KFF COVID-19 Vaccine Monitor: July 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 acceptance, information needs, trusted messengers and messages, as well as the public’s experiences with vaccination.

Key Findings

• The latest Vaccine Monitor finds the share of adults who say they have either received a COVID-19 vaccine (67%) or say they will get vaccinated as soon as they can (3%) is relatively unchanged from June. The poll, conducted July 15-27th, may not capture any recent uptick in vaccinations after the most recent data from the Centers for Disease Control and Prevention (CDC), citing the increased risk of the Delta variant to both unvaccinated and vaccinated people.
• Three in ten adults remain unvaccinated including one in ten who say they want to “wait and see” how the vaccine works for other people before getting vaccinated and 3% who say they will do so “only if required” (down from 6% in June). An additional 14% say they will “definitely not” get a vaccine, a share that has held relatively steady since December. One-fourth of unvaccinated adults (8% of all adults) say they are likely to get a vaccine before the end of 2021, including nearly half (45%) of those who say they want to “wait and see.”
• Unvaccinated adults, especially those who say they will “definitely not” get a vaccine, are much less worried about the coronavirus, the Delta variant, and have less confidence in the safety and effectiveness of the vaccines compared to those who are vaccinated. Three-fourths of unvaccinated adults, including nine in ten of those who say they will “definitely not” get the vaccine, say they are “not worried” about getting seriously sick from the virus, less than half say they are worried about the Delta variant worsening the pandemic, more than half (including 75% of “definitely not”) say getting vaccinated is a bigger risk to their health than getting infected with coronavirus, and a quarter (just one in ten of “definitely not”) say the vaccines are effective at keeping vaccinated people from dying from COVID-19 or getting seriously ill.
• The increase in COVID-19 cases and news of the Delta variant spreading in the U.S. has made some people say they are more likely to wear a mask in public or avoid large gatherings, though this is mainly driven by vaccinated adults. Majorities of vaccinated adults say news of the variants has made them more likely to wear a mask in public (62%) or avoid large gatherings (61%), while fewer unvaccinated adults say the same (37% and 40%, respectively). However, one in five unvaccinated adults (22%) say news of variants has made them more likely to get vaccinated for COVID-19. This includes one-third (34%) of those who want to “wait and see,” but few (2%) of those who say they will “definitely not” get a vaccine say the news made them more likely to get vaccinated.
• The public is divided on whether the federal government should recommend employers require vaccines among their employees. Half (51%) say the federal government should recommend employers require their employees to get the COVID-19 vaccine unless they have a medical exception while a similar share (45%) say the federal government should not recommend this. Views towards this issue are sharply divided by both vaccination status and party identification, with 68% of vaccinated adults and 75% of Democrats saying the federal government should issue this recommendation, while eight in ten (81%) unvaccinated adults and 67% of Republicans say the federal government should not do this.
• Prior to the CDC issuing the newest guidance encouraging all adults, regardless of vaccine status, to wear masks indoors if they are in an area with higher transmission levels of coronavirus, half of adults said they wore a protective mask at least “most of the time” at an indoor setting like a grocery store, while less than half report wear a mask at least “most of the time” on public transit (44%), at work (42%), outdoors in crowded places (41%), or outdoors with household members or friends (18%). Across most places asked about, vaccinated adults were more likely to report wearing a mask at least “most of the time” than unvaccinated adults. Majorities of Republicans saying they “never” wear a mask outdoors in crowded places, outdoors with friends and household members, at work, or in a grocery store. Democrats, on the other hand, are more likely to report wearing a mask in all of these locations, except when outdoors with household members and friends.

Trends In COVID-19 Vaccination Intentions And Uptake

The latest KFF COVID-19 Vaccine Monitor finds roughly two-thirds of U.S. adults (67%) saying they have received at least one dose of a COVID-19 vaccine with an additional 3% saying they will get vaccinated as soon as they can, as of July 27^th. Three in ten adults (31%) remain unvaccinated. Those who remain unvaccinated include 10% who say they want to “want and see” how the vaccines work for other people before getting vaccinated, 3% who say they will get a vaccine “only if required” to do so for work, school, or other activities (down from 6% in June), and 14% who say they will “definitely not” get the vaccine. The shares of adults who remain unvaccinated is statistically similar to the KFF June COVID-19 Vaccine Monitor and the share who are the most reluctant to get the vaccine has remained relatively unchanged since KFF began tracking vaccine intentions at the end of 2020.

Among unvaccinated adults, one-fourth (8% of all adults) say it is likely they will get the COVID-19 vaccine before the end of the year including 13% who say it is “very likely.” The majority, however, say it is either “somewhat unlikely” or “very unlikely” they will get vaccinated before the end of 2021 (25%), or originally said they will “definitely not” get a vaccine (46%). Nearly half (45%) of those who say they want to “wait and see” say it is likely they will get the vaccine by the end of the year.

At least seven in ten White adults, older adults, Democrats, college graduates, those with serious health conditions, and urban residents say they have received at least one dose of the COVID-19 vaccine. Younger adults (18-29 years old), Republicans, rural residents, and the uninsured still report lower rates of vaccine uptake than other demographic groups. A larger share of Hispanic adults (16%) than Black adults (11%) and White adults (8%) say they want to “wait and see” before getting vaccinated, and at least one fifth of uninsured adults, White Evangelical Christians, rural residents, and 18-29 year-olds say they will “definitely not” get a vaccine.

The gender gap in vaccine uptake that emerged last month is still present with women still eight percentage points more likely to report being vaccinated than men (71% vs. 63%), and a larger share of men saying they will “definitely not” get the vaccine (18% vs. 10%). Yet, this is still largely attributed to the differences in partisan identification between men and women, with larger shares of men than women identifying as Republicans or Republican-leaning independents.

In recent days there has been an increase in calls from Republican lawmakers encouraging people to get a COVID-19 vaccine. The latest data from the KFF COVID-19 Vaccine Monitor (fielded from July 15-27) finds 56% of Republicans saying they either have already gotten a COVID-19 vaccine or plan to do so “as soon as possible,” statistically unchanged from June (54%). While this is the largest share of Republicans reporting this intention since we began the Vaccine Monitor, Republicans lag behind both Democrats (89%) and independents (67%) in their willingness to get a COVID-19 vaccine.

Who Remains Unvaccinated?

A previous KFF analysis examined the demographic groups among the unvaccinated population finding two distinct groups, those who are open to getting a vaccine (“wait and see”) and those who say they will definitely not get a COVID-19 vaccine. The latest KFF COVID-19 Vaccine Monitor finds the key demographic differences between the “wait and see” and the “definitely not” groups still center on racial and ethnic identity and political partisanship. Four in ten of those in the “wait and see” group are people of color, while the most vaccine resistant group, those who say they will “definitely not” get a COVID-19 vaccine, is overwhelmingly made up of White adults (65% of the group compared to 50% of the “wait and see” group). Partisanship also plays a major role with more than half (58%) of the “definitely not” group identifying as Republican or Republican-leaning. In addition, religious identity also plays a role as White Evangelical Christians make up nearly twice the share of the “definitely not” group (32%) as the “wait and see” group.

In addition to key demographics that help explain vaccine intentions, views of the pandemic generally, concerns about getting sick, and views of whether the vaccine or the virus is a greater health risk are also   contributing factors to whether an individual has gotten a COVID-19 vaccine.

Unvaccinated adults, especially those who say they will “definitely not” get a vaccine, are more likely to say they are not worried they personally will get seriously sick from the coronavirus and to believe that getting the vaccine is a bigger risk to their own health than getting the virus. Nine in ten of those who say they will “definitely not” get the vaccine are either “not too worried” or “not at all worried” about getting sick from the coronavirus and three-fourths of this group say getting the COVID-19 vaccine is a greater risk to their health than becoming infected with the coronavirus.

A majority of vaccinated adults (61%) are also not worried about getting sick from the coronavirus, perhaps an indicator of the relief some people are now feeling as a result of getting the vaccine. Unsurprisingly, nine in ten (88%) vaccinated adults say becoming infected with coronavirus is bigger risk to their health than getting the COVID-19 vaccine.

Furthermore, the majority (57%) of unvaccinated adults say they think the news has “generally exaggerated” the seriousness of the coronavirus, while three-fourths of vaccinated adults say the news has been “generally correct” or “generally underestimated” the pandemic’s seriousness. The view that the seriousness of the coronavirus has been “generally exaggerated” is the dominant view among those who say they will “definitely not” get a vaccine (75%).

The Emergence Of The Delta Variant

News about the Delta variant and the recent increases in the number of coronavirus cases in the country has raised concerns only a few weeks after many states and businesses relaxed masking and social distancing guidelines. The vast majority of adults (90%) have heard or read at least “a little” about new strains or variants of the coronavirus, such as the Delta variant. The share of the public who had heard or read about the Delta variant remain unchanged over the field period.

Overall, nearly two-thirds of adults are worried the new variants of the coronavirus will lead to a worsening of the pandemic in the U.S., including 26% who are “very worried.” A majority are also worried that new variants will lead to a worsening of the pandemic in their local area. Fewer are worried they will personally get sick from a new variant of the coronavirus.

Vaccinated people report higher levels of concerns than unvaccinated people about new variants of the coronavirus leading to a worsening of the pandemic in the U.S. (74% vs. 39%), in their local area (65% vs. 34%), and are more worried they will personally get sick from a new variant (40% vs. 27%).

Concerns that new variant of the coronavirus will lead to a worsening of the pandemic in the U.S. increased only slightly over the last week of interviews (starting on July 19^th)¹ during which there was increased media attention on the threat of the Delta variant and more positive vaccine messaging from Republican lawmakers. Nearly two-thirds of adults interviewed during that time period say they are worried (compared to 57% in the week prior). Worries about the pandemic worsening in their local area or that they will personally get sick from a new variant stayed relatively stable over the survey field period.

News of the variants spreading in the U.S. has made some people say they are “more likely” to wear a mask in public or avoid large gatherings. Majorities of vaccinated adults say news of the variants has made them more likely to wear a mask in public (62%) or avoid large gatherings (61%). Unvaccinated adults are much less likely than vaccinated adults to report that the news of the variants has made them more likely to wear a mask (37%) or avoid large gatherings (40%). However, about one in five unvaccinated adults (22%) say the news has made them more likely to get vaccinated for COVID-19. One-third (34%) of those who want to “wait and see” say the news of the variants has made them more likely to get vaccinated for COVID-19 compared to few (2%) of those who say they will “definitely not” get a vaccine.

In addition to news about the variants, six in ten adults have heard or read “a lot” or “some” about the possibility that COVID-19 booster shots might be needed for some vaccinated people to keep them protected, including about a quarter (26%) who have heard “a lot.” While similar shares of vaccinated and unvaccinated Americans have heard “a lot” about booster shots, more than double the percentage of unvaccinated adults report hearing nothing about booster shots (28%) compared to vaccinated adults (12%).

Among vaccinated adults who have heard or read at least a little about boosters for COVID-19, around a quarter (24%) say this news has caused them to worry that they may not be well-protected from coronavirus, even though they are vaccinated. That worry is significantly larger among vaccinated Black and Hispanic adults, with 36% of Black adults and 44% of Hispanic adults reporting concern compared to 17% of White adults. Three quarters of adults who have heard something about the boosters say this news has not caused them to worry about their protection from COVID-19.

Employer mandates

In recent days some cities, states, hospitals, and the federal government have issued requirements mandating some employees be vaccinated against the coronavirus. In addition, some private businesses are requiring employees and patrons to be vaccinated and many colleges are requiring students as well as staff to get vaccinated before the start of the fall semester.

Earlier this month, the U.S. Justice Department issued a statement saying federal law doesn’t prohibit employers from requiring COVID-19 vaccines. The public is split in whether they think the federal government should recommend that employers require employees to get the COVID-19 vaccine unless they have a medical exception with similar shares saying they think the federal government should recommend this (51%) and should not (45%). An additional 3% offer a “don’t know” response.

Views toward this issue are sharply divided by both vaccination status and party identification. Two-thirds of vaccinated adults (68%) and three-quarters of Democrats (75%) say the federal government should issue this recommendation, while eight in ten (81%) unvaccinated adults and 67% of Republicans say the federal government should not do this. Independents are divided in their views with 51% saying the federal government should not make this recommendation and 46% saying it should. Health care workers are also divided with half of health care workers (48%) saying the federal government should recommend employers require COVID-19 vaccinations among their employees.²

Vaccinated Are Confident In Effectiveness Of Available Vaccines While unvaccinated are not

While most vaccinated Americans view the available coronavirus vaccines as effective against preventing many repercussions of COVID-19, unvaccinated adults are less convinced.

Majorities of vaccinated adults say the COVID-19 vaccines are either “extremely effective” or “very effective” at preventing vaccinated individuals from dying from COVID-19 (75%), at preventing vaccinated individuals from becoming seriously ill or hospitalized if they become infected (71%), and at preventing vaccinated individuals from becoming infected with coronavirus if they are exposed to someone who is sick (64%). Fewer vaccinated adults (50%) say the vaccines are “extremely” or “very” effective at preventing vaccinated individuals from passing coronavirus on to others if they become infected. This survey was fielded before recent data from the CDC, finding that vaccinated people who experience breakthrough infections can transmit the virus.

However, significantly fewer unvaccinated Americans agree about the overall effectiveness of the vaccines. Fewer than one quarter of unvaccinated adults think the available vaccines are “extremely” or “very” effective at preventing death, serious illness, infection, or transmission, and at least one-third say the vaccines are “not too effective” or “not at all effective” at preventing each of these.

Groups that have lower rates of vaccinations also have smaller shares saying the vaccines are effective at preventing death or serious illness among vaccinated adults, as well as preventing vaccinated adults from becoming infected or passing on the virus to others. But even among those groups with lower vaccine rates, including young people, Black and Hispanic adults, and Republicans, at least four in ten report thinking the vaccines are extremely or very effective at preventing hospitalization or death.

Perceived SAFETY OF THE DIFFERENT VACCINES

The percent of adults who say they are “very confident” or “somewhat confident” that each of the COVID-19 vaccines are safe has not changed significantly since April, with 74% believing the COVID-19 vaccines currently available in the U.S. are safe, similar to 71% in April. Similar shares say the same for the Pfizer vaccine (72%) and the Moderna vaccine (68%). A smaller share of the public is confident in the overall safety of the Johnson & Johnson vaccine, but it remains unchanged since April (47%).

Unvaccinated adults are much less confident in the overall safety of the COVID-19 vaccines with majorities saying they are either “not too confident” or “not at all confident” in the safety of each of the available vaccines. One-third of unvaccinated adults say they are “very” or “somewhat” confident in the overall safety of COVID-19 vaccines available in the United States. Confidence is highest among unvaccinated adults when it comes to the safety of the Pfizer vaccine (37%), compared to 31% who are confident in the safety of the Moderna vaccine and 18% who are confident in the safety of the Johnson & Johnson vaccine.

Mask-Wearing Is More Common Among Vaccinated Adults, Democrats

On July 27, 2021 the Centers for Disease Control and Prevention (CDC) issued updated guidance encouraging all adults, regardless of vaccine status, to wear masks indoors if they are in an area with higher transmission levels of coronavirus, which includes nearly two-thirds of all counties in the U.S.. Prior to the CDC issuing the newest guidance, half of adults said they wore a protective mask “every time” or “most of the time” at an indoor setting like a grocery store, while less than half report wearing a mask at least “most of the time” on public transit (44%), at work (42% of those who work outside their home), outdoors in crowded places (41%), or outdoors with household members or friends (18%).

Across most places asked about, vaccinated adults were more likely to report wearing a mask at least “most of the time” than unvaccinated adults including outdoors in crowded places (45% vs. 35%), at work (45% vs. 35%), in a grocery store (53% vs. 44%), or on public transportation (47% vs. 37%). Smaller shares of both vaccinated and unvaccinated adults say they wear masks at least “most of the time” when outdoors with household members or close friends (18% vs. 16%).

Mask-wearing has become a partisan issue during the coronavirus pandemic with majorities of Republicans saying they “never” wear a mask outdoors in crowded places, outdoors with friends and household members, at work, or in a grocery store. Democrats, on the other hand, are more likely to report wearing a mask in all of these locations, except when outdoors with household members and friends.