From Hero to Zero: Experiences of Unvaccinated Healthcare Workers During the COVID-19 Pandemic in the United States

Abstract

In 2021, many hospitals across the United States instituted COVID-19 vaccine mandates for their healthcare workers (HCWs). The minority of staff that did not comply with the requirement reported formal and informal workplace pressures, discriminatory attitudes, economic hardship, mental health challenges, and, ultimately, termination of employment. Indeed, according to HCWs in this cohort, there was a significant change in how the unvaccinated were treated by colleagues and institutions that had only recently before celebrated their conduct at the front lines of the pandemic. The objective of this study was to examine the lived experiences and perceptions of unvaccinated HCWs who identify as significantly and durably impacted by the COVID-19 vaccine mandates in the United States. In depth, semi-structured interviews were conducted with HCWs who remained noncompliant with the COVID-19 vaccine mandates to identify their core concerns and perceptions. Snowball sampling methods were employed for recruitment and interviews were conducted through Zoom teleconferencing software. Eight participants were included in the study. Interview data were coded and analyzed thematically, with four key themes identified: (1) initial perceptions and attitudes about the COVID-19 vaccines, (2) experiences with coercive pressures related to mandate compliance, (3) experiences of perceived discrimination and other interpersonal repercussions, and (4) personal and emotional impacts of the mandates. While much of the existing academic literature has focused on the public health rationale and outcomes associated with vaccine mandates, this study contributes qualitative insight into how these policies were experienced by a subset of HCWs who did not comply with the institutional requirements.