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Title: Characteristics associated with COVID-19 vaccination status among staff and faculty of a
large, diverse University in Los Angeles.
Michele Nicolo
1
, Eric Kawaguchi
1
, Angie Ghanem-Uzqueda
1,2
, Andre E. Kim
1
, Daniel Soto
1
,
Sohini Deva
1
, Kush Shanker
1
, Christopher Rogers
1
, Ryan Lee
1
, Yolee Casagrande
4
, Frank
Gilliland
1
, Sarah Van Orman
1,2
, Jeffery Klausner
1
, Andrea Kovacs
3
, David Conti
1
, Howard Hu
1
,
Jennifer B. Unger
1
.
1. Department of Population and Public Health Sciences, Keck School of Medicine, University
of Southern California, Los Angeles California
2. Family Medicine, Keck Medicine of USC, Los Angeles, California
3. Keck School Medicine of USC, University of Southern California, Los Angeles California
4.Keck Medical Center of USC, Los Angeles, California
Corresponding author: Jennifer B. Unger, Ph.D.
unger@usc.edu
Abstract
Objective: This study examined characteristics associated with being unvaccinated among a
sample of university staff and faculty prior to university campus reopening for in-person learning
in spring-summer 2021.
Methods: Staff and faculty responded to an email invitation to complete an online survey.
Survey questions included demographic data (race/ethnicity, age, sex), COVID-19 knowledge
and behaviors, employment specific data including division and subdivision (healthcare vs. non-
healthcare related division); and self-reported vaccination status. A multivariable logistic
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(which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.
The copyright holder for this preprintthis version posted October 1, 2021. ; https://doi.org/10.1101/2021.09.29.21264315doi: medRxiv preprint
NOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice.
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regression analysis was performed to determine significant characteristics associated with the
likelihood of being unvaccinated for COVID-19.
Results: Participants identifying as Asian and Asian American, Hispanic/Latinx or
Multicultural/Other had greater odds of being unvaccinated compared to Non-Hispanic White
participants. Other characteristics associated with greater likelihood of being unvaccinated
included working as university staff member (vs. faculty), older age, decrease in income,
inability to work remotely and not traveling outside of Los Angeles area. Political affiliation as
an Independent or as something else were more likely to be unvaccinated compared to
participants identifying as Democrat.
Conclusions: Findings suggest several factors associated with racial and social disparities may
delay the uptake of COVID-19 vaccination. This study highlights the need for targeted
educational interventions to promote vaccination among university staff and faculty.
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(which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.
The copyright holder for this preprintthis version posted October 1, 2021. ; https://doi.org/10.1101/2021.09.29.21264315doi: medRxiv preprint
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Background
COVID-19 vaccination is the best method for reducing morbidity and mortality.[1]
Despite variants of COVID-19 becoming more transmissible, ~30-50% of vaccine eligible
individuals in the U.S. remain unvaccinated.[2-6]. Health disparities, mistrust of government and
medical institutions, misinformation, political beliefs, and trepidation over unknown long-term
side-effects are often cited reasons for vaccine hesitancy.[7-14]
As higher education institutions resume in-person learning and on campus activities, the
likelihood of COVID-19 outbreaks will continue to be a concern for college and university
communities.[15] Successful campaigns encouraging vaccination will depend on understanding
vaccine hesitancy. To investigate reasons for lower than optimal vaccination rates among
university employees, the current study examined characteristics associated with the likelihood
of not receiving the COVID-19 vaccine among university staff and faculty during the spring and
summer of 2021.
Methods
Participants
Participants were staff and faculty at the University of Southern California (USC) in Los
Angeles, California. Participants were eligible if they were currently employed at USC, were at
least 18 years of age, and provided informed consent.
Procedure
The USC Institutional Review Board approved the study. Emails were sent to all staff
and faculty inviting them to participate in a brief COVID-19 survey and the study was advertised
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(which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.
The copyright holder for this preprintthis version posted October 1, 2021. ; https://doi.org/10.1101/2021.09.29.21264315doi: medRxiv preprint
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on university websites. Participants provided informed consent electronically and completed the
online surveys by clicking on a hyperlink link sent via email. Survey responses were collected
between 4/29/2021 and 07/21/2021. After removing duplicate and incomplete surveys, the
sample size was 2,125.
Measures
Demographic variables included self-identified race and ethnicity (White; Asian/Asian
American; Black/African American; Hispanic/Latinx; multicultural; or other), sex, age, and
political affiliation (Democrat, Independent, Republican, something else). Employment related
characteristics included division (staff, faculty, student employee) and subdivision (healthcare
related position or all other university division), change in income during the pandemic
(decreased or no change/increased) and work-from home (yes or no). COVID-19 history was
self-reported and categorized as “yes” or “no”. Additional survey questions focused on housing
situations, recent travel outside of Los Angeles, COVID-19 knowledge and attitudes and
compliance with prevention behaviors including masking and social distancing. The outcome
variable for this study was self-reported vaccination status at the time of the survey.
Data analysis
Logistic regression models were used to estimate associations and adjust for potential
confounders. Variables that were significantly associated with vaccination status at p<0.05 were
included in a final multivariable model and those deemed as a priori potential confounders (age,
sex, and ethnicity). Adjusted odds ratios and 95% confidence interval associated with
vaccination status are reported.
Results
All rights reserved. No reuse allowed without permission.
(which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.
The copyright holder for this preprintthis version posted October 1, 2021. ; https://doi.org/10.1101/2021.09.29.21264315doi: medRxiv preprint
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Among the 2817 staff and faculty who were sent invitation emails, 2125 (75.4%)
completed the survey and were included in the analysis. Demographic characteristics of the
sample are shown in Table 1. Mean age was 42.2 years (±12.3). Most respondents identified as
white (40.2%) or Asian / Asian American (23.8%). More than half of participants were female
(68.3%) and identified their political affiliation as Democrat (65.6%). Participants were mostly
employed as staff (70.5%), worked in a non-healthcare related division (55.7%), had no change
in income during the pandemic (72.9%) and currently worked from home (79%). Most
participants reported no history of COVID-19 (82.2%) and self-reported that they had received a
COVID-19 vaccination [(78.4%) Table 1)].
Adjusted odds ratios and 95% confidence intervals from the multivariable analysis for
characteristics associated with the likelihood of being unvaccinated are shown in Table 2.
Compared to Non-Hispanic White participants, Asian/Asian Americans (OR=1.44, 95% CI:
1.06, 1.96), Hispanic/Latinx (OR=1.73, 95% CI: 1.21, 2.49) and Multicultural/Other (OR=1.72,
95% CI: 1.24, 2.38) employees had higher odds of being unvaccinated. African American/Black
participants were not significantly different than Non-Hispanic Whites. Participants who were
older than 32 years had greater odds of being unvaccinated compared to participants in the
youngest age quartile (Table 2). Assigned sex and having COVID-19 were not associated with
vaccination status. Reporting political affiliation as Independent (OR=1.39, 95% CI:1.04, 1.85)
or as something else (OR= 3.84, 95% CI: 2.72, 5.41) were associated with greater odds of being
unvaccinated compared to those who self-identified as Democrats. University staff (OR= 1.69,
95% CI: 1.24. 2.30) had higher odds of being unvaccinated when compared to faculty members.
Additionally, respondents working in a healthcare related divisions were more likely to be
unvaccinated (OR=1.51, 95% CI:1.19, 1.93) compared to employees in non-healthcare divisions.
All rights reserved. No reuse allowed without permission.
(which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.
The copyright holder for this preprintthis version posted October 1, 2021. ; https://doi.org/10.1101/2021.09.29.21264315doi: medRxiv preprint
