This article is sponsored by HERO-TOGETHER, a paid, prospective, observational study of 20,000 adult U.S. health care workers who received a COVID-19 vaccine within the past 60 days. 

With over 27 million cases and 470,000 deaths reported to the Centers for Diseases Control and Prevention (CDC), the COVID-19 pandemic continues to hold a grim grip on the U.S. However, the arrival of vaccines provides a path forward and timeline to a return of pre-pandemic living. To date, over 46 million people have received at least one vaccine dose in the U.S.

Vaccines will only help the country return to normalcy if shots actually get into arms. For some, the decision to be vaccinated is straightforward — they are all in or all out.  However, for others in the middle, the so-called “vaccine-hesitant,” the decision is less clear. The Word Health Organization (WHO) describes vaccine hesitancy as a delay in acceptance or refusal of vaccines despite the availability of options.

People who are vaccine-hesitant fall along a spectrum. Some may accept but have doubts or accept but want to delay their decision, while others are declining while seeking additional information about long-term safety. People on the fence are often open to education about the role of vaccines in eradicating disease, developing vaccines, testing vaccines in clinical trials, and results from post-vaccine surveillance programs.

Impact of hesitancy on vaccine rollout

Vaccine hesitancy can have a negative impact on rollout. A striking example comes from long-term care facilities. As noted in the February 1, 2021 issue of the CDC Morbidity and Mortality Weekly Report, approximately 78 percent of residents received a vaccine. In contrast, only 37 percent of staff members agreed to be vaccinated. Reasons for refusal include:

• perceived rapidity of vaccine development
• inadequate information received about vaccine safety, side effects, and administration
• skepticism regarding the clinical trials and vaccine approval process

The HERO Research program found similar results from polling health care workers in late 2020. Results from a poll in October found that about 46 percent of participants reported some degree of vaccine hesitancy.  An overwhelming majority of respondents who reported hesitancy indicated they had concerns about safety of the COVID-19 vaccine in particular. Very few noted they were concerned about the safety of vaccines in general. The poll was repeated in late November after promising top-line results from Pfizer and Moderna. The second poll showed lower rates of vaccine hesitancy, suggesting that additional evidence may have boosted confidence and willingness.

HERO-TOGETHER

HERO-TOGETHER is a paid, prospective, observational study of 20,000 adult U.S. health care workers who received a COVID-19 vaccine within the past 60 days. A “health care worker” is defined as anyone who currently works in a place where individuals receive health care. Health care workers include clinicians, nurses, respiratory therapists, environmental services workers, as well as EMS providers, paramedics, and first responders.

After self-enrolling, HERO-TOGETHER participants answer brief surveys online over two years. Participants provide information on how they are doing, if they have been hospitalized or experienced any medical events since receiving their vaccine, and if they test positive for COVID-19.

Impact of post-authorization surveillance

The safety data from phase three clinical trials were very encouraging, with very few adverse events. However, the data submitted to obtain emergency use authorization were limited to a two-month period after vaccine. Long-term studies can help us evaluate outcomes beyond that period to ensure there are no other safety signals that require further investigation.

Another key reason to continue post-authorization surveillance is that populations enrolled in clinical trials are not always representative of who ends up receiving a vaccine. For example, women who are pregnant and breastfeeding were excluded from the initial clinical trials of vaccines. Studies such as HERO-TOGETHER performed in real-world settings can help us build safety information for these groups not included in pre-authorization research.

Results from HERO-TOGETHER can also be used to understand how different people — including men, women, older people, people with chronic diseases, and people from different race and ethnic groups — do after vaccination. The HERO research team is committed to sharing study updates and learnings with the participants and the public.

Role of health care workers in building vaccine confidence

From working on the front lines to working behind the scenes, people in health care and public service have joined together with unprecedented focus to fight COVID-19. As the first to receive vaccines against COVID-19, health care workers continue to lead the way through the pandemic and are considered trusted figures in our communities.

HERO-TOGETHER leverages the HERO Registry, which began in April 2020 and is now a community of more than 23,000 health care workers sharing their voices about their experiences and perspectives living and working in the pandemic.

Participate in HERO-TOGETHER

HERO-TOGETHER is an opportunity for people working in health care to continue the fight against COVID-19. HERO-TOGETHER participants will receive learnings and study updates, and compensation for their time. Taking part is an easy way to help fight COVID-19 and learn how to keep our communities and families healthy and virus-free.

Signup at heroesresearch.org/together

Emily O’Brien is an epidemiologist, an associate professor in population health sciences at Duke University School of Medicine, and a faculty member of the Duke Clinical Research Institute. Emily is also the principal investigator of the HERO-TOGETHER study.

Jessica Mega is co-founder and chief medical and scientific officer at Verily. Verily’s mission is to develop the infrastructure and solutions to harness the profusion of health information for good. Their data-driven solutions across research, care, and innovation aim to improve the well-being of our communities.

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