Health and care workers who feel under pressure from their employers to get a coronavirus vaccine are more likely to decline a jab, early research suggests.
Feeling pressurised often exacerbated Covid-19 vaccination concerns and hardened stances on declining a jab, according to a survey of 1,917 UK health and social care staff.
Other damaging effects included eroding trust and negatively affecting relationships at work, the research found.
The authors said it shows the importance of vaccines remaining voluntary, as the Government consults on making the jab mandatory for care home staff in England.
The study was led by the London School of Hygiene & Tropical Medicine (LSHTM) in collaboration with the NHS Race and Health Observatory, Public Health England and the Royal College of Nursing.
They surveyed staff between January 22 and February 8 and followed up with 20 in-depth interviews.
The research, which has not yet been peer-reviewed, found that more than 90% of health and social care staff had accepted a jab, but black African and mixed black African staff were almost twice as likely to decline a vaccine as white British and white Irish participants.
Reasons included concerns about a lack of research and distrust in the vaccines, healthcare providers, and policymakers.
The main motivation for vaccine acceptance was protecting family members and friends, and self-protection from Covid-19.
Staff who agreed more that they felt pressured by their employer were 75% more likely to have declined a jab.
Dr Sadie Bell, research fellow at LSHTM and lead author, said: “Our findings emphasise the importance of Covid-19 vaccination remaining voluntary.
“Organisational factors and workplace culture play an important role in the likelihood of both being offered and getting vaccinated.
“Health and social care providers need to offer a space for their staff to have “conversations” where they feel safe to ask about Covid-19 vaccination, and not feel judged and stigmatised for having questions and/or concerns.”
Sandra Mounier-Jack, an associate professor in health policy at LSHTM and study author, added: “Our work shows a move towards mandating Covid-19 vaccination is likely to harden stances and negatively affect trust in the vaccination, provider, and policymakers.”
The study also suggested that staff of black African and mixed black African ethnicity were twice as likely not to have been offered a vaccine than white British and white Irish participants at the time they were surveyed.
Social care workers were around 50% more likely not to have been offered a vaccine than healthcare colleagues.
Most NHS healthcare workers said it was easy to organise vaccination through their employer, but for others, including social care workers, it was described as “quite a battle”.
They received mixed messages about whether they should organise vaccination through their employer or GP, with some unable to get a jab via the latter route, the survey found.
Unvaccinated participants said they had been given information about the vaccine but no opportunity to discuss concerns and questions, feeling dismissed as being “anti-vax”.
One female healthcare worker of mixed ethnicity said: “I wanted to be fully informed rather than just told to take it… I was left frightened and with little information which was totally avoidable.”
Helen Donovan, Royal College of Nursing professional lead for public health, said: “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.”
Unison general secretary Christina McAnea said: “This study makes plain any talk of compulsory vaccination could damage take-up severely.
“Care workers need clear, accurate information from their employers about when and how to get their jabs.
“If achieving maximum coverage is the goal, employers and policymakers will get better results through encouragement, reassurance and removal of any practical barriers for staff.”