key: cord-0995093-3iu3t99w
authors: Nguyen, Kimberly H.; Srivastav, Anup; Razzaghi, Hilda; Williams, Walter; Lindley, Megan C.; Jorgensen, Cynthia; Abad, Neetu; Singleton, James A.
title: COVID‐19 vaccination intent, perceptions, and reasons for not vaccinating among groups prioritized for early vaccination — United States, September and December 2020
date: 2021-03-31
journal: Am J Transplant
DOI: 10.1111/ajt.16560
sha: 8ba457dcf132d1161dd266aa9af8beebcdc4da13
doc_id: 995093
cord_uid: 3iu3t99w

This article describes perceptions of the COVID‐19 vaccine among US adults, and reports that younger adults, women, non‐Hispanic Black adults, adults living in nonmetropolitan areas, adults with less education and income, and adults without health insurance have the highest estimates of nonintent to receive vaccination; due to concerns about side effects and safety of the COVID‐19 vaccine, lack of trust in the government, and concern that COVID‐19 vaccines were developed too quickly are the primary reasons for deferring vaccination. Solid organ transplant candidates and recipients may harbor similar concerns about vaccination, and further, may rely more heavily on herd immunity for protection from COVID‐19, since the efficacy of COVID‐19 vaccination among immunosuppressed individuals remains ill‐defined. Promoting vaccine confidence among transplant candidates, transplant recipients, and the general population will thus be critical to preventing spread of COVID‐19.

From September to December, vaccination intent (defined as being absolutely certain or very likely to be vaccinated) increased overall (from 39.4% to 49.1%); the largest increase occurred among adults aged ≥65 years. If defined as being absolutely certain, very likely, or somewhat likely to be vaccinated, vaccination intent increased overall from September (61.9%) to December (68.0%). Vaccination nonintent (defined as not intending to receive a COVID-19 vaccination) decreased among all adults (from 38.1% to 32.1%) and among most sociodemographic groups. Younger adults, women, non-Hispanic Black (Black) persons, adults living in nonmetropolitan areas, and adults with lower educational attainment, with lower income, and without health insurance were most likely to report lack of intent to receive COVID-19 vaccine. Intent to receive COVID-19 vaccine increased among adults aged ≥65 years by 17.1 percentage points (from 49.1% to 66.2%), among essential workers by 8.8 points (from 37.1% to 45.9%), and among adults aged 18-64 years Intent was assessed by response to the following question: "If a vaccine against COVID-19 were available today at no cost, how likely would you be to get it?" Response options were "absolutely certain," "very likely," "somewhat likely," and "not likely."

Respondents who answered "absolutely certain" or "very likely" to receive a COVID-19 vaccination were defined as intending to be vaccinated, and respondents who answered "not likely" were defined as not intending to be vaccinated. Vaccination intentions and related perceptions were stratified by the following three mutually exclusive groups representing the ACIP priorities for initial doses of COVID-19 vaccine after healthcare providers and long-term care residents: (1) essential workers, ¶ ¶ (2) adults aged 18-64 years with underlying From September to December, the proportion of adults reporting intent to receive COVID-19 vaccine as absolutely certain or very likely increased significantly by 9.7% points (from 39.4% to 49.1%), and the proportion reporting nonintent decreased by 6.0% points (from 38.1% to 32.1%) ( Table 1) . Among priority groups, intent in- planning to wait to see if the vaccine is safe and consider receiving it later (14.5%), lack of trust in the government (12.5%), and concern that COVID-19 vaccines were developed too quickly (10.4%) ( Table 3) . A larger percentage of the December survey participants than September participants reported safety concerns as a main reason (29.8% vs. 23.4%), and a smaller percentage reported concern that vaccines were developed too quickly (10.4% vs. 21.6%).

From September to December 2020, vaccination intent increased among all adults by approximately 10 percentage points and across

National polls conducted before vaccine distribution began suggested that many persons were hesitant to receive COVID-19 vaccination.

From September to December 2020, intent to receive COVID-19 vaccination increased from 39.4% to 49.1% among adults and across all priority groups, and nonintent decreased from 38.1% to 32.1%. Despite decreases in nonintent from September to December, younger adults, women, non-Hispanic Black adults, adults living in nonmetropolitan areas, and adults with less education and income, and without health insurance continue to have the highest estimates of nonintent to receive COVID-19 vaccination. U.S.C. Sect. 552a; 44 U.S.C. Sect. 3501 et seq. ¶ ¶ Essential workers were defined as those who responded "yes" to the following question: "In your work or volunteer activities, are you classified as an essential worker?" *** Mutually exclusive groups were categorized in the following order: essential workers, adults aged ≥65 years, and adults aged 18-64 years with an underlying medical condition. Anyone who selfidentified as an essential worker was categorized as an essential worker, regardless of age. Next, anyone aged ≥65 years was categorized as adult aged ≥65 years. Finally, anyone aged 18-64 years with an underlying medical condition was categorized as adult aged 18-64 years with an underlying medical condition. All others were categorized as adults aged 18-64 years who were not essential workers and had no underlying medical conditions. † † † Metropolitan statistical area (MSA) status was determined by census block group using the panelist's address. For a small number of panelists for whom the address was not available, ZIP code was used to determine MSA status. https://www.census.gov/progr ams-surve ys/ metro -micro.html

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