Abstract
ImportanceCOVID-19 vaccine hesitancy has become a leading barrier to increasing the US vaccination rate.ObjectiveTo evaluate time trends in COVID-19 vaccine intent during the US vaccine rollout, and identify key factors related to and self-reported reasons for COVID-19 vaccine hesitancy in May 2021.Design, participants and settingA COVID-19 survey was offered to US adult Facebook users in several languages yielding 5,088,772 qualifying responses from January 6 to May 31, 2021. Data was aggregated by month. Survey weights matched the sample to the age, gender, and state profile of the US population.ExposureDemographics, geographic factors, political/COVID-19 environment, health status, beliefs, and behaviors.Main outcome measures“If a vaccine to prevent COVID-19 were offered to you today, would you choose to get vaccinated.” Hesitant was defined as responding probably or definitely would not choose to get vaccinated (versus probably or definitely would, or already vaccinated).ResultsCOVID-19 vaccine hesitancy decreased by one-third from 25.4% (95%CI, 25.3, 25.5) in January to 16.6% (95% CI, 16.4, 16.7) in May, with relatively large decreases among participants with Black, Pacific Islander or Hispanic race/ethnicity and ≤high school education. Independent risk factors for vaccine hesitancy in May (N = 525,644) included younger age, non-Asian race, < 4 year college degree, living in a more rural county, living in a county with higher Trump vote share in the 2020 election, lack of worry about COVID-19, working outside the home, never intentionally avoiding contact with others, and no past-year flu vaccine. Differences in hesitancy by race/ethnicity varied by age (e.g., Black adults more hesitant than White adults <35 years old, but less hesitant among adults ≥45 years old). Differences in hesitancy by age varied by race/ethnicity. Almost half of vaccine hesitant respondents reported fear of side effects (49.2% [95%CI, 48.7, 49.7]) and not trusting the COVID-19 vaccine (48.4% [95%CI, 48.0, 48.9]); over one-third reported not trusting the government, not needing the vaccine, and waiting to see if safe. Reasons differed by degree of vaccine intent and by race/ethnicity.ConclusionCOVID-19 vaccine hesitancy varied by demographics, geography, beliefs, and behaviors, indicating a need for a range of messaging and policy options to target high-hesitancy groups.
Highlights
On December 11, 2020 [1], the Federal Drug Administration (FDA) granted the first Emergency Use Authorization of a COVID-19 vaccine in the United States (US) [2]
COVID-19 vaccine hesitancy decreased by one-third from 25.4% (95%confidence intervals (CI), 25.3, 25.5) in January to 16.6% in May, with relatively large decreases among participants with Black, Pacific Islander or Hispanic race/ethnicity and high school education
Differences in hesitancy by race/ethnicity varied by age (e.g., Black adults more hesitant than White adults
Summary
On December 11, 2020 [1], the Federal Drug Administration (FDA) granted the first Emergency Use Authorization of a COVID-19 vaccine in the United States (US) [2]. A longitudinal study of US adults (N = 7,420) by Daly et al reported an overall decrease in COVID-19 vaccine hesitancy from 46.0% in October 2020 to 35.2% in March 2021. Throughout this timeframe, younger versus older adults, and Black versus White adults, had greater COVID-19 vaccine hesitancy, trends suggested an increase in the age disparity and decrease in the racial disparity in vaccine uptake [13]. Understanding how COVID-19 vaccine hesitancy prevalence continued to change up through the time of adult universal eligibility, overall and among subgroups, as well as reasons for hesitancy at the time of universal eligibility is essential for policy makers working to increase vaccination uptake
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