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New surveys indicate more people in the United States are willing to get a COVID-19 vaccine. Octavio Jones/Getty Images
  • Experts say there has been an increase in the number of people in the United States who say they will get a COVID-19 vaccine.
  • They attribute the rise to the approval of the vaccines as well as public figures and healthcare workers publicly getting their shots.
  • They note there is still reluctance among younger adults, Republicans, rural residents, and Black adults to get vaccination.
  • They say a pro-vaccine message should be targeted at how the vaccine will help an individual’s family and community.

The rollout of COVID-19 vaccinations has been painfully slow.

By the end of December, an estimated 2 million people in the United States had received at least one of the required two rounds of vaccine shots.

That fell far short of the Trump administration’s promise to vaccinate 20 million Americans by year’s end.

Even as vaccine distribution lags, however, acceptance of the inoculations designed to prevent COVID-19 illness has grown, according to surveys by the Kaiser Family Foundation (KFF) and others.

In December 2020, 71 percent of Americans said they would definitely or probably get a vaccine for COVID-19 if it was determined to be safe by scientists and available for free to everyone who wanted it, according to the KFF COVID-19 Vaccine Monitor survey.

That’s up from 63 percent in a separate KFF survey conducted in September, prior to the Food and Drug Administration (FDA) granting emergency use authorizations for two COVID-19 vaccines developed by pharmaceutical companies Pfizer and Moderna.

Surveys conducted by Contakt World, a firm that specializes in public health technology and media campaigns for governments, as well as by Pennsylvania-based healthcare system Geisinger, which polled its 27,000 employees that included frontline healthcare workers, generally line up with the KFF findings.

Also, ChenMed, a primary care provider for older adults, released a survey on December 22 showing that 70 percent of Medicare-eligible older adults said they want to be vaccinated against COVID-19 “at the earliest opportunity” or as soon as they see others “safely benefiting” from the shots.

“Demand for the coronavirus vaccines, especially among the most vulnerable elderly populations, has become acute and appears to be rising,” Dr. Jason Lane, ChenMed’s national medical director for clinical strategy and outcomes, told Healthline. “Millions of seniors have been in self-quarantine since March, avoiding contact with family and friends, and COVID-19 vaccines are precisely what they need ASAP to safely get their lives back.”

However, about one in four Americans still say they probably or definitely won’t get vaccinated for COVID-19.

That includes disproportionately high percentages of self-declared Republicans (42 percent), people ages 30 to 49 (36 percent), rural residents (35 percent), and Black adults (35 percent).

One-third of individuals deemed “essential workers” also remain averse to getting vaccinated, according to the KFF report.

“There appears to be considerable reluctance to take the COVID-19 vaccine, both Pfizer and Moderna, especially among the individuals who are most vulnerable,” Tony Anno, a contributing faculty member in the Acute Care Nurse Practitioner program at Walden University in Minnesota, told Healthline. “Not only is the vaccine new technology… but there has also been politicization of both COVID-19 in general and the vaccination specifically. This has resulted in many people avoiding the vaccine.”

“Fortunately, given the opportunity to discuss the issues with their provider in person, some have changed their stances and have taken the vaccine,” Anno added. “Hopefully, as the vaccine becomes more readily available to less vulnerable patients, the acceptance rate will increase.”

While some early data on vaccine acceptability was “pretty grim,” Michelle Meyer, co-director of the Behavioral Insights Team in Geisinger’s Steele Institute for Health Innovation, told Healthline that “we’ve seen a steady increase in intention to get the vaccine as the process has played out.”

That has been particularly true after the FDA held hearings and approved the EUAs for the Pfizer and Moderna COVID-19 vaccines, Meyer said.

Media reports on the high effectiveness rates of the vaccine, along with images of public figures and celebrities getting vaccinated, also seem to have increased acceptance, according to Meyer.

The mixed reception to the COVID-19 vaccine was succinctly captured by a survey of teachers conducted by User Testing, a consulting firm that provides companies with insights into employee thinking and behaviors.

The survey found that while 72 percent of teachers felt they should receive the vaccine after medical professionals and related first responders, 77 percent also stated that they were concerned about the vaccinations.

According to the KFF survey, the most common concerns among “vaccine hesitant” individuals included:

  • possible side effects (59 percent)
  • lack of trust in the government to ensure the vaccines’ safety and effectiveness (55 percent)
  • concerns that the vaccine is too new (53 percent)
  • concerns over the role of politics in the development process (51 percent)

Among Black adults, fear of getting COVID-19 from the vaccine (50 percent) and distrust of vaccines in general (47 percent) were among the leading reasons for their reluctance.

“In the United States, a vocal minority has always been unwilling to take vaccines for religious or other reasons,” Dr. Richard Parker, medical director of the managed healthcare firm Arcadia, told Healthline. “The so-called ‘anti-vaxxer’ movement in the United States picked up speed prior to the outbreak of the COVID-19 pandemic. Under-vaccinated subsets of our population created the right conditions for the outbreaks of formerly vanquished infections such as the measles and mumps.”

“Given the need to vaccinate upward of 80 percent of the population to ensure herd immunity, we cannot be sanguine about people declining the COVID-19 vaccine,” said Parker. “This is truly a matter of life and death — and some of the greatest impacts are being felt by communities who have historically been underserved or ill-served by the healthcare industry and may be reluctant to take the new COVID-19 vaccines.”

Brian Castrucci, DrPH, president and chief executive officer of the de Beaumont Foundation, which works to improve community health in the United States, told Healthline that while vaccine acceptance rates have been good to date, he warned: “We’re only as safe as our communities with the lowest vaccination rates,” where future outbreaks of COVID-19 could be born and spread.

The de Beaumont Foundation has developed resources to “change the conversation” around COVID-19, including communication strategies targeting vaccination resistance among at-risk populations.

Messages aimed at Republicans and rural residents, for example, should focus on how vaccination can reopen the economy.

Women are more moved by appeals centered on protecting family members, while messages noting the vaccination could end the need for mask-wearing have resonated with Black and Latinx communities, said Castrucci.

More broadly, he said, campaigns to encourage COVID-19 vaccination need to avoid judgmental language, acknowledge legitimate fears about the new vaccines, and maintain a positive focus on the benefits of vaccination for friends and family.

“This is not about a national duty,” said Castrucci. “It’s not about doing it for your country. It’s about doing it for your family and to get things back to normal.”