COVID-19 Vaccination Among Environmental Service Workers Using Agents of Change

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Health Behavior

Background:

• Vaccine hesitancy impedes community immunity against SARS-CoV-2.
• Healthcare workers, including environmental services (EVS) staff, face infection risks and contribute to nosocomial transmission but exhibit low vaccination rates due to hesitancy.
• Targeted interventions are crucial to improve vaccine uptake in high-risk healthcare settings.

Purpose of the Study:

• To enhance SARS-CoV-2 vaccine uptake among EVS workers at a major academic medical center.
• To implement and evaluate a community-based participatory approach (CBPA) utilizing lay health educators.
• To address vaccine hesitancy and misinformation within the EVS workforce.

Main Methods:

• A CBPA was implemented from January to March 2021, engaging EVS workers.
• A 1-hour training program was developed for 29 peer lay health educators, termed agents of change (AOC).
• AOC received training on COVID-19, SARS-CoV-2 vaccination benefits, and strategies to counter vaccine misinformation, followed by semistructured interviews.

Main Results:

• 89.6% of AOC found the training informative; 79.3% used personal testimony in peer discussions about vaccination.
• The majority of AOC (89.6%) discussed vaccination outside the workplace, extending community reach.
• mRNA COVID-19 vaccination rates among EVS staff increased by 21% during the 2-month program (from 126 to 189 individuals).

Conclusions:

• The CBPA, utilizing an AOC lay health educator model, successfully increased mRNA COVID-19 vaccine uptake.
• Continued investigation into barriers and sources of vaccine hesitancy is necessary for developing tailored interventions.
• This model offers a scalable strategy for improving vaccination rates in essential healthcare worker populations.