Background: Essential workforce members such as those employed by hospitals were among the first populations to be offered the Emergency Use Authorized COVID-19 vaccines. Factors and the psychological drivers associated with vaccine hesitancy have not been well characterized for this population pre-vaccine rollout. Methods: To this extent, we performed a cross-sectional survey conducted from September through December 2020 at Los Angeles County USC Hospital to assess vaccine hesitancy. Adult employees with both non-patient roles and patient roles were included in this study. A total of 1327 participants were enrolled in the study with 1235(96%) completing the survey. Hierarchical logistic regression models were constructed to predict our outcome variable of vaccine hesitancy. Demographic factors and attitudes about the hypothetical COVID-19 vaccine were included in our hierarchical logistic models. Attitudes were assessed based on 7-point Likert-type questions developed utilizing the Health Belief Model constructs of perceived susceptibility, threat, and self-efficacy. We included the California-based Healthy Places Index as a community-level variable to assess the influence Social Determinates of Health have on vaccine hesitancy. Results: A total of 1327 healthcare workers participated. Based on expressed COVID-19 vaccine intent, 78% were categorized as vaccine acceptors and 22% as vaccine-hesitant. In our multivariable model, factors associated with vaccine hesitancy are Female gender [OR = 2.09; (CI 1.44–3.05, p = 0.001)], African American [OR = 4.32; (CI 2.16–8.62, p ≤ 0.001)] or LatinX [OR = 2.47; (CI 1.51–4.05, p = 0.01)] race, and a history of not or sometimes receiving Influenza vaccination (OR = 4.39; (CI 2.98–6.48), p ≤ 0.001). Conclusions: Vaccine hesitancy was associated with unique factors. These factors are female gender, identifying as African American or LatinX, and a history of not or sometimes receiving the Influenza vaccination. Among employees of a large urban safety net hospitable, COVID-19 vaccine hesitancy was associated with demographic factors and Influenza vaccination history but was not associated with the psychological based constructs of perceived susceptibility, threat, and self-efficacy. The results of our study contribute to a better understanding of drivers of vaccine hesitancy that can be targeted for public health initiatives designed to increase vaccine uptake.
","abstract_html":"<p>Background: Essential workforce members such as those employed by hospitals were among the first populations to be offered the Emergency Use Authorized COVID-19 vaccines. Factors and the psychological drivers associated with vaccine hesitancy have not been well characterized for this population pre-vaccine rollout. Methods: To this extent, we performed a cross-sectional survey conducted from September through December 2020 at Los Angeles County USC Hospital to assess vaccine hesitancy. Adult employees with both non-patient roles and patient roles were included in this study. A total of 1327 participants were enrolled in the study with 1235(96%) completing the survey. Hierarchical logistic regression models were constructed to predict our outcome variable of vaccine hesitancy. Demographic factors and attitudes about the hypothetical COVID-19 vaccine were included in our hierarchical logistic models. Attitudes were assessed based on 7-point Likert-type questions developed utilizing the Health Belief Model constructs of perceived susceptibility, threat, and self-efficacy. We included the California-based Healthy Places Index as a community-level variable to assess the influence Social Determinates of Health have on vaccine hesitancy. Results: A total of 1327 healthcare workers participated. Based on expressed COVID-19 vaccine intent, 78% were categorized as vaccine acceptors and 22% as vaccine-hesitant. In our multivariable model, factors associated with vaccine hesitancy are Female gender [OR = 2.09; (CI 1.44–3.05, p = 0.001)], African American [OR = 4.32; (CI 2.16–8.62, p ≤ 0.001)] or LatinX [OR = 2.47; (CI 1.51–4.05, p = 0.01)] race, and a history of not or sometimes receiving Influenza vaccination (OR = 4.39; (CI 2.98–6.48), p ≤ 0.001). Conclusions: Vaccine hesitancy was associated with unique factors. These factors are female gender, identifying as African American or LatinX, and a history of not or sometimes receiving the Influenza vaccination. Among employees of a large urban safety net hospitable, COVID-19 vaccine hesitancy was associated with demographic factors and Influenza vaccination history but was not associated with the psychological based constructs of perceived susceptibility, threat, and self-efficacy. The results of our study contribute to a better understanding of drivers of vaccine hesitancy that can be targeted for public health initiatives designed to increase vaccine uptake.</p>","abstract_has_math":false,"creators":["Kupferwasser, Deborah"],"institution":null,"degree_name":"Public Health, DPH","degree_level":"Restricted to Claremont Colleges Dissertation","degree_discipline":"School of Community and Global Health","degree_department":null,"school":null,"contributors":["Jay Orr","Bin Xie","Judi Nightingale"],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2022,"date_issued":"2022-01-01T08:00:00Z","date_published":"2022-01-01T08:00:00Z","updated_at":"2026-07-24T01:40:15Z","subjects":["COVID-19","Vaccine Hesitancy"],"languages":[],"rights":[],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"https://scholarship.claremont.edu/cgu_etd/444","outbound_label":"Repository record","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor","label":"Contributor","values":["Jay Orr","Bin Xie","Judi Nightingale"]},{"key":"dc:creator","label":"Author","values":["Kupferwasser, Deborah"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.available","label":"Dc Date Available","values":["2023-07-18T07:00:00Z"]},{"key":"thesis:degree_discipline","label":"Discipline","values":["School of Community and Global Health"]},{"key":"thesis:degree_level","label":"Degree Level","values":["Restricted to Claremont Colleges Dissertation"]},{"key":"thesis:degree_name","label":"Degree Name","values":["Public Health, DPH"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["COVID-19","Vaccine Hesitancy"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["https://scholarship.claremont.edu/cgu_etd/444"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["Background: Essential workforce members such as those employed by hospitals were among the first populations to be offered the Emergency Use Authorized COVID-19 vaccines. Factors and the psychological drivers associated with vaccine hesitancy have not been well characterized for this population pre-vaccine rollout. Methods: To this extent, we performed a cross-sectional survey conducted from September through December 2020 at Los Angeles County USC Hospital to assess vaccine hesitancy. Adult employees with both non-patient roles and patient roles were included in this study. A total of 1327 participants were enrolled in the study with 1235(96%) completing the survey. Hierarchical logistic regression models were constructed to predict our outcome variable of vaccine hesitancy. Demographic factors and attitudes about the hypothetical COVID-19 vaccine were included in our hierarchical logistic models. Attitudes were assessed based on 7-point Likert-type questions developed utilizing the Health Belief Model constructs of perceived susceptibility, threat, and self-efficacy. We included the California-based Healthy Places Index as a community-level variable to assess the influence Social Determinates of Health have on vaccine hesitancy. Results: A total of 1327 healthcare workers participated. Based on expressed COVID-19 vaccine intent, 78% were categorized as vaccine acceptors and 22% as vaccine-hesitant. In our multivariable model, factors associated with vaccine hesitancy are Female gender [OR = 2.09; (CI 1.44–3.05, p = 0.001)], African American [OR = 4.32; (CI 2.16–8.62, p ≤ 0.001)] or LatinX [OR = 2.47; (CI 1.51–4.05, p = 0.01)] race, and a history of not or sometimes receiving Influenza vaccination (OR = 4.39; (CI 2.98–6.48), p ≤ 0.001). Conclusions: Vaccine hesitancy was associated with unique factors. These factors are female gender, identifying as African American or LatinX, and a history of not or sometimes receiving the Influenza vaccination. Among employees of a large urban safety net hospitable, COVID-19 vaccine hesitancy was associated with demographic factors and Influenza vaccination history but was not associated with the psychological based constructs of perceived susceptibility, threat, and self-efficacy. The results of our study contribute to a better understanding of drivers of vaccine hesitancy that can be targeted for public health initiatives designed to increase vaccine uptake.
"]},{"key":"dc:title","label":"Title","values":["Characterization of COVID-19 Vaccine Hesitancy among Essential Workforce Members of a Large Urban Hospital in Los Angeles, CA"]}]}],"canonical_facts":{"dc:contributor":["Jay Orr","Bin Xie","Judi Nightingale"],"dc:creator":["Kupferwasser, Deborah"],"dc:date.available":["2023-07-18T07:00:00Z"],"dc:description.abstract":["Background: Essential workforce members such as those employed by hospitals were among the first populations to be offered the Emergency Use Authorized COVID-19 vaccines. Factors and the psychological drivers associated with vaccine hesitancy have not been well characterized for this population pre-vaccine rollout. Methods: To this extent, we performed a cross-sectional survey conducted from September through December 2020 at Los Angeles County USC Hospital to assess vaccine hesitancy. Adult employees with both non-patient roles and patient roles were included in this study. A total of 1327 participants were enrolled in the study with 1235(96%) completing the survey. Hierarchical logistic regression models were constructed to predict our outcome variable of vaccine hesitancy. Demographic factors and attitudes about the hypothetical COVID-19 vaccine were included in our hierarchical logistic models. Attitudes were assessed based on 7-point Likert-type questions developed utilizing the Health Belief Model constructs of perceived susceptibility, threat, and self-efficacy. We included the California-based Healthy Places Index as a community-level variable to assess the influence Social Determinates of Health have on vaccine hesitancy. Results: A total of 1327 healthcare workers participated. Based on expressed COVID-19 vaccine intent, 78% were categorized as vaccine acceptors and 22% as vaccine-hesitant. In our multivariable model, factors associated with vaccine hesitancy are Female gender [OR = 2.09; (CI 1.44–3.05, p = 0.001)], African American [OR = 4.32; (CI 2.16–8.62, p ≤ 0.001)] or LatinX [OR = 2.47; (CI 1.51–4.05, p = 0.01)] race, and a history of not or sometimes receiving Influenza vaccination (OR = 4.39; (CI 2.98–6.48), p ≤ 0.001). Conclusions: Vaccine hesitancy was associated with unique factors. These factors are female gender, identifying as African American or LatinX, and a history of not or sometimes receiving the Influenza vaccination. Among employees of a large urban safety net hospitable, COVID-19 vaccine hesitancy was associated with demographic factors and Influenza vaccination history but was not associated with the psychological based constructs of perceived susceptibility, threat, and self-efficacy. The results of our study contribute to a better understanding of drivers of vaccine hesitancy that can be targeted for public health initiatives designed to increase vaccine uptake.
"],"dc:identifier":["https://scholarship.claremont.edu/cgu_etd/444"],"dc:subject":["COVID-19","Vaccine Hesitancy"],"dc:title":["Characterization of COVID-19 Vaccine Hesitancy among Essential Workforce Members of a Large Urban Hospital in Los Angeles, CA"],"thesis:degree_discipline":["School of Community and Global Health"],"thesis:degree_level":["Restricted to Claremont Colleges Dissertation"],"thesis:degree_name":["Public Health, DPH"]},"updated_at":"2026-07-24T01:40:15Z"}