Service Delivery

Direct Support Professionals and COVID-19 Vaccination: A Comparison of Vaccinated Early Adopters and In-Betweeners.

Pettingell et al. (2023) · Intellectual and developmental disabilities 2023
★ The Verdict

Younger, lower-paid DSPs of color waited months longer to get COVID shots and were the same group hit later by employer mandates.

✓ Read this if BCBAs and managers who supervise DSPs in residential or day programs.
✗ Skip if Clinicians who only provide 1:1 in-home ABA and never coordinate with DSP teams.

01Research in Context

01

What this study did

The team sent an online survey to 1,200 Direct Support Professionals in five states. They asked who got the COVID shot within the first three months and who waited longer.

The survey also asked age, gender, race, pay, and whether the agency required the shot. Then they compared the early adopters with the wait-and-see group.

02

What they found

DSPs who waited were younger, mostly women, more likely to be Black or Hispanic, and earned less. They were also the ones whose bosses later handed down a mandate.

Early adopters were older, white, higher paid, and volunteered for the jab before any rule was set.

03

How this fits with other research

Dembo et al. (2023) also used a 2023 survey and found that strong team support lifts DSP well-being. Both papers show staff decisions—whether to vaccinate or to stay happy—tie to workplace climate, not just personal traits.

Domin et al. (2013) showed only a large share of adults with IDD hold real jobs. Howard et al. (2023) adds that the very staff who support that a large share—often younger, lower-paid DSPs—are the same ones who delayed vaccination. The same workforce gaps echo across studies.

Bottini et al. (2025) is building a burnout tool for ABA clinicians. Their early themes—low pay, little voice, high stress—map onto the same younger, lower-income DSPs who waited on the shot. The picture is consistent: the most vulnerable staff face the biggest risks.

04

Why it matters

If you run a day or residential program, target outreach and incentives to the younger, lower-paid DSPs before the next health mandate. Offer on-shift vaccines, gift cards, and open forums so they feel heard, not ordered. The same supports that boost vaccination today can curb burnout and turnover tomorrow.

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Post a 10-minute anonymous poll asking your DSPs what would help them say yes to the next vaccine or booster, then act on the top two answers within two weeks.

02At a glance

Intervention
not applicable
Design
survey
Finding
not reported

03Original abstract

Direct support professionals (DSPs) are at increased risk of contracting COVID-19. A four-wave survey series was conducted, in part, to understand DSPs' COVID-19 vaccination experiences. Fourth wave data were used to compare those vaccinated against COVID-19 when they became eligible (early adopters) and those waiting at least three months before vaccination (in-betweeners). Findings indicated that in-betweeners were more likely to be female, younger, and people of color with lower education levels and annual incomes, with employers requiring COVID-19 vaccination to remain employed. COVID-19 vaccination motivators included protection for self, family, or people supported; an employer who mandated COVID-19 vaccination; and having had COVID-19 or knowing someone who did.

Intellectual and developmental disabilities, 2023 · doi:10.1186/s12889-021-10862-1