Dynamics of Covid-19 Vaccine-Hesitancy among Primary Health Care Workers in an Urban City in India

Background: The health care workers (HCWs) were one of the vulnerable populations prioritized during the Covid-19 vaccination (COVISHIELD and COVAXIN) campaign. They are also the first point of contact for vaccine-related information and therefore, play a crucial role in shaping peoples vaccine seeking behaviour. Objectives: (i) To estimate the proportion of Covid-19 vaccine hesitancy among HCWs in urban primary health care centres (UPHC) across Hyderabad; and (ii) To explore factors influencing vaccine hesitancy and vaccine acceptance in this population. Methods: A cross-sectional study was conducted among 238 HCWs from 21 urban health centres in Hyderabad between June and July 2021. The prevalence of vaccine hesitancy was assessed using the questions adapted from the UNICEF Guyana Covid-19 Vaccination Hesitancy Survey. We used the SAGE determinants of vaccine hesitancy to determine factors underlying vaccine hesitancy and acceptance. Results: The prevalence of vaccine hesitancy among HCWs was 17% (12.3% -22.2%) during the 6 months following emergency vaccine approval. Self-protection, Vaccine-confidence, and Responsibility towards the general population were some of the reasons in favour of Covid-19 vaccination. Whereas Vaccine-safety has emerged as the primary determinant of vaccine-hesitancy in this population. HCWs were susceptible to misinformation in the social media and in their communities, which might have shaped their opinion about the vaccines for the Covid-19. Conclusion: Although the COVID-19 vaccines (COVISHIELD and COVAXIN) were approved for administration by the Drugs Controller General of India, one in every six HCWs working in the UPHCs in Hyderabad, India had either refused or delayed vaccinations mainly due to limited information on vaccine-safety. This highlights a critical need to address the vaccine-hesitancy among HCWs (especially during the initial phases of novel vaccine introduction), as similar behaviour of the HCWs towards novel vaccines could affect the uptake of these vaccines among the general population (which they serve).