University of Wisconsin–Madison Medical College of Wisconsin

COVID-19 Vaccine Acceptance or Refusal Among US Nurses: A Descriptive Cross-Sectional Study

Jacqueline Christianson, PhD, RN, FNP-C; Norah L. Johnson, PhD, CPNP-PC; Jill Guttormson, PhD, RN; Bonnie Sommers-Olson, DNP; Madaline McCarthy, BS

WMJ. 2023;122(5):399-405

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Introduction: Nurse turnover has accelerated during the COVID-19 pandemic. Nurse refusal of mandated vaccines contributes to understaffing and affects patient health outcomes. The purposes of this study were to describe (1) nurse reasons for COVID-19 vaccine decisions and (2) the relationship between vaccine status and nurse characteristics.

Methods: This cross-sectional descriptive study employed a survey of US nurses who worked in nursing during the COVID-19 pandemic. The survey included a free-text question about COVID-19 vaccine uptake rationale, self-reported vaccine acceptance/refusal, and demographic data.

Results: Of the 1682 participants, 11.2% refused the COVID-19 vaccine. Higher education level was correlated with greater vaccine acceptance rates (P < 0.001). Themes for vaccine rationale included safeguarding well-being, trust in the science, coercion to vaccinate, perceived immunity, and concern about preexisting health conditions.

Conclusions: The risks of COVID-19 vaccine mandates may be greater than the potential benefits given the potential for compounding workforce attrition during a nursing staffing crisis. Further research is needed to outline the relationships between vaccine education, advocacy, and vaccine uptake among nurses.

Author Affiliations: Marquette University College of Nursing, Milwaukee, Wisconsin (Christianson, Johnson, Guttormson, Sommers-Olson, McCarthy).
Corresponding Author: Jacqueline Christianson, PhD, RN, FNP-C, Marquette University College of Nursing, PO Box 1881, Milwaukee WI, 53201; email; ORCID ID 0000-0001-7149-4587
Funding/Support: This study was supported by an internal grant from the Marquette University College of Nursing.
Financial Disclosures: None declared.
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