A study of essential workers found that COVID-19 vaccine knowledge, attitudes, and practices (KAP) responses predicted vaccine uptake and that perceptions of the COVID-19 vaccine can improve over time. Targeting messages about vaccine safety and effectiveness thus may increase vaccine uptake for reluctant and reachable participants.

Two surveys assessed a multi-center group of 4,803 essential workers who participate in the HEROES-RECOVER COVID-9 data-analysis projects. The surveys, three months apart, captured vaccine intention, prior SARS-CoV-2 positivity, and occupation, and their impact on vaccine uptake over time.

The first survey in December 2020 categorized participants as reluctant, reachable, or endorsers. Most (70%) were vaccine endorsers, 16% were reachable, and 14% were reluctant. By May 2021, 77% had received at least one vaccine dose. KAP responses strongly predicted vaccine uptake, particularly positive attitudes about safety and effectiveness. Participants with prior SARS-CoV-2 infection were 22% less likely to believe the COVID-19 vaccine was effective compared with uninfected participants and first responders were 42% less likely to believe in COVID-19 vaccine effectiveness.

In the second survey, reluctant and reachable participants’ positive scores modestly increased for perceived vaccine effectiveness (7% and 12%, respectively); 25% of initially reluctant participants received the COVID-19 vaccine.