Page 224 - GHES-3-3

Global Health Economics and
Sustainability
COVID-19 vaccination decisions and mandate impact

Table 4. Vaccination requirements and impact on
employment status and conditions
Question Options n Percentage
Terminated or laid off due to Yes 133/166 80.1
the decision to not receive the No 17/166 10.2
COVID-19 vaccine (first or
subsequent doses)? Prefer not to 5/166 3
answer
Total 155/166 93.4
respondents
No response 11/166 7
Subjected to disciplinary Yes 70/166 42.2
measures other than
Figure 2. Physical and mental health self-rating. layoffs (e.g., accusations of No 62/166 37.3
Note: Data expressed as n, %. professional misconduct, Prefer not to 8/166 5
reports to licensing colleges, answer
temporary suspension of pay, Other 15/166 9
exclusion from pension plan,
and withdrawal of professional No response 11/166 7
license).

options included: testing, remote work, educational training,
and proof of natural immunity). Nearly half of the respondents
(73/166, 44%) requested, but did not receive an exemption,
while over one-fourth of the respondents (45/166, 27.1%)
reported that they did not request an exemption because
they were not eligible or felt intimidated or discouraged by
the rejection of other HCWs’ requests. When asked if their
Figure 3. Physical and mental health self-rating before COVID-19. Over employer (or professional college or public health authority, if
one-third (n: 57, 34.3%) of the respondents and more than half (n: 97,
58.4%) rated their physical and mental health, respectively, as higher self-employed) had provided them with written information
prior to COVID-19. about COVID-19 vaccines, most respondents (119/166,
Note: Data expressed as n, %. 72%) reported that they had not received such information.
to non-compliance with vaccination policies. The response About one-sixth (27/166, 16.3%) of the respondents reported
to the statement “I would return to my previous role if that they were provided information from public health
possible/if mandates were dropped” was mixed. While agencies or equivalent, and no respondents (0/166, 0%)
a large minority (52/138, 38%) agreed (19/138, 14%) or reported being provided a package insert from the vaccine
strongly agreed (33/138, 24%) that they would, about the manufacturer. About one-fifth (33/166, 20%) reported that,
same proportion (45/138, 33%) disagreed (11/138, 8%) or if they had received such information, the information from
strongly disagreed (34/138, 25%), while a smaller minority employers had not enabled them to make an informed
(37/138, 27%) remained neutral. Finally, respondents decision about vaccination (Table 6).
reported mixed feelings about remaining employed in When they were asked about their level of agreement
healthcare, with nearly half (74/166, 44.6%) agreeing with various statements related to informed consent, most
(27/166, 16.3%) or strongly agreeing (47/166, 28.3%) that respondents (149/166, 90%) disagreed (9/166, 5.4%) or
they intended to leave their occupation or the healthcare strongly disagreed (140/166, 84.3%) with the statement that
sector altogether due to their experiences with COVID- they had felt fully free to decline vaccination. In addition,
19 policies, while close to one-fifth (30/166, 18.1%) close to one-third of respondents of all vaccination statuses
reported no plans to leave the industry, and about the same (51/166, 31%) strongly agreed that they had felt coerced
proportion (26/166, 19%) were neutral (Table 5). to get vaccinated. Most respondents (119/166, 72%) also
disagreed (15/166, 9%) or strongly disagreed (104/166,
3.5. Accommodation, equity considerations, and 63%) that they felt comfortable sharing their concerns
informed consent
about vaccination with their employer. In contrast, most
Most respondents (155/166, 93.4%) reported that they were (151/166, 91%) agreed (1/166, 1%) or strongly agreed
not offered any alternatives to vaccination (survey response (150/166, 90.4%) that they had safety concerns with

Volume 3 Issue 3 (2025) 216 https://doi.org/10.36922/GHES025080014