KFF COVID-19 Vaccine Monitor: February 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

• As COVID-19 vaccination distribution efforts continue across the United States, the latest KFF COVID-19 Vaccine Monitor reports that a majority (55%) of U.S. adults now say they have received at least one dose of the vaccine (18%) or that they will get it as soon as they can (37%), up from 47% in January and 34% in December. The share that wants to “wait and see” how the vaccine is working for others before getting vaccinated themselves decreased from 31% in January to 22% in February, while a persistent one in five say they will get the vaccine “only if required for work, school, or other activities” (7%) or will “definitely not” get vaccinated (15%).
• While the share that is most enthusiastic to get vaccinated increased across racial and ethnic groups, Black and Hispanic adults continue to be more likely than White adults to say they will “wait and see” before getting vaccinated. Nearly four in ten Republicans and three in ten rural residents say they will either “definitely not” get vaccinated or will do so “only if required,” as do one-third (32%) of those who have been deemed essential workers in fields other than health care.
• With the potential arrival of a one-dose COVID-19 vaccine to the U.S. market, most of those who have not yet been vaccinated say the number of doses doesn’t make a difference in their own intentions, but about a quarter (26%) of those in the “wait and see” group say they’d be more likely to get a vaccine if only one dose was required.
• Having a close relationship with someone who’s been vaccinated is correlated with individuals’ own intentions to get the COVID-19 vaccine. Among those who have not yet been vaccinated, seven in ten of those with a household member who’s been vaccinated and about half of those who say a close friend or family member has been vaccinated say they want the vaccine “as soon as possible,” compared to about a third of those who don’t have a close relationship to someone who’s gotten the vaccine. Black and Hispanic adults, those with lower incomes, and those without a college degree are less likely than their counterparts to say someone close to them has gotten the vaccine, reflecting other KFF analysis showing similar disparities.
• The perceived side effects of the vaccine continue to be a top concern for the public, with eight in ten in the “wait and see” group saying they are concerned they might experience serious side effects if they get vaccinated. Large shares of those who want to “wait and see” – including majorities of Black and Hispanic adults – also say they are concerned that they might get COVID-19 from the vaccine, they might have to miss work if the side effects make them feel sick, they may have to pay an out-of-pocket cost to get vaccinated (despite the fact that the vaccine is available for free to everyone), or they won’t be able to get the vaccine from a place they trust.
• Half of Black adults and about one-third Hispanic adults (35%) say they are not confident that the COVID-19 vaccines have been adequately tested for safety and effectiveness among members of their own racial or ethnic group, and those who aren’t confident in this type of testing are much less likely to say they’ve already been vaccinated or want the vaccine as soon as they can get it.

COVID-19 Vaccine Uptake and Intentions

Trends Among Key Groups

More than half of U.S. adults (55%) now say they have already received at least one dose of the COVID-19 vaccine (18%) or they want it as soon as possible (37%). This is an increase from 47% in mid-January and up from 34% in early December before vaccine distribution began. About one in five adults (22%) say they will “wait and see” how the vaccine is working for others before getting vaccinated themselves, a share that is down from 31% in January and 39% in December. The remaining public say they will get the vaccine “only if required for work, school, or other activities” (7%) or that they will “definitely not” get vaccinated (15%), shares that have not changed much over the past two months.

Across racial and ethnic groups, there was a steady increase from December to February in the share of adults who say they’ve already been vaccinated for COVID-19 or want the vaccine as soon as possible, and a corresponding decrease in the share who say they will “wait and see” before getting vaccinated. Despite this movement, differences in vaccine enthusiasm between members of different racial and ethnic groups persist. For example, six in ten White adults (61%) say they have already gotten the vaccine or want it as soon as possible compared to about half (52%) of Hispanic adults and four in ten Black adults (41%).

The Monitor also reports changes in vaccine enthusiasm across partisans, with large gaps in enthusiasm remaining between groups. Between December and February, there was a large increase in the share of Democrats who report being vaccinated or wanting to do so as soon as possible (from 47% to 75%) and a more modest increase among Republicans (from 28% to 41%). A substantial share of Republicans remain more resistant to getting vaccinated, with 28% saying they will “definitely not” get the shot.

Similarly, there has been an increase in COVID-19 vaccine enthusiasm across residents of urban, suburban, and rural areas since December, and now at least half of each group say they have already gotten the vaccine or want it as soon as possible (55% of urban, 56% suburban, and 53% of rural residents). Still, a larger share of rural (24%) compared to urban (13%) and suburban (14%) adults say they will “definitely not” get the vaccine.

Which Groups Are Most Enthusiastic/Cautious/Resistant?

While there has been an overall shift towards greater enthusiasm for getting a COVID-19 vaccination, the demographic groups that are the most enthusiastic, most cautious, and most resistant remain similar to those reported in January. About three-quarters of adults ages 65 and over (77%) and a similar share of Democrats (75%) say they have either already gotten at least one dose of the vaccine or will do so as soon as they can. About two-thirds of college graduates (67%) and those who work in health care delivery settings (65%) also fall into this most enthusiastic group.

About one in five adults overall (22%) say they want to “wait and see” how the vaccine is working for other people before getting vaccinated themselves, including about a third of Black adults (34%) and those between the ages of 18-29 (33%), and about a quarter of Hispanic adults (26%), those without college degrees (25%), and essential workers in non-health fields (25%).

Four in ten Republicans (38%) say they will get a COVID-19 vaccine “only if required” or will “definitely not” get vaccinated, as do about three in ten (28%) of adults living in rural areas. Notably, about one-third of those who say they’ve been deemed “essential workers” and are required to work outside their homes during the pandemic (excluding those who work in health care settings) say they will get the vaccine “only if required” (9%) or will “definitely not” get it (24%).

Demographic Differences In Vaccine Intentions

Looking at patterns of vaccine intentions across demographic groups, it’s notable that lower levels of enthusiasm among Black adults compared to White adults persist even after controlling for education levels. For example, among White adults without a college degree, 54% say they’ve already gotten the vaccine or will get it as soon as they can, compared to 38% of Black adults without a college degree. Similarly, among those who have graduated from college, vaccine uptake and enthusiasm is higher among White adults (72%) compared to their Black counterparts (48%).

Adults ages 65 and over are one of the target groups for early vaccination, and one of the groups most likely to say they’ve already been vaccinated or want the vaccine as soon as possible. Looking at vaccine intentions by a combination of race and age, large majorities of both Black and White adults ages 65 and over fall into the most enthusiastic categories. However, while nearly half of older White adults (46%) say they they’ve already gotten the vaccine, about one-third of Black older adults say the same (35%). Half (46%) of Black adults 65 and older say they will get it as soon as they can.

Among younger age groups, Black adults are nearly twice as likely as White adults to say they will “wait and see” before getting vaccinated (35% vs. 18% among those ages 50-64 and 41% vs. 23% among those ages 18-49).

Two-Dose Versus Single-Dose Vaccine

With the potential arrival of a single-dose vaccine to the U.S. market, the Vaccine Monitor probed people’s willingness to get a vaccine that required only one dose as opposed to the currently available two-dose vaccines. A large majority (83%) of those who have not yet been vaccinated say that the number of doses doesn’t make a difference in their own intentions to get vaccinated. However, about a quarter of (26%) of those who want to “wait and see” before getting vaccinated say they’d be more likely to get a vaccine if only one dose was required (including 20% of Black adults, 28% of Hispanic adults, and 29% of White adults in the “wait and see” group).

Personal Experiences With COVID-19 Vaccination

Having a close relationship with someone who’s been vaccinated is correlated with individuals’ own intentions to get the COVID-19 vaccine. Among those who have not yet gotten the vaccine but live in a household with someone who has been vaccinated, about seven in ten (69%) say they will get the vaccine as soon as they can. Similarly, about half (49%) of those who say a close friend or family member outside of their household has been vaccinated are in the “as soon as possible” group. Among those who have only a casual connection or no connection to someone who’s been vaccinated, about one-third say they want the vaccine as soon as they can get it, while larger shares (compared to those with a close personal connection to someone who’s been vaccinated) say they want to “wait and see” before getting vaccinated.

Given this association between having a close relationship to someone who has gotten the vaccine and an individual’s personal level of vaccine enthusiasm, it’s notable that Black and Hispanic adults, those with lower incomes, and those without college degrees are less likely than their counterparts to report having these connections. For example, three-quarters of White adults have a close personal connection to someone who has gotten the vaccine (including themselves) compared to 57% of Black and Hispanic adults. Similarly, 83% of those with incomes of $90,000 or more report a close personal connection to someone who has been vaccinated compared to 59% of those with incomes under $40,000, as do 86% of college graduates compared to 64% of adults without college degrees.

Personal Concerns About COVID-19 Vaccination

The February COVID-19 Vaccine Monitor probed a variety of personal concerns people might have when it comes to receiving a vaccine. As reported previously, side effects remain a prominent concern; over half (56%) of those who have not yet been vaccinated, including 80% of those in the “wait and see” group, say they are “very concerned” or “somewhat concerned” that they might experience serious side effects from the vaccine. Other concerns cited by about a third of the unvaccinated and about half of those in the “wait and see” group” are that they might have to pay out of pocket for the vaccine (despite the fact that the vaccine is available at no cost), they might have to miss work if the vaccine’s side effects make them feel sick, or that they might get COVID-19 from the vaccine.

While the possibility of experiencing serious side effects from the vaccine is a top concern across racial and ethnic groups, larger shares of Black and Hispanic adults compared to White adults in the “wait and see” category express concern that they might get COVID-19 from the vaccine, might miss work due to side effects, or have to pay out of pocket to get vaccinated (despite the fact that the vaccine is free for everyone). Among those who want to “wait and see,” about six in ten Hispanic adults (58%) and about half of Black adults (52%) are concerned that they won’t be able to get the vaccine from a place they trust, compared with about one-third of White adults (32%). In addition, about four in ten Hispanic adults in this group are concerned that they might need to take time off work to get vaccinated (43%) or they will have difficulty traveling to a vaccination site (39%).

Confidence In Vaccine Development And Testing Among Black And Hispanic Adults

Concerns about COVID-19 vaccination among Black and Hispanic adults may be linked to perceptions of whether people of color were represented in clinical trials and other vaccine research. In fact, half of Black adults say they are “not too confident” or “not at all confident” that the COVID-19 vaccines were adequately tested for safety and effectiveness specifically among Black people, and about a third of Hispanic adults (35%) say the same thing about testing among Hispanic people.

Confidence in adequate testing among one’s own racial or ethnic group is related to vaccine intentions and enthusiasm among Black and Hispanic adults. Those who are at least somewhat confident that the vaccines have been adequately tested for safety and effectiveness among their own racial or ethnic group are about twice as likely to say they’ve already been vaccinated or want the vaccine as soon as they can get it compared to those who are not confident (58% vs. 24% among Black adults, 63% vs. 30% among Hispanic adults).