People Can Change Their Minds About Vaccines

A new study paints an evolving picture of vaccination acceptance and hesitancy
A health care worker prepares to give a vaccination shot. A new Tufts study looked at the change in people’s attitudes toward the COVID-19 vaccine over the first few months of the year.
Over the first few months of 2021, the percentage of Americans who had received at least one vaccine dose or definitely intended to get the jab increased from 54.7% to 72.3%. Photo: Shutterstock
September 14, 2021

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Vaccination behavior and attitudes among adults changed in the early months of this year, with more people reporting they intended to get vaccinated, according to a recent study by Kimberly Nguyen, an assistant professor at Tufts University School of Medicine, and collaborators.

The paper, published in Annals of Medicine, looked at data from January 6 to March 29 of 2021. While one of the most encouraging findings was that the percentage of Americans who had received at least one vaccine dose or definitely intended to get the jab increased from 54.7% to 72.3%, Nguyen still worries about the number of people who are still hesitant to get vaccinated.

According to the analysis, Non-Hispanic Black Americans and people who live in certain southeastern states are less likely to get vaccinated or intend to get vaccinated against COVID-19. Younger adults and people who are less educated or economically secure are also more reluctant to get vaccinated.

“It’s important that we target messages to continue to increase vaccine confidence and uptake in these populations,” she said. Another bright spot was that while vaccination rates among non-Hispanic Black Americans were relatively low, this group showed the greatest increase in intent to get vaccinated—jumping more than 30%—over the study period.

The survey’s insights can help guide health communication strategies and efforts to increase vaccination rates, particularly among vulnerable populations that have been disproportionately affected by COVID-19. These populations often have less access to healthcare, or live under other conditions—crowded housing, food insecurity—that make them more susceptible to COVID-19 infection and ultimately death.

The analysis used data gathered by the Census Bureau’s Household Pulse Survey, a large, national survey that started collecting data at the pandemic’s beginning in April 2020. Some 75,000 adults were surveyed. This is among the first studies to look at how U.S. adults’ vaccination rates and willingness to be vaccinated have changed over time, viewed through sociodemographic and geographic lenses.

Zip Code Connection

People living in region 4 (Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee) were the least likely to get vaccinated compared to adults in other regions. Nguyen said that in addition to vaccine hesitancy, logistical barriers such as vaccine supply and vaccination clinic availability may be responsible for low vaccination intent in this part of the country. Residents of the District of Columbia were the most likely to say they definitely planned to get vaccinated (85.4%).

Hesitancy and Its Roots

Nguyen is concerned about a 5% overall increase in the percentage of unvaccinated adults who say they believe a vaccine is not needed. “While the change is small, it is concerning because of the rise in COVID-19 cases,” she said, adding that the vaccine provides the best protection against the virus that causes COVID.

Among those who said they definitely will not get vaccinated (approximately 10% of the sample), the two most common reasons for their hesitation were distrust of the vaccine (47.9%) and concern about side effects (46.5%). While the survey didn’t address the issue of vaccine misinformation, Nguyen believes it is implicit in the latter data point.

“Approximately one half of the sample who said they definitely will not get vaccinated were concerned about possible side effects, even though the percentage of people experiencing severe side effects is small,” she said.

How to Increase Vaccination Rates

The study recommends that states seeking to increase vaccination rates devise strategies that:

  • Increase confidence in vaccines among vulnerable groups
  • Monitor and address barriers to vaccination. Two ways of lowering barriers include offering free transportation to vaccination sites and locating sites in places that are more accessible
  • Direct vaccines to vulnerable communities
  • Engage communities to build trust and collaboration

Disseminating clear and accurate messages about COVID-19 vaccines is critical, Nguyen said. “We need to highlight how important vaccines are to resuming social activities and ensure that healthcare providers are having discussions about the importance of vaccination,” she said.

What role can individuals play in increasing vaccination rates? “Receiving all recommended doses of the vaccine is important for getting the most protection against COVID-19,” Nguyen suggested. “In addition, encourage non-vaccinated family members and friends to get vaccinated to protect their health as well as those around them. Advise them to discuss any questions or concerns they have with their healthcare provider. The CDC website has a lot of good information as well.”