Many Americans remain hesitant about getting a COVID-19 immunization as soon as an FDA-approved vaccine is available
Editor’s Note (07/09/2020): This article includes findings from our fourth wave of data collection that fielded June 22 through June 29. This fourth wave collected another 1,000 completes using a census-balanced, national non-probability sample. The new information, shared below, expands on our May findings regarding American attitudes towards a COVID-19 vaccine. Learn more about the ICF COVID-19 Monitor Survey of U.S. Adults.
On June 22, the United States reached almost 2.3 million confirmed cases of COVID-19 and approximately 120,000 coronavirus deaths. The government and many pharmaceutical companies are racing to quickly launch clinical trials to develop and produce a safe and effective vaccine—potentially by the end of 2020. However, in May we reported that only 34% of Americans indicated that they were very likely to get the coronavirus vaccine as soon as an FDA-approved one becomes available. With increasing cases, including the emergence of many hot spots in the southern and western United States, we examine 1) whether this trend changed in June, and 2) for the first time how the likelihood to get the COVID-19 vaccine is related to attitudes towards vaccines in general.
Americans’ attitudes toward a COVID-19 vaccine in June were unchanged compared to May.
Fewer than a third of adults (31%) in June said that they would be very likely to get the coronavirus vaccine as soon as an FDA-approved one becomes available, while another 32% said that they would be somewhat likely. These rates were essentially unchanged from May.
As reported in May, the perceived likelihood of contracting the coronavirus in June continues to be related to public interest in getting a vaccine for it. Nearly half who feel they are not at all likely (48%)—and a majority of those who feel they are not too likely (62%)—to get the virus are still very or somewhat likely to get a vaccine as soon as it is available. This increases to 73% for those who feel they are somewhat likely and 87% for those who feel they are very likely to get sick with the virus. These differences are statistically significant.
Vaccination likelihood may increase if the vaccine is free, if there are no side effects within 6 months, or if there is a second wave of coronavirus.
To better understand the relatively low rate of willingness to receive an FDA-approved vaccine for COVID-19 as soon as it is available, we included three additional scenarios after our base question in the June survey. Those who did not say that they were very likely to take the vaccine in the first question were asked how likely they would be to receive the vaccine if it were free, to receive it within six months if there were no side effects or other problems, or to receive it if there were a second wave of coronavirus. Rates of likelihood to get the coronavirus vaccine increased within each scenario, as shown in the table below.
These findings suggest that there are several scenarios in which a majority of adults might be very willing to be vaccinated with an FDA-approved vaccine for COVID-19. Under each of these scenarios, the proportion of adults who indicate that they would be at least somewhat willing to be vaccinated was 72% or higher.
Why is it then that more than half of adults are not very likely to get the vaccine right away, even if it were free, and nearly a quarter are not likely to get the vaccine even after 6 months with no problems or even if there were a second wave?
Attitudes towards vaccines are strongly linked to likelihood of getting coronavirus vaccine.
Vaccine attitudes have been found to be related to vaccine behaviors for other diseases and other populations (Boyle, et al., Vaccine, 2020.) Respondents in this survey were asked: “How much would you say that you agree or disagree with people who strongly oppose vaccines, sometimes called anti-vaxxers?” Nearly a quarter of the sample said they strongly agreed (9%) or more agreed than disagreed (13%) with the anti-vaxxers. Another quarter (24%) more disagreed than agreed with them, and nearly half (46%) strongly disagreed with the anti-vaxxers. Nearly one in ten (8%) preferred not to answer.
The attitudes toward anti-vaxxers are related to likelihood of getting a vaccine within six months of its availability. Nearly half of those who strongly agree with anti-vaxxers (46%) are not too or not at all likely to get a vaccine for COVID-19 within six months of its availability even if no problems are reported. By contrast, nearly all (93%) of those who strongly disagree with the anti-vaxxers would be very or somewhat likely to get the vaccine under those conditions. Those with more mixed feelings about the anti-vaxxers also have more mixed feelings about getting a vaccine for COVID-19.
In order to better understand the role of attitudes toward vaccines in the public's willingness to accept an FDA-approved vaccine for COVID-19, we introduced 11 vaccine attitude questions in the June survey.
A number of positive attitudes towards vaccines are held by large majorities of U.S. adults. For example, four out of five Americans agree that vaccines are very effective (82%), vaccines are important to their health (81%), and being vaccinated is important to the health of the others in the community (80%). Three quarters (76%) of Americans agree that vaccines are very safe.
At the same time, a substantial segment of the public also holds attitudes that may produce reluctance to try new vaccines. A majority (50%) agree that some vaccines have ingredients that may be harmful. More than a third (35%) feel that some vaccines are linked to long-term health problems.
|
Attitude toward vaccination |
Strongly disagree |
Somewhat disagree |
Somewhat agree |
Strongly agree |
Don't know/Not sure |
|
Some vaccines are linked to long term health problems |
20% |
21% |
24% |
11% |
25% |
|
Natural infection is safer than vaccines for providing immunity |
28% |
24% |
19% |
9% |
20% |
|
There is little risk of getting the disease from the vaccine |
8% |
19% |
34% |
27% |
12% |
|
Some vaccines may cause learning disabilities, such as autism |
33% |
15% |
18% |
9% |
25% |
|
Some vaccines have ingredients that could be harmful |
13% |
17% |
34% |
16% |
20% |
|
Vaccines are given to prevent diseases that most people are not likely to get |
20% |
24% |
28% |
18% |
10% |
|
Overall, vaccines are very safe |
5% |
11% |
41% |
35% |
8% |
|
Overall, vaccines are very effective |
4% |
7% |
39% |
43% |
6% |
|
Vaccines are important for my health |
6% |
7% |
34% |
48% |
6% |
|
My being vaccinated is important for the health of others in my community |
5% |
8% |
33% |
47% |
6% |
|
The information I receive about vaccines from government health agencies is reliable and trustworthy |
8% |
14% |
42% |
24% |
13% |
Ten out of the 11 vaccine attitudes examined in the survey had a statistically significant relationship with willingness to get the COVID-19 vaccine within six months after it becomes available (assuming no problems). Indeed, all 10 of these attitudes had a correlation with willingness to use an FDA-approved COVID-19 vaccine that was as high or higher than the correlation with perceived personal risk of contracting the coronavirus.
| Attitude toward vaccination | N | Pearson R | Significance |
| Overall, vaccines are very safe | 965 | -.485 | .000 |
| Overall, vaccines are very effective | 983 | -.449 | .000 |
| Vaccines are important for my health | 986 | -.489 | .000 |
| Me being vaccinated is important for the health | 999 | -.506 | .000 |
| The information I receive about vaccines from government health agencies is reliable and trustworthy | 923 | -.463 | .000 |
The attitudes that had the highest correlation with willingness to try a coronavirus vaccine within six months after it is available include: vaccines are important to my health; being vaccinated is important for the health of others in my community; overall, vaccines are very safe; and overall, vaccines are very effective. The belief that information about vaccines from government health officials is reliable and trustworthy is positively correlated with willingness to try a COVID-19 vaccine within six months. Unfortunately, fewer than two thirds of respondents agree that information about vaccines from government health officials is reliable and trustworthy.
As expected, positive attitudes toward vaccines are positively correlated with willingness to adopt a COVID-19 vaccine, while negative attitudes are negatively related to vaccine adoption. Perhaps more importantly, the negative attitudes have lower correlations with COVID-19 vaccine adoption than did the positive attitudes. Nonetheless, these attitudes are negatively correlated with willingness to adopt an FDA-approved COVID-19 vaccine either as soon as it is available or after six months even if no side effects or other problems are reported.
Policy implications
Given the continuing low base rate of likely early adopters for an FDA-approved COVID-19 vaccine—and the relatively high rate of some negative attitudes toward vaccines—it will be vital to develop a convincing communications campaign about COVID-19 vaccination in the next six months. The June survey also finds that the erosion of public confidence in government and public health agencies continues, while public trust in scientists remains high. Our conclusions from the May report on immunization remain unchanged. For maximum impact, it will be important for scientists and public health officials to lead the communications about the vaccine with the public.
