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I'm often asked “Why are so many nurses declining the COVID vaccine?"— & I'm usually unsure how to respond. I’m torn between being embarrassed/upset by low vaccine uptake among nurses or sympathetic to the reasons why nurses don't automatically trust hospitals & biomedicine. 
I’m involved in a study of COVID-19 vaccine decision-making & perceptions among healthcare workers and have gotten to talk to nurses first-hand who both accepted and declined the vaccine. Some things I've learned:
- Most declinations by nurses are not a hard 'no.' They are more in the camp of 'not yet' and some 'I don't know.'
- Nurses are not declining because they don't understand research; they're often declining because they DO understand research.
- Nurses are not declining because they don't understand research; they're often declining because they DO understand research.
They are concerned by the lack of long-term data about mRNA vaccines because they know most vaccines have data from much longer periods of time. This is one of the #1 concerns that has come up in my interviews, and it's not unreasonable, even if I disagree personally.
- Some nurses are declining because they are pregnant or breastfeeding and there is limited data about these issues (though we are learning more all the time). This makes sense, as nursing is still a predominantly woman profession.
- Most nurses said they go to the CDC, NIH, and research literature first to learn about COVID vaccines. I didn't talk to any in the fake news/anti-vax/conspiracy theory world. Not that these nurses don't exist (they do), but they don't seem to be the majority of those declining.
- Several nurses pointed out that pro-vaccine messaging & high-profile coverage of physicians getting the vaccines was not compelling & did not dispel all concerns. They said they would have been more convinced by hearing from patients who had COVID and wished for a vaccine...
...than from hospital leaders/physicians, who have not always historically treated nurses with respect or looked out for their safety and have sometimes prioritized pharmaceutical/biomedicine interests over patient safety (with exceptions, of course).
- The most common reasons nurses told me they DID decide to get the vaccine? To end the pandemic and to protect their families/communities. We should think much more about these themes when it comes to vaccine messaging.
The reasons some nurses are declining the COVID vaccines are complicated and they are not a homogenous group. I'm sure these themes don't even come close to capturing all the reasons why some nurses have said 'not yet.'
It's not as simple as "they're conspiracy theory anti-vaxxers" or "they obviously don't have enough education to understand the research." The fact that nurses do not automatically trust hospitals & pharma makes perfect sense given how nurses have been treated in this pandemic 
