KFF COVID-19 Vaccine Monitor: December 2022

Key Findings

• While most of the public continue to have confidence in the benefits of childhood vaccines for measles, mumps, and rubella, the experience of the COVID-19 pandemic and debates over vaccine requirements and mandates appear to have had an impact on public attitudes towards MMR vaccine requirements for public schools. The latest KFF COVID-19 Vaccine Monitor survey finds that about seven in ten adults (71%) say healthy children should be required to get vaccinated for MMR in order to attend public schools, down from 82% who said the same in an October 2019 Pew Research Center poll. Almost three in ten (28%) now say that parents should be able to decide not to vaccinate their school-age children, even if this creates health risks for others, up from 16% in 2019. Among Republicans and Republican-leaning independents, there has been a 24 percentage-point increase in the share who hold this view (from 20% to 44%).
• With COVID-19 cases rising across the country, just about a third of adults say they are worried they will get seriously sick from COVID-19, though nearly half of the public say they are worried about an increase in COVID-19 cases and hospitalizations in the U.S. this winter. As previous KFF surveys have repeatedly found, Black and Hispanic adults continue to be more concerned about the pandemic compared to White adults, with about two-thirds of Black adults (68%) and Hispanic adults (69%) saying they are worried about an increase in cases and hospitalizations this winter, compared to about four in ten White adults who say the same. Older adults are more likely than those under age 65 to say they are worried they will get seriously sick from COVID-19 (43% vs. 34%) and that cases and hospitalizations will rise this winter (60% vs. 46%).
• As the country faces a “tripledemic”, with a surge in flu and RSV (respiratory syncytial virus) cases accompanying the rise in COVID-19 cases, many parents are now concerned about not one, but all three of these viruses. About half of parents are worried their child will get seriously sick from COVID-19 or the flu. A slight majority of parents (56%) say they are worried their child will get seriously sick from RSV – rising to more than seven in ten parents with a child under the age of 5 (73%), an age group that is particularly vulnerable to RSV.
• Though many no longer see COVID-19 as a uniquely urgent threat, public health officials continue to encourage vaccination and emphasize the importance of the updated bivalent booster to help prevent serious illness and death from COVID-19, particularly in light of holiday gathering and travel. However, public uptake of the updated booster is relatively tepid, with just about one in five adults saying they have already gotten it. Democrats (38%) and adults ages 65 and older (39%) have been more eager, with about four in ten saying have already gotten the updated COVID-19 booster which has been available since September. Fewer young adults under the age of 30 (11%) and Republicans (12%) report having gotten an updated booster dose.
• Though public health officials have stressed the importance of the updated COVID-19 booster for older adults who are more vulnerable to complications from a COVID infection, more than half of adults ages 65 and older have not yet gotten the updated booster. About a third (36%) of vaccinated adults ages 65 and older who have not yet gotten the bivalent booster say they don’t think they need it (36%) and a similar share say they don’t think the benefit of the updated booster is worth it.
• Vaccinated Republicans and Republican-leaning independents are particularly skeptical of the value of the updated booster with about two-thirds of those who have not yet gotten it saying they don’t think they need it (64%) and that the benefit is not worth it (61%) while Democrats are most likely to say they have been too busy or haven’t had the time to get the update booster (51%).

The Impact Of COVID-19 On Attitudes Towards Other Childhood Vaccines

Despite the politicization of the COVID-19 vaccine and decreasing levels of trust in the FDA and CDC, most adults (85%) say the benefits of childhood vaccines for measles, mumps, and rubella (MMR) outweigh the risks, with little change from the share who said the same in a Pew Research Center poll in 2019 (88%). Though there were no significant differences across partisans in 2019, our survey finds that Republicans and Republican-leaning independents are now less likely than their Democratic counterparts believe the benefits of MMR vaccines outweigh the risks (83% vs. 91%).

While most parents of children under age 18 (80%) say they think the benefits of childhood MMR vaccines outweigh the risks, about one in six parents (17%) think the risks of these vaccines outweigh the benefits. Among adults who have not gotten vaccinated for COVID-19, about one in four (26%) say the risks of childhood vaccines for measles, mumps, and rubella outweigh the benefits. Nonetheless, it remains notable that even among adults who have not gotten the COVID-19 vaccine, most (70%) say the benefits of childhood MMR vaccines outweigh the risks.

While confidence in the benefits of childhood MMR vaccines remains high, the debate over COVID-19 vaccine mandates may have had some spillover effects on attitudes towards requiring MMR vaccines for children attending public school. Currently, all states and the District of Columbia require children to be vaccinated against certain diseases, including measles and rubella, in order to attend public schools, though exemptions are allowed in certain circumstances. Yet, there has been a notable decrease since 2019 in the share of adults who say “healthy children should be required to be vaccinated (for MMR) in order to attend public schools because of the potential risk for others when children are not vaccinated,” with 71% saying they should be required to do so, an 11 percentage point decrease from a October 2019 Pew Research Center poll. Almost three in ten (28%) now say parents “should be able to decide not to vaccinate their children, even if that may create health risks for other children and adults,” an increase from 16% in 2019.

This decrease in support for MMR vaccine requirements for children in public schools is driven by Republicans and Republican-leaning independents – just a slight majority of Republicans (56%) say healthy children should be required to be vaccinated to attend public schools, a 23 percentage-point decline from 2019 when about eight in ten expressed support for such a requirement. More than four in ten Republicans and Republican-leaning independents (44%) now say that parents should be able to decide not to vaccinate their children, up from 20% in 2019. This compares to 11% of Democratic-leaning parents who say the same, a share that has held steady since 2019.

Among parents of children under age 18, about two-thirds (65%) think healthy children should be required to be vaccinated to attend public schools, down from 76% who said the same in 2019. One-third (35%) of parents now believe parents should be able to decide not to vaccinate their children, up from 23% in 2019.

While we cannot know the pre-pandemic attitudes that adults who are currently not vaccinated for COVID-19 held about childhood MMR vaccines, most (63%) of these adults unvaccinated for COVID-19 say that parents should be able to decide not to vaccinate their children, even if that creates health risks for children and adults. Just about four in ten (37%) adults who are not vaccinated for COVID-19 say that healthy children should be required to be vaccinated in order to attend public school.

COVID-19 And Other Winter Illnesses

With reports of COVID-19 cases increasing across the country, just about a third of adults (36%) say they are worried that they will get seriously sick from COVID-19, similar to the share which expressed this concern in January (34% worried) amidst the initial omicron surge in the U.S., but up from November 2021 (30% worried) before the omicron variant became widespread. However, about half of the public (49%) say they are worried that there will be an increase in COVID-19 cases and hospitalizations this year. Adults ages 65 and older, who are more vulnerable to negative outcomes from a COVID-19 infection, are more likely than younger adults to express worry about a winter COVID-19 surge (60% vs. 46%) and to worry that they will get seriously sick from the virus (43% vs. 34%).

As previous KFF surveys have found time and time again, people of color continue to be more concerned about the pandemic compared to White adults. The December KFF COVID-19 Vaccine Monitor survey finds that about two-thirds of Black adults (68%) and Hispanic adults (69%) say they are very worried about an increase in COVID-19 cases and hospitalizations this winter, compared to about four in ten White adults (39%) who express the same concern. Black and Hispanic adults (49% and 60%, respectively) are also more likely than White adults (26%) to worry that they will personally get seriously sick from the virus.

Worries About COVID-19 And Other Winter Viruses In Children

This winter has not only brought reports of increasing COVID-19 cases, but also widespread reports of a surge in flu and RSV cases, particularly among children. In a sign that COVID-19 is changing from being a singular concern to part of the landscape of different illnesses people worry about, parents’ worries about their children getting sick from COVID this winter are about on par with their worries about other viruses like flu and RSV. About half of parents (47%) say they are “very” or “somewhat” worried that their children will get seriously sick from COVID-19 and a similar share (51%) say they are worried their children will get seriously sick from the flu. A slight majority of parents (56%) say they are worried their child will get seriously sick from RSV – rising to 73% of parents with children under the age of 5, who are particularly vulnerable to RSV. Notably, despite half of parents saying they are worried their child may get seriously sick from the flu, just a third of parents (34%) say their child has gotten a flu shot for the current flu season.

Uptake Of The Updated Bivalent COVID-19 Booster

Although for many people COVID-19 may be less of an urgent concern this winter, public health officials continue to emphasize the importance of boosters in reducing the risk of serious illness and death particularly among the most vulnerable. Despite this, the public’s response to the new bivalent booster has been somewhat lackluster. About four in ten adults say they have either received the updated bivalent COVID-19 booster dose (22%)¹, which has been available since September, or say they plan to get the new booster as soon as possible (16%). About one in ten adults say they want to “wait and see” before getting the new booster (12%), while a similar share (13%) say they will only get it if they are required to do so. A further 9% say they will definitely not get the new updated booster while about one in four adults (27%) are unvaccinated or only partially vaccinated, and therefore not eligible for the updated bivalent booster dose.

KFF’s September COVID-19 Vaccine Monitor survey, fielded shortly after the new updated booster was made available, found that more than a third of older adults ages 65 and older said they intended to get the updated booster as soon as possible. This month’s survey finds that many of these older adults remain eager, with four in ten adults ages 65 and older (39%) saying they have already gotten the updated COVID-19 booster while 16% say they will do so as soon as they can. However, this still leaves more than half of older adults, who are more vulnerable to complications from a COVID infection, without the protection of the updated booster.

Democrats also seem eager to get the updated booster with about four in ten (38%) saying they have already done so. Indeed, Democrats are three times as likely as Republicans to report having already gotten the updated COVID-19 booster (38% vs. 12%). Notably, about three in ten Republicans say they will only get the updated booster if they are required to do so (12%) or say they will “definitely not” get the new COVID-19 booster dose (18%). A further 37% of Republicans are unvaccinated or only partially vaccinated and therefore not eligible for the new updated COVID-19 booster dose.

Vaccinated adults who have not yet gotten a dose of the bivalent COVID-19 booster cite a variety of reasons for not getting the updated booster; about four in ten (44%) say they do not think they need it and about a third (37%) say they do not think the benefit is worth it. About a third (36%) say they have been too busy or have not had the time to get it, while about one in four (23%) say they have not gotten the updated booster because they had bad side effects from a previous COVID-19 vaccine dose. About one in six (17%) vaccinated adults who have not gotten the updated booster say they have not done so because they are waiting to see if COVID-19 cases increase in their area, while 12% say they are waiting until before they travel or see vulnerable family and friends to get the updated booster.

Though public health officials have stressed the importance of the updated COVID-19 booster for older adults, who are more vulnerable to complications from a COVID infection, about one third (36%) of vaccinated adults ages 65 and older who have not yet gotten the booster say they don’t think they need it (36%) and a similar share say they don’t think the benefit of the updated booster is worth it. About one in four (23%) vaccinated adults ages 65 and older say they have not gotten the updated booster because they have been too busy or have not had time to get it yet.

Notably, at least six in ten vaccinated Republicans or Republican leaning independents who have not yet gotten the updated booster say they haven’t done so because they don’t think they need it (64%) or do not think the benefit is worth it (61%). Among vaccinated Democrats or Democratic-leaning independents who have not yet gotten the updated booster, the most common reason for not yet doing so is having been too busy or not having the time to get it (51%).

About one in four parents of teenagers ages 12 to 17 say their child has already gotten the updated COVID-19 booster (16%) or that they will definitely be doing so (8%). A further 18% say their teen will probably get the update booster. Notably, about four in ten parents of teenagers say their 12-17 year old is not vaccinated for COVID-19 and therefore not eligible to get the updated bivalent booster.

Among parents of younger children between the ages of 5 and 11, six in ten (61%) say their child is unvaccinated and therefore not eligible for the new COVID-19 booster. About one in five parents say their 5 to 11 year old has either gotten the updated booster (14%) or will definitely be doing so (7%), while a further 9% say their child will probably get the updated booster.