Abstract
Background: Coronavirus disease 2019 (COVID-19) resulted in significant morbidity and mortality around the world. Vaccines were important for the containment of the continued spread of COVID-19; however, the uptake thereof in South Africa was sub-optimal.
Aim: To understand the determinants of COVID-19 vaccination uptake among clinical and non-clinical workers employed at a large organisation in South Africa.
Methodology: A quantitative cross-sectional study was conducted from September to October 2024 with clinical and non-clinical workers from South Africa who received COVID-19 vaccines in a workplace with a mandatory COVID-19 vaccine policy. Workers completed a once-off self-administered online questionnaire using Microsoft Forms that explored the determinants of COVID-19 vaccination, barriers and enablers to accessing vaccines, and workers’ perspectives towards mandatory vaccine policies. All workers aged 18 and older who received a COVID-19 vaccine were invited to participate. Data were analysed using IBM-SPSS Statistics, version 29. T-tests were used to compare the reasons for COVID-19 vaccination stratified by age, sex, previous COVID-19 infection and type of worker. Ethics approval to conduct this study was obtained from the University of Johannesburg, Faculty of Health Sciences (REC 2949-2024)
Results: The survey was emailed to 334 workers; 106 responded (32% response rate), and 88 were enrolled. The mean age was 41 (±9.98), and 70% (n = 62) were female. Over a third of the respondents (35%, n = 31) reported a history of chronic illness, 12 of whom had hypertension. Three-quarters of workers reported that vaccines were easily / very easily accessible due to them being available at the workplace (42%, n = 33), the vaccine roll-out site being close to the workers’ home/workplace (22%) and the vaccine being available at no cost (32%, n = 25). More than two-thirds (71%) agreed / strongly agreed to receiving a COVID-19 vaccine to prevent the spread of the virus. Other reasons for agreeing / strongly agreeing to receiving COVID-19 vaccine included fear of contracting COVID-19 (64%), protecting colleagues and patients (64%) and the mandatory workplace policy (60%). No significant differences between groups in relation to age, sex, previous history of COVID-19, worker category and the combined reason for COVID-19 vaccination, i.e., fear of contracting COVID-19 and fear of complications due to COVID-19 (all p values > 0.05) were identified. Just under two-thirds of workers (63%; n = 55) were supportive / very supportive of the mandatory COVID-19 vaccine policy. Reasons for support included that vaccination would create a safer work environment, protecting oneself and others from contracting COVID-19, and receiving encouragement from employer and information about COVID-19. Only 15% (n = 13) of workers were not supportive / against the policy.
Conclusion: Fear of contracting COVID-19 and fear of complications due to COVID-19 were important reasons for workers receiving vaccines. Workers were generally supportive of the mandatory COVID-19 vaccine workplace policy and recognised the benefits of vaccination to safeguard both themselves and others. Workplaces provided convenient access to vaccines. The findings from this study could inform policy/guidelines for occupational health, counselling and support in workplaces for pandemics.