Understanding factors associated with COVID-19 vaccination among health care workers using the Diffusion of Innovation Theory

Gail C D'Souza; Casey N Pinto; Cara L Exten; Jessica M Yingst; Jonathan Foulds; Jocelyn Anderson; Rachel Allen; William A Calo

doi:10.1016/j.ajic.2023.11.019

Understanding factors associated with COVID-19 vaccination among health care workers using the Diffusion of Innovation Theory

Am J Infect Control. 2024 May;52(5):509-516. doi: 10.1016/j.ajic.2023.11.019. Epub 2024 Jan 11.

Authors

Gail C D'Souza¹, Casey N Pinto², Cara L Exten³, Jessica M Yingst², Jonathan Foulds⁴, Jocelyn Anderson³, Rachel Allen³, William A Calo⁵

Affiliations

¹ Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA.
² Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA; Penn State Cancer Institute, Cancer Control Program, Hershey, PA.
³ Penn State Ross and Carol Nese College of Nursing, Penn State University, University Park, PA.
⁴ Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA; Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, PA; Penn State Cancer Institute, Cancer Control Program, Hershey, PA.
⁵ Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA; Penn State Cancer Institute, Cancer Control Program, Hershey, PA. Electronic address: wcalo@pennstatehealth.psu.edu.

PMID: 38218328
DOI: 10.1016/j.ajic.2023.11.019

Abstract

Background: The COVID-19 vaccine was initially offered to frontline health care workers (HCWs), due to the high risk of contracting COVID-19 through occupational exposure to patients. Low HCW vaccine uptake can impact overall community-level vaccine uptake. This study used the Diffusion of Innovation (DOI) Theory to understand factors related to COVID-19 vaccine uptake in HCWs.

Methods: We surveyed Pennsylvanian HCWs (excluding Philadelphia) from August 2022 to February 2023. Survey questions inquired about demographics, COVID-19 vaccination status, reasons for receiving/declining the COVID-19 vaccine, and sources of information about the vaccine.

Results: Participants (n = 3,490) were 85% female, 89% White, and 93% (n = 3,255) reported receiving at least one dose of a COVID-19 vaccine. HCWs were categorized into adopter categories of the DOI Theory: innovators (56%), early adopters (9%), early majority (11%), late majority (7%), and laggards (17%). The major reason that prompted participants to get the vaccine was to protect them against COVID-19 infection (78%), while the major reason for declining the vaccine was due to concern about possible side effects from the vaccine (78%).

Conclusions: We applied the DOI Theory to characterize adopters and identify factors related to COVID-19 vaccine uptake in HCWs. As updated COVID-19 vaccines are approved for the United States market, our findings may be used to improve vaccine education and communication among HCWs to support vaccine uptake.

Keywords: Early adopters; Innovators; Pennsylvania; Vaccine refusal.