COVID-19 Vaccine Hesitancy and Uptake Among Firefighters: An Application of the Health Belief Model

J Occup Environ Med. 2025 Jan 1;67(1):19-26. doi: 10.1097/JOM.0000000000003232. Epub 2024 Oct 10.

Abstract

Objective: The aim of this study was to assess COVID-19 vaccination prevalence and explore whether health beliefs were associated with vaccination among firefighters.

Methods: A cross-sectional online survey was distributed to Minnesota firefighters in March-April 2022. Survey questions included demographics, vaccination status, and beliefs about COVID-19 and vaccines.

Results: Of the survey respondents ( n = 974, 91% male, 89% White), 76% were fully vaccinated and 53% were boosted. Firefighters were less likely to be vaccinated if they reported more perceived barriers (OR = 0.42, P < 0.001), greater decision-making ease (OR = 0.42, P < 0.001), and greater autonomy (OR = 0.65, P = 0.04). Greater perceived benefits (OR = 2.63, P < 0.001) and social norms (OR = 2.10, P < 0.001) were associated with a greater likelihood of being vaccinated. Similar results were seen predicting booster status.

Conclusions: Firefighters had similar vaccination rates as the general population, despite high exposure risks. Health beliefs are strongly related to vaccination status.

MeSH terms

  • Adult
  • COVID-19 Vaccines*
  • COVID-19* / prevention & control
  • Cross-Sectional Studies
  • Female
  • Firefighters* / psychology
  • Firefighters* / statistics & numerical data
  • Health Belief Model*
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Male
  • Middle Aged
  • Minnesota
  • SARS-CoV-2
  • Surveys and Questionnaires
  • Vaccination / psychology
  • Vaccination / statistics & numerical data
  • Vaccination Hesitancy* / psychology
  • Vaccination Hesitancy* / statistics & numerical data

Substances

  • COVID-19 Vaccines