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Expectations, and fear of side-effects stop social care staff COVID vaccinations

Social care staff felt less expectation from family, friends, colleagues and employers to be vaccinated, and were more concerned than healthcare workers about possible side effects and the safety and effectiveness of the COVID vaccine.

That’s a finding from a report by Public Health Scotland on Frontline health and social care workers’ views and experiences of the COVID-19 vaccination programme in Scotland

The report additionally examines demographics of vaccine take-up in Scotland and found that those who had decided not to take up the vaccine were proportionately more likely to be young, female and social care workers.

Reasons for not being vaccinated centred around worry about long- and short-term side effects; lack of belief of the danger of the virus for them; and issues surrounding pregnancy and fertility. Those who decided not to be vaccinated did not seem to do so because of programme factors: they reported no different satisfaction by invite method, process of making and changing appointments and accessibility of the venue than those who had been vaccinated. In fact, those who decided not to take up the vaccine reported the vaccine as being easier to access than those who did take it up.

Overall, participants found it easy to access the vaccination, with 71.3% of those in health care and 81.3% of those in social care rating access easy or very easy. However, 9.0% of those in health care and 6.2% of those in social care found the vaccine at least difficult to access in their organisation

The most common job groupings who reported that they had not been offered within social care were social care support staff (32.5%).

There were two factors found which were correlated with vaccine offer: age and income, with younger participants and less affluent participants more likely to report they had not been offered the vaccine.  Other reasons why staff believed they had not been offered a vaccine included: because they worked in administrative or management roles that did not have patient/client facing contact (although they worked in offices with colleagues who did); they worked in the third sector and had not been routinely invited through their organisation; they had missed the workplace-based clinic and were now waiting to be invited by age; and because there was no suitable vaccine for them (due to allergies) at the time of the workplace clinic.

Participants who reported that they had not been offered the vaccine were asked whether they planned to take up the vaccine when offered. The majority (90.3%) of healthcare staff stated that they would or were leaning towards yes, while all social care staff who had not been offered reported that they would take up the offer or were leaning towards yes

As with vaccine offer, there was a difference between health and social care staff: 2% of healthcare staff had decided not to take the vaccine compared to 2.9% of social care staff.

 In terms of attitudes to vaccination, almost all believed COVID-19 is deadlier than seasonal flu; that it was important for them to get the vaccine to protect themselves, their families and their patients; that it was important to be vaccinated to get life back to normal; and that they felt well informed about the COVID-19 vaccine.  

Social care respondents were more likely to report they did not know whether COVID-19 vaccines were safe (8.4% compared to 4.8% healthcare respondents) or effective (12.2% v 8.4% healthcare respondents). A greater proportion of social care respondents disagreed with the statements that COVID-19 is deadlier than flu, and that they felt well informed about the COVID-19 vaccine than healthcare respondents.

The report, which includes the views of staff in all Scottish health board areas, makes three recommendations to improve the current COVID-19 and future workforce vaccination programmes:

  • A common definition of ‘frontline health and social care staff’ to ensure parity of access across Scotland. This will be particularly important to avoid confusion around eligibility if flu and COVID-19 vaccines are to be co-administered in autumn 2021
  • Make access to the vaccine as convenient as possible for all eligible staff. This is likely to require a range of different booking options, delivery models and venues to accommodate different working patterns, business needs and personal circumstances. Providing ongoing flexible opportunities for engagement are key to maximising uptake in those who miss or are unable to engage with traditional workplace-based clinics
  • National and local communications that support emerging evidence about the safety and effectiveness of COVID-19 vaccines to support informed consent. Any future policy changes (for example timing of second doses) should be communicated with clear rationale and at the earliest opportunity.
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