Facilitators and Barriers to COVID-19 Vaccine Uptake Among Meat Processing Workers in Nebraska: A Mixed-Methods Analysis Using the COM-B Model

The meat processing industry was significantly impacted by the COVID-19 pandemic. Deemed essential, the meat processing workforce faced the risk of exposure to the SARS-CoV-2 virus. Along with other essential workforces, meat processing workers were prioritized in the national approach to receive COVID-19 vaccines by the Centers for Disease Control and Prevention Advisory Committee on Immunization Practices. This mixed methods study aimed to identify the facilitators and barriers to COVID-19 vaccine uptake by meat processing workers in Nebraska through interviews (n = 29), a survey (n = 857), and application of the COM-B model. We found that facilitators for vaccine uptake included having information about the vaccine available; providing vaccines at the workplace, in pharmacies, and throughout the community to increase accessibility; feeling that there was a social responsibility to get vaccinated; believing that the vaccine was protective; and the use of various incentives. Barriers for vaccine uptake included workers' personal health issues; not having the right information to make an informed decision; logistical and contextual issues that made it challenging to get vaccinated; the disconnect between faith and science; individual choice being highly valued; and uncertainty and misinformation causing fear of the vaccine. Understanding facilitators and barriers to vaccine uptake by meat processing workers is critical to informing public health interventions, evidence-informed guidelines and policies, and tailored messaging to increase vaccination coverage among an essential workforce that inherently assumes occupational risk during infectious disease events, such as the COVID-19 pandemic. Implications for public health practitioners are provided.