Flu COVID Vaccine Views

This study uses a sequential explanatory mixed-methods design. The first phase utilizes a cross-sectional, multi-site electronic survey. The quantitative survey will characterize willingness of approximately 550 HCWs to receive a combination influenza/COVID-19 vaccine and to identify demographic, attitudinal, and structural predictors of vaccination. Participants will complete a one-time REDCap survey (approximately 20-30 minutes).

In the second phase, a subset of 10-20 HCWs will be invited to participate in qualitative interviews that will be used to interpret and elaborate on quantitative findings. Specifically, the qualitative analysis allows for exploration of the nuanced rationale behind reported willingness to vaccinate, gives additional context to latent constructs identified in factor analysis, and identifies communication preferences that are not adequately captured by closed-ended questions. Integration will occur at the interpretation stage: quantitative results will inform purposive sampling for the qualitative phase, and qualitative themes will be used to contextualize and explain patterns observed in the quantitative analysis. A joint display table will be used in reporting to show how qualitative findings confirm, extend, or challenge quantitative results.

• Survey (Other): One-time RedCAP electronic survey on the willingness of healthcare workers to receive a combination influenza/COVID-19 vaccine and factors that might influence this decision.

Primary outcomes

• Proportion of health care workers (HCWs) who indicate that they would "definitely" or "probably" receive a combination influenza and COVID-19 vaccine. [Day 1]

Secondary outcomes

• Proportion of HCWs willing to receive standalone seasonal influenza vaccines. [Day 1]
• Proportion of HCWs willing to receive standalone COVID-19 vaccines, also stratified by COVID-19 vaccine platform (mRNA vs. protein-based). [Day 1]
• Determinants of willingness to receive combination influenza and COVID-19 vaccines as assessed by multivariable logistic regression. [Day 1]: Adjusted odds ratios (aOR) for demographic, occupational, behavioral, attitudinal, and emotional predictors associated with vaccination willingness, measured using responses from the REDCap electronic survey.
• Categorization of attitudes toward co-administration compared with true combination vaccine formulations as assessed by semi-structured qualitative interviews. [Day 1 through completion of the qualitative surveys, an average of 1 month.]: Qualitative thematic analysis of healthcare worker attitudes and preferences recorded using a semi-structured qualitative interview guide.
• Participant ranking of messaging options associated with willingness to receive combination vaccines as assessed by REDCap survey. [Day 1 through completion of the qualitative surveys, an average of 1 month.]: Mean ranking scores of communication messaging options measured via ordinal ranking items in the REDCap electronic survey.
• Proportion of participants in different thematic categories regarding concerns, motivations, and preferred communication strategies as assessed by qualitative thematic analysis. [Day 1 through completion of the qualitative surveys, an average of 1 month.]: Identified qualitative themes and sub-themes synthesized using qualitative thematic analysis from REDCap survey free-text fields and semi-structured interview transcripts.
• Proportion of participants in different thematic categories associated with willingness to receive combination vaccines as assessed by semi-structured qualitative interviews. [Day 1 through completion of the qualitative surveys, an average of 1 month.]: Qualitative themes identified through inductive thematic analysis of semi-structured interview transcripts.

Sex: All, ages: 18 Years to 89 Years, accepts healthy volunteers

Inclusion Criteria:

* Age 18-89 years old
* Currently employed or enrolled as a student at GWU, GW MFA or CNH
* Eligible for institutional influenza vaccination
* Able to complete the survey in English

Exclusion Criteria:

* On long-term leave at the time of survey launch
* Contractors without institutional email access
* Contraindication to receiving influenza vaccination
* Contraindication to receiving COVID-19 vaccination

• Daniel Park, PhD, Principal investigator, George Washington University