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To evaluate coronavirus disease 2019 (COVID-19) vaccine hesitancy among healthcare personnel (HCP) with significant clinical exposure to COVID-19 at 2 large, academic hospitals in Philadelphia, Pennsylvania.
Design, setting, and participants:
HCP were surveyed in November–December 2020 about their intention to receive the COVID-19 vaccine.
Methods:
The survey measured the intent among HCP to receive a COVID-19 vaccine, timing of vaccination, and reasons for or against vaccination. Among patient-facing HCP, multivariate regression evaluated the associations between healthcare positions (medical doctor, nurse practitioner or physician assistant, and registered nurse) and vaccine hesitancy (intending to decline, delay, or were unsure about vaccination), adjusting for demographic characteristics, reasons why or why not to receive the vaccine, and prior receipt of routine vaccines.
Results:
Among 5,929 HCP (2,253 medical doctors [MDs] and doctors of osteopathy [DOs], 582 nurse practitioners [NPs], 158 physician assistants [PAs], and 2,936 nurses), a higher proportion of nurses (47.3%) were COVID-vaccine hesitant compared with 30.0% of PAs and NPs and 13.1% of MDs and DOs. The most common reasons for vaccine hesitancy included concerns about side effects, the newness of the vaccines, and lack of vaccine knowledge. Regardless of position, Black HCP were more hesitant than White HCP (odds ratio [OR], ∼5) and females were more hesitant than males (OR, ∼2).
Conclusions:
Although most clinical HCP intended to receive a COVID-19 vaccine, intention varied by healthcare position. Consistent with other studies, hesitancy was also significantly associated with race or ethnicity across all positions. These results highlight the importance of understanding and effectively addressing reasons for hesitancy, especially among frontline HCP who are at increased risk of COVID exposure and play a critical role in recommending vaccines to patients.
As of 2016, almost all states retain religious exemption statutes related to childhood vaccination and school immunization, part of a larger movement to accommodate devout believers whose faith requires their undivided conviction in the healing powers of a higher being. For strict adherents, this manifests itself in the form of “prayer healing.” This chapter offers arguments explaining why religious exemptions undermine the state’s legitimate interest in the well-being of its most vulnerable citizens—children. The chapter explores certain idiosyncratic influences that compel believers to withhold modern medicine for their ill-child, summarizes instances where a child, under the care of well-intentioned but ultimately negligent parents, is refused life-saving treatment, and documents instances where the child’s life could have been saved, but for the parent’s insistence on prayer-healing. The chapter also recommends repealing state statutes that provide medical exemptions for faith healing parents intent on praying for, rather than treating, their sick child, since such laws contravene the child’s fundamental right to life.
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