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Vaccinated, Unvaccinated First Responders Have Significantly Different Beliefs About Effectiveness


Depending on their COVID-19 vaccination status, there were differences in the sources first responders in Kentucky preferred to receive information from, their willingness to believe conspiracy theories, and the perceived risk of the virus.

Sources of information about vaccines, willingness to believe conspiracy theories, and perceived risk of the COVID-19 virus differed between first responders who were vaccinated and unvaccinated against it, according to a study published in Health Communication.

"This study provides guidance for those designing health messages for the first responder population," the authors noted.

More than 1.2 million residents of Kentucky have contracted COVID-19 and more than 14,000 have died due to the virus. First responders in the state have a higher risk of contracting the virus due to their frequent exposure to their communities. However, resistance to vaccination persists. This study aimed to assess the beliefs of first responders who had previously expressed hesitancy in getting vaccinated against COVID-19.

Qualtrics was used to collect a sample of first responders throughout March of 2021, at which time first responders in Kentucky had priority in receiving the vaccine. First responders had completed a Qualtrics survey that assessed their beliefs on the COVID-19 virus, COVID-19 vaccines, vaccine motivation, and source trustworthiness. All first responders aged 18 years and older were invited to participate.

All participants needed to disclose their vaccination status and their vaccination intention. They also ranked the importance of different sources in making their decisions on COVID-19 and getting vaccinated. The Health Belief Model was used to measure patients’ beliefs about vaccines with participants being asked about perceived risk, perceived barriers, perceived susceptibility, perceived benefits, cues to action through vaccine information amount, and cues to action through sources. All questions used a 5-point scale with 1 meaning to strongly agree and 5 meaning to strongly disagree.

Participants were also asked to rank information sources by importance in deciding. These sources included family members, coworkers, television, personal doctor, social media, and medical experts. Participants were lastly asked about their belief in conspiracy beliefs about COVID-19, such as whether the danger of the virus was being purposefully exaggerated, which was rated on the same 5-point scale.

There were 1168 participants included in this study, 399 (34.2%) who had not received a vaccine and 769 (65.8%) who had received 1 shot of the vaccine; 384 unvaccinated participants and 151 vaccinated participants proceeded to complete at least 1 aspect of the survey.

A similar percentage of participants were diagnosed with COVID-19 across the vaccinated and unvaccinated groups (17.2% and 18.5% respectively). Percentages were also similar in participants who had a family member or a close contact test positive for COVID-19 (84.1% and 83.3% respectively).

A total of 34.5% of unvaccinated participants felt that they would probably not get the vaccine and 27.5% felt that they would definitely not get the vaccine, with only 15.8% indicating that they would definitely get the vaccine.

Participants who were unvaccinated felt that they were less susceptible to contracting COVID-19 compared with participants who were vaccinated (mean [SD], 2.97 [0.81] vs 2.52 [0.92]). Participants who were unvaccinated also believed COVID-19 to be less severe (3.03 [0.77] vs 2.45 [0.81]).

First responders who were unvaccinated were more likely to believe conspiracy theories that COVID-19 was harmless (2.70 [0.92] vs 3.46 [0.88]) and that COVID-19 was created on purpose (3.10 [0.65] vs 3.37 [0.58]).

All participants generally ranked their sources of information on the vaccine in the same order, but unvaccinated individuals were more likely to rank family members, coworkers, and friends higher in importance whereas participants who were vaccinated tended to rank medical experts, newspapers, and social media higher. Rankings for the doctors was not significantly difference.

There were some limitations to this study. The study focused entirely on first responders from Kentucky, which compromises the generalizability of the study. The study was conducted during the first rollout of the vaccine, which could affect the way that first responders felt at the time of the survey. Conspiracy theory questions were likely unable to capture the extent of political tension surrounding decisions on the vaccine. Social factors at work playing a part in decision-making should also be considered in future studies.

The researchers concluded that this data on how people viewed the COVID-19 vaccine could help in getting vaccine hesitant people to have their concerns addressed properly.


Darnell WH, Daugherty CD, Hart ZP, South AL. Exploring first responder beliefs and decisions to vaccinate against SARS-COV-2. Health Commun. Published online January 12, 2023. doi:10.1080/10410236.2022.2149065

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