KFF/The Washington Post Frontline Health Care Workers Survey
KFF/Washington Post Frontline Health Care Workers
The latest partnership survey from the Kaiser Family Foundation (KFF) and The Washington Post examines the experiences and attitudes of frontline health care workers during the coronavirus pandemic. More than one year into a global pandemic that has infected almost 29 million Americans including more than 500,000 who have died due to the coronavirus, one of the most directly impacted groups has been frontline health care workers. These individuals, who work across many different health care fields including doctors and nurses, nursing home managers, front desk clerks, as well as those who assist with patient care such as bathing, eating, cleaning, exercising, or housekeeping, have been on the front lines of an industry providing care for the sickest adults. The spread of COVID-19 throughout the country overwhelmed many health care settings with intensive care units at capacity and other facilities struggling to keep both patients and employees safe. Now, with three COVID-19 vaccines currently being distributed to adults across the country, this project takes a look at the toll of the last year on frontline health care workers.
The project includes interviews with a nationally representative sample of 1,327 frontline health care workers (direct contact with patients and their bodily fluids), representing hospitals, doctors’ offices, outpatient clinics, nursing homes and assisted care facilities, and those working in home health care. The sample includes workers who work in many, and multiple, different aspects of patient care including patient diagnosis and treatment (n=636), administrative duties (n=251), and/or assisting with patient care such as bathing, eating, cleaning, exercising, and housekeeping (n=526). The survey also included a comparison survey allowing researchers to compare the group of frontline health care workers to the general population, that included 971 U.S. adults not working as frontline health care workers. For more information about sampling and method of recruitment, see methodology.
This survey is the 35th in a series of surveys dating back to 1995 that have been conducted as a part of The Washington Post/KFF Survey Project.
Vaccine Intentions Among Frontline Health Care Workers
As of early March, just over half (52%) of frontline health care workers say they have received at least one dose of a COVID-19 vaccine, including 42% who have received both doses. This leaves 48% of frontline health care workers who have not yet received a COVID-19 vaccine despite the fact that health care workers who have direct contact with patients were the among the first groups prioritized for vaccine access across all states (NOTE: the survey was fielded February 11- March 7th, 2021, at the start of which both the Pfizer vaccine and Moderna vaccine had already received emergency use authorization from the Food and Drug administration, the Johnson & Johnson single dose vaccine was authorized during the survey field period on February 27, 2021).
Majorities of health care workers working in hospitals (66%) and outpatient clinics (64%) say they have received a COVID-19 vaccine, compared to half of those working doctors’ offices (52%), or in nursing homes or assisted care facilities (50%), and just one in four (26%) home health care workers. Similarly, about seven in ten (68%) of those responsible for patient diagnosis and treatment like a doctor or a nurse report receiving a COVID-19 vaccine, compared to about four in ten of those who perform administrative duties (44%) or who assist with patient care such as bathing, eating, cleaning, exercising, and housekeeping (37%).
Less than half of Black frontline health care workers (39%) and Hispanic frontline health care workers (44%) report personally receiving a COVID-19 vaccine, compared to six in ten (57%) White health care workers, mirroring the disparities found in vaccine uptake rates among the national adult population. While the KFF COVID-19 Vaccine Monitor has found a steady increase in the share of Black adults and Hispanic adults who report being vaccinated for COVID-19 or saying they will get the vaccine as soon as it’s available to them, these populations remain more likely than White adults to say they’re waiting to see how the vaccine works for other people before getting vaccinated themselves.
The unvaccinated group includes one in five frontline health care workers who either have their vaccine scheduled (3%) or who plan to get vaccinated but haven’t scheduled it yet (15%), as well as 12% who have not decided whether they will get vaccinated, and one in five (18%) who say they do not plan on receiving a COVID-19 vaccine. About three in ten (28%) of Black health care workers say they do not plan on getting vaccinated, as do one-fourth of health care workers working in nursing homes or assisted care facilities (24%) or providing patient in-home care (23%), those who assist with patient care (24%), and health care workers without a college degree (24%).
WHY ARE NEARLY HALF OF HEALTH WORKERS NOT VACCINATED? The Role of employers
The role of employers in getting frontline health care workers vaccinated may be a factor for the nearly half of frontline health care workers who say they have not received a COVID-19 vaccine. Reflecting the overall vaccination rates among frontline health care workers, the share of workers who were offered a COVID-19 vaccine from their employer was much lower among those working in patients’ homes. One in three home health care workers (34%) say they have either been offered or received a COVID-19 vaccine from their employer compared to eight in ten of those working in hospitals (80%), and majorities working in nursing homes or assisted care facilities (72%), outpatient clinics (64%), and doctors’ offices (50%).
More than eight in ten (84%) vaccinated health care workers who are not self-employed say they received a COVID-19 vaccine from their employer, including 93% of vaccinated workers who work in a hospital, 90% of those working nursing homes or assisted care facilities, eight in ten of those working doctor’s office (79%) or outpatient clinics (79%), and seven in ten (69%) home health care workers. About one in five (17%) vaccinated health care workers who provide in-home care say they received a COVID-19 vaccine from their state or county health department.
The vast majority of health care workers who were able to get vaccinated through their employer say it was easy to schedule their COVID-19 vaccine, including 70% who say it was “very easy.” On the other hand, four in ten (41%) of the vaccinated health care workers who did not get a vaccine from their employer (16% of all non-self employed vaccinated frontline health care workers) say it was difficult to schedule. The majority of self-employed frontline health care workers had not received a COVID-19 vaccine (61%).
Among those who are not self-employed and have not received a COVID-19 vaccine but are planning to get vaccinated or have a vaccine appointment scheduled, six in ten say they plan on getting it through their employer (60%) while 6% say they were offered it from their employer are planning to get it somewhere else. An additional 28% say they were not offered a COVID-19 vaccine from their employer.
WHY ARE NEARLY HALF OF HEALTH WORKERS NOT VACCINATED? Concerns About Safety And Efficacy
Concerns about vaccine safety and effectiveness are major factors why some frontline health care workers say they have not received a COVID-19 vaccine. Among the nearly half of health care workers who have not received a COVID-19 vaccine, eight in ten say worries about potential side effects (82%) and thinking the vaccine is too new and wanting to wait to see how it works for others (81%) are major factors in their decisions on whether to get vaccinated. In addition, two-thirds (65%) say distrust in the government to ensure safety and effectiveness is a major factor. The concerns of the unvaccinated health care workers mirror the concerns among the general public and highlight challenges for national vaccination adoption.
The top concerns are consistent across key demographic groups, with larger shares saying side effects and newness of the vaccines are major factors in their decision to not get a COVID-19 vaccine than lack of trust in the government (but still a majority say it is a major factor). Notably, three-fourths of Black health care workers who have not received a COVID-19 vaccine (77%) say distrust of the government to ensure safety and effectiveness is a major factor in their decision, compared to smaller shares of White and Hispanic health care workers (60% and 61%).
While large majorities of unvaccinated health care workers say worries about possible side effects are a major factor why they haven’t been vaccinated, few (6%) vaccinated health care workers report experiencing major side effects. The majority of vaccinated health care workers (60%) say they experienced minor side effects and one-third (34%) say they didn’t experience any side effects. The most commonly reported major side effects include pain (4%), headaches (3%), fever (3%), tiredness (3%), and chills (2%). According to the Centers for Disease Control and Prevention, most of these reported side effects would be classified as mild to moderate, and are common.
Majorities of frontline health care workers and the general public are confident that the COVID-19 vaccines available in the U.S. have been tested for safety and effectiveness. More than six in ten are confident vaccines being used in the U.S. have been properly tested for safety and effectiveness (64% and 65%, respectively), but still more than one-third of frontline health care workers say they are not confident (36%). Among health care workers, views on the safety and effectiveness of the vaccines are largely connected to vaccine intent with seven in ten (71%) of those who are confident in the vaccines’ safety and effectiveness reporting receiving at least one dose of a vaccine, compared to 17% of those who are less confident.
Overall confidence in the U.S.’s testing of the vaccines differs among race and ethnic groups, education levels, and partisanship, both among health care workers and the public overall. Large shares of Black adults, adults without a college degree, and Republican and Republican-leaning adults say they are not confident the COVID-19 vaccines have been properly tested for safety and effectiveness. Among frontline health care workers, these groups are also the groups in which one in five say they will definitely not receive a COVID-19 vaccine.
Views of the safety and effectiveness of the vaccine are different among Republican health care workers and total Republican adults at higher levels of education. Seven in ten Republican health care workers with a college degree (69%) and more than eight in ten (85%) Republican health care workers with a post-graduate degree are confident that the vaccines have been properly tested and approved. This is compared to around six in ten of total Republican adults with higher levels of education who are confident.
These differing views of the safety and efficacy of the vaccines may also be related to vaccine intent with majorities of Republican health care workers with a college degree (57%) and a post-graduate degree (69%) say they have received at least one dose of a COVID-19 vaccine, compared to 37% of Republican health care workers with less than a college degree.