More than 10% (about 19.7 million part- and full-time jobs) of U.S. workers are employed in food and agriculture occupations and are essential during emergencies such as the COVID-19 pandemic. A new study reports that fewer food system workers were vaccinated with at least one dose of a COVID-19 vaccine, and a higher proportion were vaccine hesitant, compared to non–food system essential workers between April through November 2021 of the COVID-19 pandemic.

In a JAFSCD original research article, "Disparities in COVID-19 vaccine uptake, attitudes, and experiences between food system and non–food system essential workers," Smarsh and colleagues analyzed data surveying a large population including more than 150,000 essential workers by industry and occupation. Researchers used data from CDC’s National Immunization Survey Adult COVID Module to examine food system essential workers in three groups of industries: agriculture, forestry, fishing, and hunting; food manufacturing facilities; and food and beverage stores.

This study highlights many differences in vaccine coverage, attitudes and beliefs about the virus and the vaccine, and difficulties in getting vaccinated among food system worker industry and occupation groups. Researchers also found differences within food system industry and occupation sociodemographic groups, and when compared to essential non–food system workers such as healthcare, schools, correctional facilities, and public transit. This study may be the first to use national-level data to explore factors related to vaccination with a special focus on food system essential workers.

KEY POINTS

Significantly lower percentages of food system workers reported being vaccinated compared with non–food system workers. There were large differences in concern about getting the virus, if the vaccine was safe, or was important for protection, within food system worker groups, and between food system workers and non–food system worker groups. There were differences in vaccine coverage and intent, attitudes and behaviors, and experiences getting the vaccine by sociodemographic characteristics such as age, race and ethnicity, income, and foreign-born status.

Essential Food Systems Workers compared to Essential Non-Food System Workers

A significantly lower percentage of food system workers reported being vaccinated, concerned about getting COVID-19, or had vaccine requirements at work or school compared to non–food system workers. Differences were seen by sociodemographic characteristics such as age, race and ethnicity, income, and foreign born status. Essential workers who reported receiving at least one COVID-19 vaccine were significantly lower among all food system worker groups (58.5% agriculture, forestry, fishing, or hunting, 59.8% food manufacturing facility, 61.6% food and beverage store) compared to non-food system workers (68.5%).
Among sociodemographic characteristics, significantly fewer vaccinated food system workers who were white, adults aged 30 to 39, insured, not foreign born, lived in urban or rural areas, or did not have underlining medical conditions reported having at least one vaccination when compared to vaccinated non–food system workers.
When compared with unvaccinated non–food system workers, a higher proportion of unvaccinated food and beverage store workers reported difficulties getting to vaccine sites (11.6%, 7.5% respectively) or difficulty getting an appointment online (10.2%, 7% respectively).
A higher percentage (26.3%) of agriculture, forestry, fishing, or hunting were reluctant to get vaccinated—with differences by sociodemographic characteristics—when compared to non–food system workers (18.2%).
Among food system workers who were unvaccinated, a higher percentage of food and beverage store (20.4%) and food manufacturing facility (18.9%) workers would consider getting vaccinated compared with non–food system workers (13.3%).

Essential Food System Workers by industry and occupation groups.

A significantly higher percentage of unvaccinated agriculture, forestry, fishing, and hunting, and food and beverage store workers, compared to their vaccinated counterparts, reported barriers to getting vaccinated including getting to a vaccine site, and vaccine sites not being open at convenient times. This included:
- Workers who reported having difficulties getting to a vaccine site: 3.5% vaccinated verses 12.1% unvaccinated agriculture, forestry, fishing, and hunting; and 5.8% vaccinated verses 11.6% unvaccinated food and beverage store workers.
- Workers who reported having difficulties finding vaccines sites open at convenient times: 6.6% vaccinated verses 18.2% unvaccinated agriculture, forestry, fishing, and hunting; and 5.9% vaccinated verses 14.1% unvaccinated food and beverage store workers.
A significantly lower percentage of unvaccinated food and beverage store workers (10.2%) and food manufacturing workers (5.8%) compared to their vaccinated counterparts; food and beverage store workers (16.2%) and food manufacturing workers (17.1%) reported difficulties with getting an appointment online.

RECOMMENDATIONS FOR POLICY, PRACTICE, AND RESEARCH

It is important to monitor COVID-19 vaccine uptake, attitudes, experiences, and difficulties in getting the vaccine of essential workers overall and by specific industry and occupation groups. This study reflects the diversity of food safety workers and highlights the importance of collecting occupational data to determine vaccine assess, barriers, and attitudes. Strengthening efforts in vaccine confidence and rates against infectious diseases, such as COVID-19, can help protect essential food system workers from getting COVID-19 and severe illness. Considering vaccine access for different types of workers, including food system workers, present opportunities for both research and practice.

This study is perhaps the first to explore these vaccine outcomes in a representative national sample with a specific emphasis on food system workers. The novel findings of this research underscore the need for attention to and support for food system workers.

Considerations for future vaccine efforts could include reviewing additional gaps related to essential food system workers and expand on methods in this study or provide additional measures.
It is important to collect and analyze occupational data and key sociodemographic characteristics, such as age, race and ethnicity, income, and foreign-born status. These factors can contribute to health barriers, including vaccine access. Identifying overlapping vulnerabilities may allow for a strategic tailoring of public health strategies, health-promotion systems, and infrastructure to address health gaps more effectively.

The study’s authors discussed potential opportunities for practitioners and organizations to find effective ways of reaching essential food system workers with vaccine and health information, strategies, and institutional support.

Public health agencies and institutions can improve health and address disparities (e.g., improving vaccine uptake) by building and enhancing collaborative partnerships with trusted organizations. This could include providing funding, training, and technical assistance to build capacity of trusted organizations.
Trusted organizations can build existing assets such as having staff who speak the same language as their priority population and connecting workers to key community services and infrastructure to support interventions among priority populations, for example by delivering programs in familiar and convenient places such as worksites and distributing vaccines that considers work locations and schedules.
Improved data collection and interpretation can help inform these efforts. For instance, practitioners and trusted organizations can collect and ascertain food system worker data to better document, characterize, and understand needs and barriers of these workers.

Local partners, leaders, and communities can learn more about strengthening public trust in life-saving protection of vaccines at https://www.cdc.gov/vaccines/partners.

SHARE ON YOUR SOCIALS

A new study from researchers at the CDC and other entities has found that fewer essential food system workers compared to other essential workers were vaccinated for COVID-19 during the pandemic in 2021. Some groups reported difficulties getting to vaccine sites and getting an appointment online. Read the full @JAFSCD article for free: https://doi.org/10.5304/jafscd.2024.132.012