was published in the CDC’s Morbidity and Mortality Weekly Report (MMWR) on May 14. “These interim results demonstrate that complete vaccination with authorized mRNA COVID-19 vaccines is highly effective in preventing symptomatic COVID-19 among HCP, supporting the results of phase III trials and additional accruing evidence in recent observational studies,” the MMWR study states. “Real-world VE [vaccine effectiveness] data are critical to guiding evolving COVID-19 vaccine policy. In addition to adherence to recommended infection control and prevention practices, a critical component of controlling the U.S. COVID-19 pandemic and protecting HCP is ensuring high coverage with safe and effective COVID-19 vaccines.”

The study responds to HCP concerns raised in a recent study in the American Journal of Infection Control (and summarized in Infection Control Today®) that states that vaccine hesitant HCPs want more data before they get inoculated. Specifically, many of those vaccine hesitant HCPs in the AJIC study want to see how their colleagues faired before taking the plunge themselves, and the study stated “that many who hesitate or refuse vaccination initially, could accept vaccination in the future, providing that their reasons for hesitancy are alleviated.”

The ramifications of vaccine hesitancy among health care workers reach far beyond the hospital walls. HCPs “are not only among the first to be vaccinated in most jurisdictions, but they are also role models for the general public, therefore their acceptance and recommendation may influence hesitant members of the general population to eventually accept vaccination,” the AJIC study states. “It is thus crucial that we address barriers to vaccine acceptance in this group. Our findings suggest that providing more information on the safety and efficacy of the new vaccines and promoting positive peer influence could be key in addressing the major concerns of the HCWs who hesitate to be vaccinated.”

As Kevin Kavanagh, MD, a member of ICT®’s Editorial Advisory Board (EAB) put it recently: “It’s hard to convince a patient to become vaccinated when they were just escorted to the room with a nurse who did not have the vaccine.”

In an interview in February, Rebecca Leach, RN, BSN, MPH, CIC, also an ICT® EAB member, explained how IPs should gently try to convince their health care colleagues of the importance of getting the COVID-19 vaccine. Leach said that “mostly, it’s the concerns about safety that I hear, because it is an emergency use authorization. It hasn’t been around for very long. So, I just try to explain to them that the findings, the studies, the research … that it was done in an ethical way, and that this is what we know. And so far, the safety has been shown to be really good. There have not been major safety issues, especially as time goes on, and more people get vaccinated. I think that helps people because I keep telling them, ‘It’s being studied, even now, as people have been vaccinated.’”

As Leach said, the safety and efficacy of the vaccines continue to be studied. The CDC just proved that.