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COVID-19 vaccine refusal: study shows pressure from employers has adverse effect

12 May 2021

New research emphasises the importance of voluntary vaccination for health care workers.

Nurse holding vaccine vial

A study looking into factors influencing COVID-19 vaccine uptake among health and social care workers shows those who felt under greater pressure from their employers to receive the vaccine were more likely to decline it. 

Led by the London School of Hygiene and Tropical Medicine in collaboration with the RCN, NHS Race and Health Observatory and Public Health England, the study surveyed nearly 2,000 participants. 

They were asked what level of agreement they had with the statement ‘I feel/felt under pressure from my employer to get a COVID-19 vaccine’ on a 4-point scale from (1) strongly disagree to (4) strongly agree. 

For each additional point of agreement on the scale, participants were 75% more likely to have declined COVID-19 vaccination.

Amongst unvaccinated participants, worrying concerns were raised about how their vaccination decision might impact their job security. For social care workers, pressure was exacerbated by hearing of care sector employers making COVID-19 vaccination mandatory for staff, and the vulnerability of social care worker positions. 

Feeling pressurised had damaging effects, eroding trust and negatively affecting relationships at work, and often exacerbated COVID-19 vaccination concerns and hardened stances on declining vaccination.

The RCN believes all health and social care staff should have the COVID-19 vaccination to help protect themselves, their patients and their friends and family. 

However, we do not believe making vaccination compulsory is the right approach. 

Helen Donovan, RCN Professional Lead for Public Health, said: "We are proud to have worked on this important study to better understand the attitudes, experiences and concerns of health and social care workers to the COVID-19 vaccine rollout.

"As this evidence shows, there are better ways to improve vaccine uptake in staff who have concerns than mandating them. These include support from experienced peers who we know instil confidence in their colleagues.

“We also know that making sure the vaccines are easily accessible during the working day is an essential part of improving uptake.

“Being vaccine hesitant doesn’t mean people will never get the vaccine which is why supportive conversations are also key.”

Read our FAQs on vaccination.

Page last updated - 15/10/2021