The KFF COVID-19 Vaccine Monitor is an ongoing research project tracking the public’s attitudes and experiences with COVID-19 vaccinations. Using a combination of surveys and qualitative research, this project tracks the dynamic nature of public opinion as vaccine development and distribution unfold, including vaccine confidence and hesitancy, trusted messengers and messages, as well as the public’s experiences with vaccination.

Key Findings

• With news reports about states lagging in their vaccine distribution efforts and concerns that the supply of available vaccines will not meet demand, the latest KFF COVID-19 Vaccine Monitor poll (conducted January 11-18) finds two-thirds of U.S. adults (65%) say the federal government is doing a “fair” or “poor” job of distributing vaccines to the states. About three in ten adults give the federal government a positive rating of “excellent” or “good”. Likewise, six in ten think their state government is doing a “fair” or “poor” job of distributing the vaccine to people in their state. Notably, while similar shares across partisans give their state government negative marks, nearly half of Democrats (45%) think the federal government is doing a “poor” job while Republicans are more divided in their assessment.
• About half of the public think that efforts to distribute the vaccine will “get better” under a President Biden Administration, compared to about a third who think efforts will “stay about the same,” and one in ten who say it will “get worse”. Democrats overwhelmingly expect distribution efforts to improve under President Biden (83%) as do a plurality of independents (45%), while most Republicans (57%) say it will remain about the same.
• Two-thirds of adults say they are confident that the COVID-19 vaccines in the U.S. are being distributed fairly, including most Black adults (58%). However, about half of Black adults say they are “not too” or “not at all” confident that the vaccine distribution efforts are taking into account the needs of Black people (52%).
• Majorities of the public who have not yet gotten vaccinated (94% of all adults) say they do not have enough information about when people like them will be able to get the vaccine (60%) and about where they will be able to get the vaccine (55%). Notably, about six in ten Black and Hispanic adults say they do not have enough information about where to get the vaccine, compared to about half of White adults who say the same. Among adults 65 and over – a group that has higher priority for the vaccine – about six in ten say they do not have enough information about when (58%) and where (59%) they will be able to get the vaccine.
• Despite some discontent with government vaccine distribution efforts, two-thirds of the public saying they feel “optimistic” about the current status of vaccinations in the U.S. Though amidst reports of delays in the vaccine rollout in some areas, half also say they feel “frustrated” by the state of the vaccination efforts – including six in ten Democrats (61%), nearly half of independents (48%), and four in ten Republicans (42%). Notably, a third of adults say they feel “confused” by the state of vaccinations in country, which is similar to share who say they feel “satisfied,” indicating there is room for improvement in the first weeks of the Biden Administration.

Most Give Negative Assessment of Federal, State Government Vaccine Distribution Efforts

With news that some states and localities are lagging behind in their distribution efforts and reports that demand for COVID-19 vaccines is outstripping supply, about two-thirds of adults say the federal government is doing a “fair” (33%) or “poor” (31%) job of distributing the COVID-19 vaccines to the states. Just under three in ten give the federal government a positive rating of either “good” (21%) or “excellent” (8%).

State governments also get a negative rating from the public with a majority saying their state government is doing just a “fair” job (36%) or a “poor” job (25%) of distributing vaccines to people in their state while a third say they are doing a “good” (25%) or “excellent” (7%) job.

Notably, Democrats and Republicans give their state governments similar ratings with about six in ten saying they are doing a “fair” or “poor” job distributing the vaccine to people in their state. However, with the survey fielded in the last days of the Trump Administration, partisan opinions are more split when rating the federal government. Eight in ten Democrats say the federal government is doing a “fair” or “poor” job of distributing the COVID-19 vaccines to the states, whereas Republicans are more divided in their rating of the federal government (43% say “excellent” or “good”, and 46% “fair” or “poor”).

About half of adults (48%) think efforts to distribute the vaccine in the U.S. will “get better” under the new President Biden Administration. About a third (36%) say they think vaccine distribution efforts will “stay about the same” while 12% say it will stay “get worse.” An overwhelming majority of Democrats (83%) think vaccine distribution efforts will “get better” under the Biden Administration while a majority of Republicans (57%) think distribution efforts will remain “about the same.” About four in ten independents (45%) expect distribution efforts to improve under President Joe Biden while 38% think it will “stay about the same.”

Despite some discontent with the vaccine distribution efforts of the federal government and state governments, most adults (65%) – including majorities across Democrats (70%), independents (64%), and Republicans (59%) – are confident that vaccines are being distributed in a way that is fair. About a third of the public say they are “not too confident” (20%) or “not at all confident” (12%) that the COVID-19 vaccines are being distributed fairly. In the December KFF COVID-19 Vaccine Monitor, fielded before COVID-19 vaccinations began in the U.S., a similar share of adults (67%) expressed confidence that the vaccine would be distributed in a fair manner.

Nonetheless, while the public overall expresses confidence that the vaccines are being distributed fairly, concerns remain about whether the needs of people of color are being taken into account in the vaccine distribution process. While most Black adults (58%) are at least “somewhat confident” that the vaccine is being distributed fairly in the U.S., just 9% are “very confident” that is the case. Indeed, about half of Black adults (52%) say they are “not too” or “not at all” confident that the distribution of a COVID-19 vaccine is taking the needs of Black people into account. While most about half of Hispanic adults (53%) express some confidence that the needs of Hispanic people are being taken into account in the distribution of the vaccine, a large share (44%) say they are “not too confident” or “not at all confident.”

In KFF’s December 2020 COVID-19 Vaccine Monitor, half of Black adults (49%) and six in ten Hispanic adults (60%) said they were confident that the development of the vaccine was taking into account the needs of Black and Hispanic people respectively.

Majorities Say They Do Not Have Enough Information About Where And When To Get Vaccine

Among those who have not yet gotten the COVID-19 vaccine (94% of all adults), six in ten say they do not have enough information about when people like them will be able to get the vaccine. Information on where to get a vaccine is also needed as a majority (55%) of those who are not yet vaccinated say they do not have enough information about where they will get a vaccine. Despite some states having slightly different vaccine priority criteria, most adults (55%) say they have enough information about how their state is deciding who gets priority for the COVID-19 vaccine, with four in ten (43%) saying they do not have enough information.

Adults 65 and older are among the groups many states are prioritizing for vaccine distribution. However, among those older adults who have not yet been vaccinated, about six in ten say they do not have information about when people like them will be able to get the COVID-19 vaccine (58%) and about where they will be able to get it (59%). Notably, a majority of essential workers who have not yet gotten the vaccine say they have enough information about where to get the vaccine (55%), but most say they do not have enough information about when people like them will be able to get vaccinated (55%). This includes health care workers (one-fifth of essential workers work in a health care delivery setting) who have not yet gotten vaccinated and say they don’t have enough information about when they will be able to get vaccinated (21%). A similar share (18%) of health care workers haven’t gotten vaccinated and say they don’t have enough information about where to get vaccinated.

About six in ten Black (62%) and Hispanic (63%) adults say they do not have enough information about where to get a COVID-19 vaccine, compared to about half of White adults who say they do not enough information (51%). Six in ten lower income adults with a household income under $40,000 (61%) say they do not have enough information about where they will be able to get a vaccine, compared to about half of those with a household income of $90,000 or more (49%). Similarly, lower income adults are also less likely than their higher income counterparts to say do not have enough information about when people like them will be able to get the vaccine (66% vs. 54%).

Public Is Optimistic About COVID-19 Vaccination Efforts, Though Some Concerns Remain

With millions of health care workers, long term care workers and residents, and older adults throughout the country getting vaccinated against COVID-19, two-thirds of the public (66%) say they feel “optimistic” about the current status of vaccinations in the U.S. Nonetheless, perhaps reflecting the negative ratings given to the federal and state government vaccine distribution efforts, half of the public (50%) say they feel “frustrated” with the current status of COVID-19 vaccinations in the country. Additionally, one-third of adults say they feel “confused” about the status of vaccinations, including about four in ten Black adults (46%), young adults ages 18 to 29 (40%), and those with a household income under $40,000 (42%). A third of the public say they feel “satisfied” about current status of vaccinations in the U.S. while about one in four say they feel angry (23%).

Optimism about vaccinations crosses party lines with about two-thirds of Democrats, independents, and Republicans saying they feel optimistic about the current status of vaccinations in the country. However, despite the shared optimism, about six in ten Democrats (61%) also say they are frustrated, compared to less than half of Republicans (42%) and independents (48%) who say the same.

These additional findings were released January 27, 2021.

The KFF COVID-19 Vaccine Monitor is an ongoing research project tracking the public’s attitudes and experiences with COVID-19 vaccinations. Using a combination of surveys and qualitative research, this project tracks the dynamic nature of public opinion as vaccine development and distribution unfold, including vaccine confidence and hesitancy, trusted messengers and messages, as well as the public’s experiences with vaccination.

Key Findings

• As millions of Americans get their first and second doses of a COVID-19 vaccine, the latest KFF COVID-19 Vaccine Monitor reports that a growing share of the public is open to getting vaccinated, but many of the same groups that were hesitant in December remain hesitant now. The share of U.S. adults who want to get the vaccine as soon as possible has increased since December among Black, Hispanic, and White adults alike, and the share who say they want to “wait and see” how it works for other people has declined. Similarly, vaccine enthusiasm has shifted among those living in urban, suburban, and rural communities, but rural residents continue to be among the most resistant to getting vaccinated.
• Partisanship continues to be a factor in attitudes towards COVID-19 vaccination. While vaccine enthusiasm increased for both Democrats and independents, it has not shifted among Republicans, who remain the most resistant, with 33% saying they will definitely not get the vaccine or will get it only if required to do so for work, school or other activities.
• Racial and economic equity remains at the forefront of the COVID-19 vaccine conversation. Black and Hispanic adults and those with lower incomes are less likely than their White and higher-income counterparts to say they have personally received at least one dose of the vaccine or that they know someone who has. Black and Hispanic adults are also among those most likely to say they want to “wait and see” how the vaccine is working for other people before getting vaccinated themselves.
• Knowing someone who has been vaccinated for COVID-19 is correlated with vaccine hesitancy and enthusiasm. Among those who say they want the vaccine “as soon as possible,” about half (52%) know someone who has been vaccinated, while among those who say they’ll get it “only if required,” a much smaller share (29%) know someone who has received the vaccine.
• Those who have not yet been vaccinated for COVID-19 have many concerns and information needs related to the new vaccines, particularly when it comes to side effects and the effectiveness of the vaccine. About half say they don’t have enough information about the vaccine’s side effects or effectiveness, with higher shares of younger, Black, and Hispanic adults citing these information needs.
• When examining messages and information that might increase the public’s willingness to get vaccinated, the messages the public finds the most convincing emphasize the vaccine’s effectiveness at preventing illness, protection for those who are vaccinated, and the ability to return to normal life. On the other hand, hearing that some people experience short-term side effects from the vaccine or that a small number of people have experienced serious allergic reactions has the potential to decrease willingness to get vaccinated for a substantial share of people.
• Reinforcing previous findings about trusted sources of information, the survey finds that doctors, nurses, and other health care providers are the sources that people say they’re most likely to turn to when making their own decisions about whether to get vaccinated. Still, these conversations have not started yet for many, with only about a quarter (26%) saying they have asked a health care professional for information about the vaccine so far.

COVID-19 Vaccine Hesitancy and Enthusiasm

Trends in Hesitancy and Enthusiasm

With millions of Americans having received at least one dose of a COVID-19 vaccine, the latest KFF COVID-19 Vaccine Monitor (fielded just before President Biden took office) reports that enthusiasm for getting vaccinated has increased markedly since December. Four in ten U.S. adults (41%) now say that when an FDA-approved vaccine for COVID-19 is available to them for free, they will get the vaccine “as soon they can,” up from 34% in December. An additional 6% say they have already received at least one dose of the vaccine¹ , bringing the total in this “as soon as possible” group to nearly half the public (47%). About three in ten (31%) say they want to “wait until it has been available for a while to see how it is working for other people” before getting the COVID-19 vaccine themselves, down from 39% in December. One in five adults are more reluctant to get vaccinated, including 7% who say they will get the vaccine only “if they are required to do so for work, school, or other activities” and 13% who say they will “definitely not” get the vaccine.

The share of U.S. adults who want to get the vaccine as soon as possible has increased since December among Black, Hispanic, and White adults alike, and the share who say they want to “wait and see” how it works for other people has declined among Black and White adults. However, Black adults (43%) and Hispanic adults (37%) remain significantly more likely than White adults (26%) to say they want to “wait and see,” while White adults (53%) are more likely to say they have already been vaccinated or want the vaccine “as soon as possible” compared Black or Hispanic adults (35% and 42%, respectively).

Similarly, there has been a shift in COVID-19 vaccine enthusiasm across different types of communities, including in urban, suburban, and rural areas. Among rural residents, 42% now say they have either already been vaccinated or want the vaccine “as soon as possible” and 27% want to “wait and see” how it’s working, essentially reversed from December when 29% said “as soon as possible” and 38% said “wait and see.” Still, rural residents remain much more likely than those living in urban areas to say they will “definitely not” take the vaccine (21% vs. 8%).

Politically, the shift in COVID-19 vaccine enthusiasm between December and January was driven almost entirely by Democrats (and to a lesser extent, independents). Nearly two-thirds of Democrats (64%) now say they have either already been vaccinated or want the vaccine as soon as possible, up from 47% in December, and the share of independents who fall into this group increased from 30% to 45%. Republicans remain the least enthusiastic group, with 32% saying they have already been vaccinated or want the vaccine as soon as they can, 33% saying they want to wait and see how it works for others, and 25% saying they will definitely not get the vaccine, similar to the December results.

Which Groups Are Most Enthusiastic/Hesitant/Resistant?

Who is most enthusiastic to get vaccinated against the novel coronavirus? Adults ages 65 and over (66%) and Democrats (64%) are among those most likely to say that they have already gotten the vaccine or that they will get it “as soon as they can.” Those who work in a health care delivery setting (58%), White adults (53%) and those who live in households where someone has a serious health condition (51%) are also more likely than their counterparts to say they have been vaccinated already or want the vaccine “as soon as possible.”

Who is most likely to say they want to wait to see how vaccination goes for other people before getting vaccinated themselves? Young adults ages 18-29 (43%), Black adults (43%), Hispanic adults (37%), and those living in urban areas (37%) are the most likely to say they want to “wait and see” how the COVID-19 vaccine is working for other people before getting vaccinated themselves.

One in five U.S. adults overall say they will either “definitely not” get vaccinated or that they’ll get vaccinated “only if required” for work, school, or other activities. One-third (33%) of Republicans fall into one of these most reluctant categories, as do about three in ten rural residents (29%) and a similar share of essential workers in fields other than health care (28%).

Health Care Workers and Other Essential Workers

One priority group for early COVID-19 vaccination is essential workers – those who are required to work outside their home during the pandemic – including those who work in health care delivery settings. Twelve percent of all essential workers, including 32% of health care workers and 5% of non-health essential workers, say they have received at least one dose of the vaccine. Still, substantial hesitation remains even among these priority groups. Three in ten non-health essential workers (31%), and a similar share of health care workers (28%) say they want to wait and see how the vaccine is working for other people before getting it themselves. Among essential workers in fields other than health care, 12% say they’ll get the vaccine only if required, and 16% say they will definitely not get it, though these shares are somewhat smaller among health care workers (5% and 9%, respectively).

Personal Experiences With Vaccination

At the time the survey was fielded, access to the COVID-19 vaccine in most states was limited to health care workers and long-term care workers, and some states had begun to open up access to other groups including older adults, other front-line workers, and those with certain health conditions. While just 6% of U.S. adults say they have personally received at least one dose of the COVID-19 vaccine, an additional 41% say they know someone who has been vaccinated. However, this proximity to vaccination is unevenly distributed across demographic groups. White adults (51%) are more likely than their Black and Hispanic counterparts (38% and 37%, respectively) to say they’ve either been vaccinated or know someone who has. Further, those with household incomes of $90,000 or more are almost twice as likely as those with incomes under $40,000 to say that they or someone they know has been vaccinated (65% vs. 33%). These patterns are consistent with a recent KFF analysis that found that the shares of vaccinations among Black and Hispanic people were lower compared to their shares of the total population in most states where data were reported by race and ethnicity.

Knowing someone who has been vaccinated for COVID-19 is also correlated with vaccine hesitancy and enthusiasm among those who have not yet been vaccinated themselves. Among those who say they want the vaccine “as soon as possible,” about half (52%) know someone who has been vaccinated, while among those who say they’ll get it “only if required,” a much smaller share (29%) know someone who has received the vaccine.

Concerns and Information Needs

Concerns About COVID-19 Vaccines

Understanding the concerns or reservations that people have about vaccines can be helpful for crafting effective messages to convince people to get vaccinated. Asked about a variety of things they might be concerned about, the most common concern among U.S. adults who have not yet been vaccinated is that “the long-term effects of the COVID-19 vaccines are unknown” (68% say they are “very” or “somewhat” concerned about this). Majorities are also concerned that they might experience serious side effects from the vaccine (59%), that the vaccines are not as safe as they are said to be (55%), or that they are not as effective as they are said to be (53%). Fewer (31%) say they concerned that they might get COVID-19 from the vaccine.

Concerns about safety and side effects are highest among those who want to wait and see how the vaccine is working for others as well as those who are more reluctant to get vaccinated. Among the “wait and see” group that is closely watching how things go for others during the initial vaccine rollout, nine in ten (89%) are concerned about the long-term effects of the vaccine, eight in ten are concerned they may experience serious side effects, three-quarters are concerned the vaccines are not as safe as they are said to be, and two-thirds (68%) are concerned they might not be as effective as claimed.

Still, concerns about the vaccine are not completely absent for those who are eager to get vaccinated, or even those who have already received at least one dose of the vaccine. Notably, about half of those who have already received at least one dose (49%) and a similar share of those who say they want the vaccine as soon as possible (48%) say they are at least somewhat concerned that the long-term effects of the COVID-19 vaccines are unknown.

Echoing previous findings that different groups have different reasons for being hesitant to get vaccinated, the January KFF COVID-19 Vaccine Monitor reports that different groups express different levels of concern about side effects, safety, and effectiveness as well. For example, among those who have not yet been vaccinated, about half of Black (54%) and Hispanic adults (50%) say they are concerned they might get COVID-19 from the vaccine, compared to a much smaller share of White adults (20%). Black and Hispanic adults are also more likely than White adults to express nearly every concern measured in the survey, with large shares of Black adults saying they are concerned that the long-term effects of the vaccine are unknown (86%), that they might experience serious side effects (75%), and that the vaccines may not be as safe (75%) or effective (71%) as they are said to be. Those with lower incomes and those who have not graduated from college are also more likely to express each of these concerns compared to their higher-income and more educated counterparts, and larger shares of women than men are concerned about each of these things.

Information and Misinformation

Echoing the public’s concerns about side effects and effectiveness, nearly six in ten (57%) of those who have not been vaccinated against COVID-19 say they don’t have enough information about the potential side effects of the vaccine, and about half (49%) say they don’t know enough about the vaccine’s effectiveness. Notably, these information needs are substantially higher among those who say they are waiting to see how the vaccine works for others and those who say they will get vaccinated only if required. Just over three-quarters in both these groups say they don’t have enough information about the vaccine’s side effects, and about seven in ten say they don’t know enough about its effectiveness.

Information needs about COVID-19 vaccine side effects and effectiveness are higher among younger adults and those who are Black or Hispanic. Among Black and Hispanic adults who have not been vaccinated, about two-thirds say they don’t have enough information about the side effects of the vaccine and about six in ten say the same about the vaccine’s effectiveness. Among those under age 50, roughly six in ten say they don’t know enough about side effects and more than half need more information about effectiveness.

Information needs also vary by education and income. Among adults with a high school education or less, 63% say they don’t know enough about the COVID-19 vaccine side effects and 57% say they lack information about its effectiveness. Similarly, among those with household incomes under $40,000, two-thirds say they don’t have enough information about side effects and six in ten (61%) don’t know enough about effectiveness.

The Vaccine Monitor also reports that some of those who have not yet been vaccinated have heard misinformation about the COVID-19 vaccines and either believe it to be true or are unsure whether it is true or false. Most commonly, 8% of those who haven’t been vaccinated believe the vaccines currently being distributed contain the live virus that causes COVID-19, and an additional 11% say they’ve heard this and are unsure if it’s true. Small shares also believe or are unsure whether the COVID-19 vaccines have been shown to cause infertility (13%) or whether getting vaccinated requires paying an out-of-pocket cost (12%). Overall, one-third (34%) of those who have not been vaccinated believe or are unsure about at least one of these things.

Notably, the share who believe or are unsure about at least one of these vaccine “myths” (that the vaccine contains the live coronavirus, that it causes infertility, or that an out-of-pocket cost is required to get vaccinated) is higher among those who want to “wait and see” how the vaccine works for other people (41%) and those who say they will “definitely not” get vaccinated (53%). These shares also vary by education level; 37% of those without a college degree believe or are unsure about at least one of these things, compared with 28% of college graduates.

On the other hand, about half (47%) of those who have not been vaccinated know that people will still need to wear face masks after getting vaccinated to help limit the spread of coronavirus, though this level of awareness is somewhat lower among the groups that are move hesitant to get vaccinated (36% in both the “wait and see” and “only if required” groups and 35% in the “definitely not” group).

How Messages And Information Affect Willingness To Get Vaccinated For COVID-19

Messages and Information That Might Convince People To Get Vaccinated

The latest COVID-19 Vaccine Monitor tested different messages and information that might make people more likely to get vaccinated for COVID-19, and found that the messages the public finds the most convincing emphasize the vaccine’s effectiveness, protection from illness, and the ability to return to normal life. Among those who have not yet been vaccinated, majorities say they would be more likely to get a vaccine if they heard it was “highly effective” in preventing illness from COVID-19 (57%), that getting vaccinated offers protection from getting sick (56%), and that the vaccine offers “the quickest way for life to return to normal” (54%). Over four in ten say they would be more likely to get vaccinated if they heard that “millions of people have already safely been vaccinated” (46%) and that vaccination is needed to “get the U.S. economy back on track” (45%). Somewhat fewer said that knowing the vaccine is free (36%) or hearing that a doctor or health care provider they trust (38%) or a close friend or family member (32%) got vaccinated would make them more likely to get vaccinated themselves.

Among the important “wait and see” group that is the best target for converting from vaccine hesitant to vaccine enthusiastic, the most convincing messages are similar to those for the public overall. Two-thirds (67%) of this group says hearing that the vaccine will help protect them from getting sick would make them more likely to get vaccinated, and 64% say the same thing about hearing that the vaccines are highly effective. The same share (64%) say they would be more likely to get vaccinated after hearing that vaccination offers the quickest return to normal live. Few in the “definitely not” group say they’d be convinced by any of the messages tested, reflecting the daunting challenge of addressing reluctance to get vaccinated among this group.

Whether people find pro-vaccine messages and information convincing also varies by demographic group and by partisan identification. For example, larger shares of Black and Hispanic adults compared to White adults say they would be more likely to get vaccinated after hearing most messages tested in the survey. In particular, Hispanic adults are much more likely than White adults to report increased likelihood of getting vaccinated after hearing that there is no cost to get vaccinated (54% vs. 32%) or that a friend or family member (53% vs. 26%) or a health care provider they trust (51% vs. 34%) got the vaccine. Young adults ages 18-29 are also more likely than their older counterparts to say they’d be more likely to get vaccinated after hearing there is no cost (48%) or that a close friend or family member got vaccinated (41%).

Republicans are less likely than Democrats and independents to say that each message tested would make them more likely to get vaccinated. Despite many polls showing Republicans are concerned about reviving the U.S. economy, 30% of Republicans say they would be more likely to get vaccinated after hearing that getting people vaccinated will help get the economy back on track, compared to 57% of Democrats and 47% of independents.

Messages and Information That Might Deter People From Getting Vaccinated

Just as messaging can help convince people to get vaccinated, the public may also hear things that would make them less eager to get a COVID-19 vaccine. In the Monitor we report on a few of these messages and find that hearing about rare allergic reactions and short-term side effects may increase vaccine hesitancy for some. Overall, 39% of those who have not yet been vaccinated say that hearing that “a small number of people have experienced a serious allergic reaction” to the vaccine would make them less likely to get vaccinated, and 33% say the same after hearing that some-people experience “short-term side effects like pain or fever.” Fewer say they would be deterred after hearing that masks and social distancing will still be required after getting vaccinated (20% say this would make them less likely) or that two vaccine doses are required (18%).

Of particular concern, six in ten of those who want to “wait and see” how the vaccine is working say hearing about rare allergic reactions would make them “less likely” to get vaccinated, and half of this group says the same about hearing of short-term side effects.

About half of Black and Hispanic adults also say that hearing about short-term side effects and rare allergic reactions to the COVID-19 vaccine would make them less likely to get vaccinated. While one in five adults overall (18%) say that learning they would need to receive two doses of the vaccine several weeks apart would make them less likely to get vaccinated, about a quarter of Hispanic adults (28%), Black adults (26%), and those with household incomes under $40,000 (26%) say this is the case.

Who Will The Public Turn To When Making Decisions About Whether To Get Vaccinated?

Echoing previous findings about trusted sources of information on COVID-19 vaccination, the latest survey finds that 79% of U.S. adults who have not yet been vaccinated say they would be likely to turn to a doctor, nurse, or other health care provider when deciding whether to get a vaccination, including almost half (46%) who say they would be “very likely.” About six in ten say they’d be likely to turn to other sources such as the U.S. Centers for Disease Control and Prevention (CDC) (60%), family or friends (58%), their state or local health department (57%), or a pharmacist (54%). Few say they’d turn to a religious leader such as a priest, rabbi, or minister (17%).

Despite the fact that health care providers are the source people say they are most likely to turn to for vaccine information, relatively few (24%) of those who have not yet been vaccinated say they have already asked a doctor or other health care professional for information about the vaccine, a share that rises to 32% among those who say they want to get vaccinated “as soon as possible.”

Health care providers are the top source that Americans say they’ll turn to for help with vaccine decision-making across demographic groups. However, there are some differences in how different groups plan to use other sources in making this decision. For example, larger shares of Black and Hispanic adults, as well as young adults ages 18-29, say they’re likely to turn to the CDC or their state and local health department, reflecting partisan differences in how these sources of information are viewed. Further, a larger share of Black adults (33%) and Hispanic adults (29%) say they will turn to a religious leader for help with this decision compared to White adults (11%), suggesting a potential pathway for information delivery that could be productive with some communities of color.

These additional findings were released February 3, 2021.

The KFF COVID-19 Vaccine Monitor is an ongoing research project tracking the public’s attitudes and experiences with COVID-19 vaccinations. Using a combination of surveys and qualitative research, this project tracks the dynamic nature of public opinion as vaccine development and distribution unfold, including vaccine confidence and hesitancy, trusted messengers and messages, as well as the public’s experiences with vaccination.

Key Findings

• Adults with differing levels of enthusiasm towards getting the COVID-19 vaccine also report different media sources of information. Among those who say they want to get the COVID-19 vaccine as soon as they can, about half say they have gotten at least a fair amount of information about the vaccine from cable news (51%) and network television news (48%) in the past two weeks compared to about a third of adults who say they definitely will not get the vaccine (37% and 32% respectively) or who want to “wait and see” (37% and 36% respectively).
• Adults who are hesitant about the COVID-19 vaccine and say they want to “wait and see” before getting it or who say they definitely will not get it are more likely to say they have gotten information about the vaccine from social media (37% and 40% respectively) than those who are more enthusiastic about getting the vaccine (25%). This likely reflects the higher levels of enthusiasm for the vaccine among older adults – who are more likely to say they have gotten information from cable news – and reflects vaccine hesitancy among younger adults, who are more likely to say they have gotten information from social media.
• The public is also turning to more personal sources of information, as nearly four in ten adults say they have gotten vaccine information from family and friends. Notably, those who say they want the vaccine as soon as possible are more likely than those most resistant to the vaccine to say family and friends have been an information source.
• Adults who say they want to get the vaccine “as soon as they can” are most likely to say they have gotten information about the vaccine from CNN (41%) and MSNBC (31%) while those who say they will definitely not get the vaccine are most likely to say they have gotten information from Fox News (33%). This split reflects both the fractured media environment and the partisan differences in enthusiasm for getting the COVID-19 vaccine.
• Facebook is a key social media source of information with at least one in five adults across levels of vaccine enthusiasm and hesitancy saying they got information about the vaccine from Facebook, including more than a third of those who say they definitely will not get the vaccine.

Recent Sources Of COVID-19 Vaccine Information

The KFF COVID-19 Vaccine Monitor, conducted January 11-18, 2021, reports that majorities of the public say they do not have enough information about when they can get a COVID-19 vaccine and where to get their vaccine once it is time. As public health officials are tasked with making sure accurate and timely COVID-19 vaccination information is reaching the public, television news, social media, and family and friends are likely to be key mediums. Currently, many adults report getting information about the COVID-19 vaccine from television, including about four in ten who say that in the past two weeks they have gotten at least a fair amount of information about the vaccine from cable news (43%), network news (41%), and local TV news (40%). This includes a majority of adults 65 and older (54%) who say they have gotten at least a fair amount of information about the COVID-19 vaccine from cable news in the past two weeks. Notably, about two-thirds of Black adults – a group that is more likely to report they do not have enough information about where and when to get a COVID-19 vaccine – say they have gotten at least a fair amount of information about the vaccine from cable news (65%) and network news (68%) in the past two weeks.

Three in ten adults (31%) say they have gotten at least a fair amount of information about the vaccine from social media in the past two weeks while about one in five have gotten information from national newspapers (23%), radio (20%), and local newspapers (19%). Large shares of adults 18 to 29 (42%), Hispanic adults (40%), and Black adults (39%) report getting at least a fair amount of information about the vaccine from social media.

When it comes to more personal and direct sources of information, four in ten adults (40%) say they have gotten at least at a fair amount of information about the vaccine from family and friends. Though nearly eight in ten adults say they will turn to doctors, nurses and other health care providers when deciding whether to get vaccinated for COVID-19, currently most of the public is not getting recent information about the vaccine from these medical professionals as just three in ten (31%) report getting information from a doctor, nurse or other health care provider in the past two weeks. One in five adults (20%) say they have gotten information about the vaccine from an employer while fewer have gotten vaccine information from a health insurance provider (15%) or from a place of worship (9%). Though notably, Black (19%) and Hispanic adults (14%) are more likely than their White counterparts (7%) to say they have gotten a lot or a fair amount of vaccine information from a place of worship in the past two weeks.

Adults with differing levels of enthusiasm towards getting the COVID-19 vaccine report different media sources of information. Among the 41% of adults who say they want to get the COVID-19 vaccine as soon as they can, about half say they have gotten “a lot” or a “fair amount” of information about the vaccine from cable news (51%) and network television news (48%) in the past two weeks. Smaller shares of those who say they definitely will not get the vaccine and those who say they want to “wait and see” before getting the vaccine say they have gotten at least a fair amount of information about it from cable news or network news. Indeed, those who say they want to “wait and see” or who say they definitely will not get the vaccine are somewhat more likely to say they have gotten information about the vaccine from social media (37% and 40% respectively) than those who are more enthusiastic about getting the vaccine (25%).

One-third (33%) of the public believe or are unsure about at least one vaccine myth including that the vaccines currently being distributed contain the live virus that causes COVID-19, that it causes infertility, or that getting vaccinated requires paying an out-of-pocket cost. Despite concerns that vaccine misinformation may be spreading, particularly through social media, the KFF COVID-19 Vaccine monitor finds that overall, similar shares of both those who believe or are unsure about at least one of the these myths and those who do not believe this misinformation say they have gotten information from television news and social media.

While sizeable shares of adults across levels of vaccine enthusiasm say they have gotten information about the vaccine from friends and family in the past two weeks, those who say they want the vaccine as soon as possible are more likely than those most resistant to the vaccine to say family and friends have been an information source (44% vs. 34%). On the other hand, the most vaccine resistant group is at least twice as likely as those most enthusiastic for the vaccine to say they have gotten at least a fair amount of information from a place of worship (15% vs. 6%).

Specific Cable News Information Sources

Reflecting the fractured media environment and the partisanship that has characterized the U.S. COVID-19 response, people with different levels of vaccine enthusiasm report different sources of COVID-19 vaccine information when it comes to cable news. Those who say they want to get the vaccine as soon as possible are most likely to say they have gotten information about the vaccine from CNN (41%) and MSNBC (31%), while those who say they will definitely not get the vaccine are most likely to say they have gotten information from Fox News (33%). Notably, those who say they definitely will not get the vaccine are about twice as likely to say they have gotten information from Newsmax (13%) than those who want to get the vaccine as soon as possible (5%) or who want to “wait and see” (6%). Among adults who say they want to “wait and see” before getting the vaccine or who say they will only get the vaccine if required, one in four say they have gotten information from CNN and Fox News.

When thinking about what is said in the news, adults who say they think the seriousness of COVID-19 is generally underestimated or generally accurate are most likely to say they have gotten information about the vaccine from CNN (43% and 36% respectively). On the other hand, those who say the seriousness of COVID-19 is exaggerated are most likely to say Fox News was their cable news source for information about the vaccine (29%). Similarly, those who say the seriousness of COVID-19 is exaggerated are three times as likely as those who say the seriousness of the virus has been presented accurately or has been underestimated to say they have gotten information from Newsmax. Given that people self-select their news sources, these data do not necessarily prove a causal relationship; it may be that those who believe the seriousness of COVID-19 is exaggerated are more likely to select specific news sources, rather than the news sources being the origin of the belief that the seriousness of COVID-19 is exaggerated.

Specific Social Media Information Sources

Facebook is a key social media source of information with at least one in five adults across levels of vaccine enthusiasm and hesitancy saying they got information about the vaccine from Facebook in the past two weeks. It emerges as a particularly important media source for those most reluctant to get the vaccine with 36% of those who say they will definitely not get the vaccine saying they have gotten information from Facebook.

Irrespective of whether people think the seriousness of COVID-19 has been exaggerated, accurately presented, or underestimated, Facebook maintains a dominant position as a social media source of information.

This KFF COVID-19 Vaccine Monitor was designed and analyzed by public opinion researchers at the Kaiser Family Foundation (KFF). The survey was conducted January 11- 18, 2021, among a nationally representative random digit dial telephone sample of 1,563 adults ages 18 and older (including interviews from 306 Hispanic adults and 310 non-Hispanic Black adults), living in the United States, including Alaska and Hawaii (note: persons without a telephone could not be included in the random selection process). Phone numbers used for this study were randomly generated from cell phone and landline sampling frames, with an overlapping frame design, and disproportionate stratification aimed at reaching Hispanic and non-Hispanic Black respondents. Stratification was based on incidence of the race/ethnicity subgroups within each frame. Specifically, the cell phone frame was stratified as: (1) High Hispanic: Cell phone numbers associated with rate centers from counties where at least 35% of the population is Hispanic; (2) High Black: Cell phone numbers associated with remaining rate centers from counties where at least 35% of the population is non-Hispanic Black; (3) Else: numbers from all remaining rate centers. The landline frame was stratified as: (1) High Black: landline exchanges associated with Census block groups where at least 35% of the population is Black; (2) Else: all remaining landline exchanges. The sample also included 246 respondents reached by calling back respondents that had previously completed an interview on the KFF Health Tracking Poll at least nine months ago. Another 197 interviews were completed with respondents who had previously completed an interview on the SSRS Omnibus poll (and other RDD polls) and identified as Hispanic (n = 75; including 24 in Spanish) or non-Hispanic Black (n=122). Computer-assisted telephone interviews conducted by landline (287) and cell phone (1,276, including 931 who had no landline telephone) were carried out in English and Spanish by SSRS of Glen Mills, PA. To efficiently obtain a sample of lower-income and non-White respondents, the sample also included an oversample of prepaid (pay-as-you-go) telephone numbers (25% of the cell phone sample consisted of prepaid numbers) Both the random digit dial landline and cell phone samples were provided by Marketing Systems Group (MSG). For the landline sample, respondents were selected by asking for the youngest adult male or female currently at home based on a random rotation. If no one of that gender was available, interviewers asked to speak with the youngest adult of the opposite gender. For the cell phone sample, interviews were conducted with the adult who answered the phone. KFF paid for all costs associated with the survey.

The combined landline and cell phone sample was weighted to balance the sample demographics to match estimates for the national population using data from the Census Bureau’s 2019 U.S. American Community Survey (ACS), on sex, age, education, race, Hispanic origin, and region, within race-groups, along with data from the 2010 Census on population density. The sample was also weighted to match current patterns of telephone use using data from the January- June 2019 National Health Interview Survey. The weight takes into account the fact that respondents with both a landline and cell phone have a higher probability of selection in the combined sample and also adjusts for the household size for the landline sample, and design modifications, namely, the oversampling of prepaid cell phones and likelihood of non-response for the re-contacted sample. All statistical tests of significance account for the effect of weighting.

The margin of sampling error including the design effect for the full sample is plus or minus 3 percentage points. Numbers of respondents and margins of sampling error for key subgroups are shown in the table below. For results based on other subgroups, the margin of sampling error may be higher. Sample sizes and margins of sampling error for other subgroups are available by request. Note that sampling error is only one of many potential sources of error in this or any other public opinion poll. Kaiser Family Foundation public opinion and survey research is a charter member of the Transparency Initiative of the American Association for Public Opinion Research.

These additional findings were released February 3, 2021.

1. Estimates of the number of people vaccinated from this or any survey may vary from government statistics due to survey timing or margin of sampling error. ↩︎

Introduction

Across states, health and long-term care workers and residents have been the first groups offered COVID-19 vaccines, consistent with federal recommendations. Previous KFF analysis estimated that, nationwide, 19.7 million adults work in health and long-term care settings, of which roughly 15.5 million are estimated to have direct patient contact and be included in the initial priority group for vaccination. Media reports suggest that the initial vaccination efforts have been slower than expected and that some health care workers who have been offered the vaccine have chosen not to get vaccinated, particularly among staff in long-term care facilities. More information is needed to understand why some health care workers are declining the vaccine, although there are anecdotal reports of concerns about safety and/or side effects. KFF survey data show that roughly three in ten health care workers (29%) express hesitancy about getting the COVID-19 vaccine and that, among all adults, levels of vaccine hesitancy and reasons for hesitancy vary across demographic groups.

This analysis provides an overview of demographic characteristics and health insurance coverage of health care workers with direct patient contact, including those working in hospital and long-term care settings, who may be most at risk of patient contact with someone with coronavirus due to the concentration of cases in these facilities. Increased understanding of who these health care workers are can help inform vaccination efforts and prevent disparities in vaccination among this group.

Findings

Table 1 presents data on race/ethnicity, citizenship status, sex, age, education, poverty status and health insurance coverage for the 15.5 million health and long-term care workers who are estimated to have direct patient contact. It also includes separate data for those working in hospitals and long-term care facilities, who account for 37% and 25% of health care workers with direct patient contact, respectively.

Overall, the data show that, although most of these health care workers are White (59%) and citizens (95%), 41% are people of color and 5% are noncitizens. The majority are women (77%), and nearly one in four (23%) are age 55 or older. Most have completed at least some college (80%), and, reflecting that they are all employed, few are low-income (17%) and nearly all have health insurance coverage (93%). Hospital workers largely mirror these overall patterns, although they have higher levels of education, income, and health coverage. Workers in long-term care settings include higher shares of people of color (52%), non-citizens (8%), women (84%), and workers age 55 or above (27%) and have lower levels of educational attainment, lower incomes, and higher uninsured rates compared to the overall population of health care workers with direct patient contact. More detailed findings include:

Race/ethnicity. Roughly six in ten health care workers with direct patient contact are White (59%), while the remaining 41% are people of color, including 17% who are Black, 14% who are Hispanic, and 8% who are Asian (Figure 1). Among those working in long-term care settings, over half (52%) are people of color, including over one in four (28%) who are Black.¹ 

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Citizenship Status. The large majority of health care workers with direct patient contact are citizens (95%), while 5% are noncitizens (Figure 1). However, the share who are noncitizens is higher, at 8%, among those working in long-term care settings.

Sex. Over three-quarters (77%) of health care workers with direct patient contact are women, and this share rises to 84% among those working in long-term care settings.

Age. Nearly a quarter (23%) of health care workers with direct patient contact are age 55 or older, while four in ten (41%) are age 35-54 and over one-third (35%) are below age 35. Those working in long-term care settings include a slightly higher share of workers age 55 or above (27%), while those working in hospital settings have a slightly lower share of workers age 55 and older (21%).

Education. Eight in ten of health care workers with direct patient contact have completed at least some college, including 45% who have a bachelor’s degree of higher (Figure 1). Education levels are higher among hospital workers, with nearly nine in ten (88%) completing at least some college, including over half (54%) who have a bachelor’s degree or higher. In contrast, among those working in long-term care, six in ten have completed some college, with only 20% having a bachelor’s degree or higher and 10% having less than a high school education.

Poverty Status. Overall, 17% of health care workers with direct patient contact are low-income (household income less than 200% of the federal poverty level (FPL)), with only 5% with household income below the poverty level (Figure 1). Over half (54%) have income at 400% FPL or higher. Those working in hospitals generally have higher incomes, with nearly two-thirds (64%) having household income at 400% FPL or higher. Household income is lower among those working in long-term care, where one-third (33%) are low-income, including 11% who have household income below poverty.

Health Insurance Coverage. Less than one in ten (7%) health care workers with direct patient contact are uninsured (Figure 1). Nearly eight in ten (79%) have private health insurance coverage, 10% are covered by Medicaid, and 4% have Medicare coverage. Coverage rates are higher among those working in hospitals, with only 3% uninsured and 90% having private coverage. In contrast, coverage rates among those working in long-term care are lower, with 14% uninsured. Moreover, they have higher rates of Medicaid coverage (21%) and lower rates of private insurance (60%).

Discussion

Increased understanding of who health care workers with direct patient contact are can help inform vaccination efforts and prevent disparities in vaccination among this group. In sum, these findings show that the roughly 15.5 million health care workers with direct patient contact are a racially diverse workforce. They are predominantly female, with most between ages 35-54. Most have completed at least some college and, reflecting their employment, few are low-income, and the large majority have health insurance. However, those working in long-term care settings are more likely to be Black and have lower levels of education, income, and insurance coverage, which may have implications for access to the COVID-19 vaccine and willingness to get vaccinated.

KFF survey data show, as of December 2020, roughly one in three adult health care workers (29%) said they probably or definitely would not get vaccinated, similar to the share among adults overall (27%). Data also show that levels of vaccine hesitancy vary across demographic groups. For example, adults age 30-49 and Black adults have relatively high levels of hesitancy, while adults ages 65 and older report greater willingness to get the vaccine. Hesitancy varies among health care workers in similar ways. For example, an earlier KFF/The Undefeated survey found that, among adults who are health care workers or who live in a household with a healthcare worker, Black adults were much less likely to say they would definitely get vaccinated compared to White adults (24% vs. 46%). Moreover, different groups have different reasons for vaccine hesitancy. For example, among adults overall who say they probably or definitely won’t get vaccinated, Black adults are more likely than White adults to cite concerns about side effects and the newness of the vaccine, and about half of Black adults in this group cite worries they may get COVID-19 from the vaccine or that they don’t trust vaccines in general as major reasons.

People living in immigrant families and people who are uninsured may also have specific concerns which could make them less likely to seek vaccination. For example, people living in immigrant families may have concerns about potential negative effects on their or a family member’s immigration status. People who are uninsured are less likely to have an established relationship with a health care provider and generally have greater concerns about potential costs of health care.

Addressing concerns and potential access barriers to vaccination among health care workers will be particularly important since, as one of the first groups offered the vaccination and a top trusted messenger for information on the COVID-19 vaccine, their experiences and take-up may help inform the general public’s attitudes and willingness to get the vaccine. Together these data suggest that providing information to respond to concerns about potential side effects and safety of the vaccine is key, particularly among Black health care workers. Clearly communicating that personal information collected for vaccination cannot be used for immigration-related purposes may help reduce fears among noncitizen workers. Moreover, ensuring people know that they will not face any costs associated with the vaccine may reduce concerns among people who are uninsured. Beyond providing education and information, making the vaccine easily accessible is key. While many health care workers are able to access the vaccine directly through their employment site, ensuring it is available in ways that accommodate workers’ varied schedules, caregiving responsibilities, and transportation options can help reduce potential access barriers among those who need to obtain it through pharmacies or community sites.

The estimates of health care workers are based on KFF analysis of the 2019 American Community Survey (ACS), 1-year file. The ACS includes a 1% sample of the US population. The health care industry is defined as industry codes 5070 and 7970 through 8290 and does not include the childcare or vocational training industries. We include retail pharmacies (industry code 5070) as a healthcare industry. We identified people working specifically within hospital settings using industry code 8191 and 8192, which includes psychiatric and substance abuse hospitals, and people working specifically within long-term care settings using industry codes 8270 (skilled nursing facilities), 8290 (residential care facilities), and 8170 (home health care services). For more information see here. This analysis only includes those individuals who work in health care settings, so does not include health professionals working in other care settings, such as school nurses, and does not include individuals who provide other services to clients, such as social services. We exclude individuals in these industries who are not currently in the labor force. For information on how the healthcare workforce has changed during the course of the pandemic see here.

We identified health care workers who likely have direct patient contact by reviewing the occupation codes of workers in healthcare industries. We included workers providing direct clinical care, such as doctors, nurses, and aides; workers providing direct patient support, such as environmental and food staff; and first line supervisors and managers of these occupations. We excluded administrative and managerial staff who are likely able to work remotely and/or not expected to have direct patient contact through their job duties. It is possible that estimate includes some workers who normally have direct patient contact but who can work remotely, for example, through the use of telehealth.

1. This share differs slightly from that published in previous KFF analysis due to the inclusion of people earning less than $1,000 per year and slightly different definitions of direct contact workers. ↩︎