KFF COVID-19 Vaccine Monitor: Vaccine Attitudes Among Essential Workers

The KFF COVID-19 Vaccine Monitor is an ongoing research project tracking the public’s attitudes and experiences with COVID-19 vaccinations. Using a combination of surveys and qualitative research, this project tracks the dynamic nature of public opinion as vaccine development and distribution unfold, including vaccine confidence and acceptance, information needs, trusted messengers and messages, as well as the public’s experiences with vaccination.

Overview

There has been little research on how essential workers not employed in the health care sector have been impacted by the pandemic and their views on and experiences with COVID-19 vaccines. According to estimates from the latest KFF COVID-19 Vaccine Monitor, these workers make up about three in ten of the total U.S. adult population. These workers are those whose work requires them to work outside of the home during the pandemic, and many of them perform crucial jobs that Americans depend on, such as factory or warehouse work, delivery drivers, construction jobs, school and childcare center workers, retail jobs such as grocery and hardware store clerks among other jobs.

This analysis of the March KFF COVID-19 Vaccine Monitor examines the attitudes of those who identify as essential workers working outside their homes in non-health care settings. Despite many states prioritizing these workers during their vaccine rollouts, when compared to other employed adults these types of essential workers are less eager to get the vaccine right away, and a larger share express opposition to employer mandated vaccination.

Who ARE ESSENTIAL WORKERS?

For this analysis, essential workers are classified as anyone who self-identifies as being required to work full time or part time outside their home during the coronavirus outbreak. This analysis excludes essential workers employed in health care settings, a group discussed in the KFF/Washington Post Frontline Health Care Worker Survey. Essential workers in non-health care settings report working in a variety of different types of jobs including office jobs (16%), factories and warehouses (15%), delivery or transportation jobs (10%), retail (10%), schools and childcare centers (7%), construction (7%), and food service (6%). The remaining essential workers are employed in other settings such as house cleaners, landscapers, plumbers, and home maintenance workers (4%), or working at farm, garden, or agricultural sites (2%).

Compared to employed adults working from their homes, those identifying as essential workers are disproportionately male (63% vs. 52%), of Hispanic ethnicity (22% vs. 13%), and have less than a college degree (74% vs. 41%). Four in ten (39%) in this group also identify as either Republican or Republican-leaning independents compared to about a quarter (26%) of other employed adults.

About one-third (34%) of essential workers say they know someone who has died from the coronavirus and 64% know someone who tested positive for the disease. Another 13% of essential workers report that they themselves tested positive for the coronavirus (compared to 6% of adults employed in non-essential jobs).

Attitudes Towards COVID-19 Vaccination

As of mid-March, roughly half (48%) of essential workers say they have already received at least one dose of the COVID-19 vaccine or will get a vaccine as soon as they can. This is a lower share than the nearly 7 in 10 workers employed in other professions (69%) and among adults without jobs (67%), despite the fact that most states prioritized these populations early during vaccine distribution.

About one in five essential workers (19%) say they will “wait and see” how the vaccine is working for others before getting vaccinated themselves, the same share as among those who are employed in non-essential jobs. However, essential workers are more likely than those who are doing their jobs from home to say they will get the vaccine “only if required” (11% vs. 3%) or that they will “definitely not” get vaccinated (21% vs. 7%).

Differences between demographic groups among essential workers

As with the public overall, partisanship plays a role in vaccination intentions among essential workers. Four in ten (40%) of Republican and Republican-leaning essential workers say they will “definitely not” get vaccinated, compared to just 5% of Democratic-leaning essential workers who say the same. Three-fourths (74%) of Democratic or Democratic-leaning essential workers say they’ve already been vaccinated or will get the vaccine as soon as possible compared to about three in ten (29%) Republican or Republican-leaning essential workers. By race and ethnicity, opposition to the vaccine is highest among White essential workers, with about a quarter (26%) saying they will definitely not get the vaccine compared to 7% of Black and 11% of Hispanic essential workers.

Similarly, essential workers’ opinions about the coronavirus vaccine show deep divides by education. Essential workers without college degrees are less likely than college graduates to say they have already gotten the vaccine or will get it as soon as they can. Among those with less than a college degree, 42% say they have already gotten the vaccine or will do so as soon as possible compared to two-thirds (66%) of those with a college education. Across income levels, roughly half (Household income under $40K: 47%, $40K-$89.9K: 48%, $90K+: 47%) of essential workers had already received a vaccine or plan to get one as soon as they can.

Although there are divides among essential workers in their attitudes towards the vaccine by party, race, and education, the demographics of essential workers cannot fully account for the lower enthusiasm for the vaccine among essential workers. A statistical analysis using the technique of multiple regression shows that even after controlling for demographic factors such as party, age, gender, education, race, income, ideology, and experience with contracting the coronavirus, essential workers remain more likely than non-essential workers to say they will “definitely not” get the vaccine. However, this analysis shows among these factors, the strongest predictors of vaccine intentions are party identification and political ideology.

VACCINE CONCERNS, ELIGIBILITY AND INFORMATION ABOUT WHERE TO BE VACCINATED

Among those who are not yet vaccinated and do not plan to get the vaccine as soon as they can, two-thirds (66%) are concerned about the possibility of experiencing serious side effects from the vaccine. In addition, essential workers express several work-related concerns about the COVID-19 vaccine. Majorities of these workers are very or somewhat concerned that they will be required to get vaccinated even if they don’t want to (63%), and about half (53%) are concerned they may have to miss work if they experience side effects from the vaccine.

This analysis also finds that substantial shares of essential workers are not sure where they can be vaccinated or aren’t sure whether they are currently eligible to receive the vaccine. Among unvaccinated essential workers, roughly 3 in 10 (31%) say they do not have enough information about where they will be able to get a vaccine and nearly 4 in 10 (39%) are not sure whether they are currently eligible to receive the vaccine in their state.

Among essential workers, education and income sharply divide understanding of where to get a coronavirus vaccine. Over one-third (37%) of unvaccinated essential workers without a college degree and 7% of college educated workers say they do not know where to get a COVID-19 vaccine. Among lower income essential workers (those with household incomes under $40,000), 45% say they do not have enough information about where they will be able to get a vaccine, compared to one quarter among those with incomes $40,000 and over.

As with knowledge of where to get a vaccine, uncertainty about current eligibility shows stark divides by education, ethnicity, and income. Unvaccinated essential workers without a college education express greater uncertainty about whether they are currently eligible to receive a vaccine, with 44% of essential workers without college educations saying they do not know whether they are eligible compared to 16% of college educated essential workers. Hispanic essential workers who are unvaccinated are also more likely to express doubt about whether they are eligible to receive a vaccine: half (53%) of unvaccinated Hispanic workers do not know whether they are eligible compared to three in ten (31%) unvaccinated White essential workers. A higher share of low-income essential workers are not sure whether they are eligible to receive the vaccine than essential workers with higher incomes; a 58% majority of those with household incomes under $40,000 are not sure whether they are eligible, compared to three in ten (30%) essential workers in households earning $40,000 or more. Uncertainty about vaccine eligibility may be mitigated moving forward now that all people ages 16 and older are eligible to receive a vaccine nationwide as of April 19.

Employer policies THAT MIGHT INCREASE VACCINATION UPTAKE

The latest COVID-19 Vaccine Monitor tested several policies that employers could implement to increase vaccination uptake among their workers. The hypothetical policies tested may be helpful to convert some unvaccinated essential workers to getting vaccinated. For example, roughly one-quarter (23%) of essential workers who are not convinced to get vaccinated right away say they would be more likely to get the vaccine if a medical provider came to their work to administer the shot.

Financial incentives also may convince some essential workers to get the vaccine. About one in five (19%) non-health essential workers who are not yet convinced to get the vaccine as soon as possible say they would be more likely to get the vaccine if their employer offered them $50 to get it, a share that increased slightly to 22% if the incentive was raised to $200.

EMPLOYER MANDATED VACCINATION

A 57% majority of non-health care essential workers say employers should not be allowed to require certain employees to get vaccinated for COVID-19. Opposition among essential workers is higher than among non-essential workers (42%) and those who are not currently employed (36%). Currently, employers can mandate vaccinations for their employees except under specific circumstances that conflict with federal law. However, a number of states have pending legislation that address vaccine mandates which may limit employer mandated vaccination on a state-by-state basis.

Views on employer mandates are divided along partisan lines among essential workers as they are among the general public. Nearly 8 in 10 (79%) Republican and Republican leaning essential workers oppose employer required vaccinations while about two-thirds (65%) of Democratic leaning workers support such mandates.

This KFF COVID-19 Vaccine Monitor was designed and analyzed by public opinion researchers at the Kaiser Family Foundation (KFF). The survey was conducted March 15-22, 2021, among a nationally representative random digit dial telephone sample of 1,862 adults ages 18 and older (including interviews from 476 Hispanic adults and 490 non-Hispanic Black adults), living in the United States, including Alaska and Hawaii (note: persons without a telephone could not be included in the random selection process). Phone numbers used for this study were randomly generated from cell phone and landline sampling frames, with an overlapping frame design, and disproportionate stratification aimed at reaching Hispanic and non-Hispanic Black respondents. Stratification was based on incidence of the race/ethnicity subgroups within each frame. Specifically, the cell phone frame was stratified as: (1) High Hispanic: Cell phone numbers associated with rate centers from counties where at least 35% of the population is Hispanic; (2) High Black: Cell phone numbers associated with remaining rate centers from counties where at least 35% of the population is non-Hispanic Black; (3) Else: numbers from all remaining rate centers. The landline frame was stratified as: (1) High Black: landline exchanges associated with Census block groups where at least 35% of the population is Black; (2) Else: all remaining landline exchanges. The sample also included 190 respondents reached by calling back respondents that had previously completed an interview on the KFF Health Tracking Poll at least nine months ago. Another 402 interviews were completed with respondents who had previously completed an interview on the SSRS Omnibus poll (and other RDD polls) and identified as Hispanic (n = 178; including 63 in Spanish) or non-Hispanic Black (n=224). Computer-assisted telephone interviews conducted by landline (356) and cell phone (1,506, including 1,093 who had no landline telephone) were carried out in English and Spanish by SSRS of Glen Mills, PA. To efficiently obtain a sample of lower-income and non-White respondents, the sample also included an oversample of prepaid (pay-as-you-go) telephone numbers (25% of the cell phone sample consisted of prepaid numbers) Both the random digit dial landline and cell phone samples were provided by Marketing Systems Group (MSG). For the landline sample, respondents were selected by asking for the youngest adult male or female currently at home based on a random rotation. If no one of that gender was available, interviewers asked to speak with the youngest adult of the opposite gender. For the cell phone sample, interviews were conducted with the adult who answered the phone. KFF paid for all costs associated with the survey.

The combined landline and cell phone sample was weighted to balance the sample demographics to match estimates for the national population using data from the Census Bureau’s 2019 U.S. American Community Survey (ACS), on sex, age, education, race, Hispanic origin, and region, within race-groups, along with data from the 2010 Census on population density. The sample was also weighted to match current patterns of telephone use using data from the January- June 2020 National Health Interview Survey and to adjust for non-response bias, predominantly in the callback sample frames, on health insurance coverage, registered voter status, age, and reported vaccination rates (based on the non-callback RDD sample). The weight takes into account the fact that respondents with both a landline and cell phone have a higher probability of selection in the combined sample and also adjusts for the household size for the landline sample, and design modifications, namely, the oversampling of prepaid cell phones and likelihood of non-response for the re-contacted sample. All statistical tests of significance account for the effect of weighting.

The margin of sampling error including the design effect for the full sample is plus or minus 3 percentage points. Numbers of respondents and margins of sampling error for key subgroups are shown in the table below. For results based on other subgroups, the margin of sampling error may be higher. Sample sizes and margins of sampling error for other subgroups are available by request. Note that sampling error is only one of many potential sources of error in this or any other public opinion poll. Kaiser Family Foundation public opinion and survey research is a charter member of the Transparency Initiative of the American Association for Public Opinion Research.

This work was supported in part by grants from the Chan Zuckerberg Initiative DAF (an advised fund of Silicon Valley Community Foundation), the Ford Foundation, and the Molina Family Foundation. We value our funders. KFF maintains full editorial control over all of its policy analysis, polling, and journalism activities.