Page 227 - GHES-3-3

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

Table 7. Level of agreement with statements on vaccine concerns and informed consent
Statement (level of agreement with the Strongly Disagree Neutral Agree (n, Strongly agree N/A (n, %) No response
following related to the decision on disagree (n, %) (n, %) (n, %) %) (n, %)
COVID‑19 vaccines)
I felt entirely free to choose whether or not 140/166, 84.3 9/166, 5.4 3/166, 2 2/166, 1.2 1/166, 1 0/166, 0 11/166, 7
to get vaccinated
I had safety concerns with the COVID-19 4/166, 2/4 0/166, 0 0/166, 0 1/166, 1 150/166, 90.4 0/166, 0 11/166, 7
vaccines
I had personal medical concerns with 8/166, 9 6/166, 6.2 11/166, 9.2 5/166, 6 91/166, 45.4 33/166, 20 12/166, 7.2
the COVID-19 vaccines (e.g., I have an
autoimmune disorder)
I had religious concerns with the COVID-19 17/166, 10.2 16/166, 10 11/166, 7 16/166, 10 79/166, 47.6 25/166, 15.1 12/166, 7.2
vaccines.
I felt comfortable expressing safety concerns 104/166, 63 15/166, 9 2/166, 1.2 6/166, 4 23/166, 14 4/166, 2.4 12/166, 7.2
about the COVID-19 vaccines with my
employer
I did my own research to determine the 3/166, 2 2/166, 1.2 7/166, 4.2 13/166, 18 126/166, 76 3/166, 2 12/166, 7.2
safety and efficacy of the COVID-19
vaccines
I felt coerced to get vaccinated 2/166, 12 1/166, 1 1/166, 1 0/166, 0 51/166, 31 99/166, 66 12/166, 7.2
I am happy with my choice to get vaccinated 10/13, 77 1/13, 8 0/13, 0 0/13, 0 2/13, 15.4 141/143, 99 12/166, 7.2
(if you did not get vaccinated, choose N/A)
I am happy with my choice to not 2/143, 1.4 0/143, 0 2/143, 1.4 2/143, 1.4 132/143, 92.3 13/13, 1 15/166, 9
get vaccinated (if you got vaccinated,
choose N/A)
Abbreviation: N/A: Not applicable.

been accused of undermining COVID-19’s public health respondents felt coerced into accepting vaccination. A large
response or patient care due to their reservations about minority sought exemptions but were denied, and another
vaccination, and over half of the respondents (94/166, 57%) sizable minority did not seek exemptions due to high
agreed (22/166, 13.3%) or strongly agreed (72/166, 43.4%) rejection rates by employers. Among the small number
that they had been disciplined for this reason (Table 9). of vaccinated respondents, most got vaccinated to avoid
Finally, the two respondents (2/166, 1.22%) – whose termination. Most unvaccinated workers were satisfied
job responsibilities included administering COVID-19 with their choice but reported significant negative impacts
vaccines – when asked how they felt upon completing this on their finances, mental health, relationships, and, to a
task, reported feeling uneasy and unsure about what might lesser extent, physical health, due to workplace mandates.
happen to the vaccine recipients (Table 8). In addition, both In contrast, most vaccinated respondents were dissatisfied
of the respondents agreed that they believed that vaccines with their vaccination decisions and experienced mild
could cause serious or life-threatening injuries, including to serious adverse events. In addition, over half of the
death, and one reported that they had felt coerced to vaccinated respondents reported being coerced—under
administer the vaccine despite their reservations (Table 9). threat of termination—into taking additional doses.
4. Discussion In addition, a large minority of the respondents reported
witnessing underreporting or dismissal of post-vaccination
In our exploratory survey of a convenience sample of adverse events, worse treatment of unvaccinated patients,
166 HCWs in BC, Canada, nearly half of the respondents and concerning changes in practice protocols. About
had over 16 years of working experience. Most of the one-third of the respondents were encouraged or coerced
respondents were unvaccinated or did not meet full to minimize patients’ concerns about, or resistance to,
COVID-19 vaccination requirements, and most had vaccination by urging them to trust health authorities and
been terminated for non-compliance with mandates. In official sources, reassuring them that the vaccines were
addition, a significant proportion of respondents reported safe and effective, dismissing contradictory information
feeling unable to freely decline vaccination or express as “misinformation,” and turning down requests for
concerns about vaccine safety, and about one-third of the vaccine exemptions or off-label prescription drugs. Most

Volume 3 Issue 3 (2025) 219 https://doi.org/10.36922/GHES025080014