Correlates and Disparities of COVID-19 Vaccine Hesitancy

Objective: To understand the correlates of COVID-19 vaccine hesitancy in the American public and the reasons why individuals intend to refuse a COVID-19 vaccine. Rationale: Recent polls suggest that a significant share of the American public is reluctant to receive an impending COVID-19 vaccine. However, far less is known about which Americans are most likely to refuse the vaccine and their reasons for reluctance. Understanding these issues is critical to developing effective health communications to improve COVID-19 vaccination and end the pandemic. Method: We rely on a demographically representative survey of 5,009 American adults collected from May 28-June 8, 2020. We analyze the influence of demographic factors, political ideology, and COVID-19 experiences on COVID-19 vaccine hesitancy. Results: 31.1% of Americans do not intend to pursue getting vaccinated when a COVID-19 vaccine becomes available. The likelihood of refusal is higher for Blacks, women, and conservatives. People who are more concerned about COVID-19 were less likely to refuse the vaccine. Positive views of vaccination in general (vaccines are safe, effective, and important) were also negatively associated with vaccine refusal intention. The two most cited reasons for refusal are concerns about vaccine safety, and effectiveness. Reasons for reluctance vary across sub-populations. Women were most likely to be hesitant based on concerns about safety and efficacy. Blacks were more likely to be hesitant than Whites because of concerns about safety and efficacy, because they lack needed financial resources or health insurance, and because already had COVID-19. Conclusion: Large proportions of the American public do not intend to pursue a vaccine against COVID-19 once it becomes available, reducing its potential impact. Blacks are particularly likely to be hesitant, exacerbating existing disparities in COVID-19 outcomes.