KFF COVID-19 Vaccine Monitor: March 2023

Key Findings

• With the end of the public health emergency (PHE) and the impacts that will have on the health care system, one in five adults have heard “nothing at all” about the Biden administration’s plan to end the COVID-19 PHE. Six in ten (59%) adults think the end of the PHE will have “no impact” on them and their family and almost half (46%) say it won’t have an impact on the country overall. The end of the PHE is a bigger concern to some groups who have been more negatively affected by the coronavirus pandemic, including people of color and those with lower household incomes.
• The latest KFF COVID-19 Vaccine Monitor reports a quarter of adults (23%) saying they have received the bivalent booster, the most recent version of the COVID-19 vaccine that became available in September 2022. As discussions surrounding the timing of boosters continue, about half of adults say they’re likely to get a COVID-19 vaccine annually if one was offered in that time frame, like a flu shot, including one in three (32%) who say they’re “very likely” to get an annual COVID-19 vaccine. Vaccinated adults and those who already receive annual flu shots are among the largest shares to say they’re likely to get an annual COVID-19 booster.
• About two-thirds of U.S. adults say they have either tested positive for COVID-19 (55%) or thought they had it even if they didn’t test positive (13%). This leaves around one-third of adults who don’t think they have had COVID-19. When it comes to who hasn’t had COVID yet, smaller shares of those ages 65 and older and Democrats report testing positive for or thinking they’ve had the virus at some point.
• When those who say they’ve never had COVID are asked to say, in their own words, why they believe they haven’t been infected, 24% say they’ve avoided other people and crowds or stayed home. Another 14% say they’re generally healthy or have a good immune system. Around one in ten say they haven’t had COVID because they wore a mask (11%), they were vaccinated (10%), or they were generally careful and took hygiene precautions (10%). Fewer than one in ten (6%) say they were lucky. Similar shares across partisan lines cite avoiding people and staying home as their reasoning for never having COVID-19, but larger shares of Republicans than Democrats say they’re healthy with a good immune system (22% v. 5%) while larger shares of Democrats than Republicans say wearing a mask was the main reason they haven’t contracted the virus (20% v. 1%). 

The Ending Of The Public Health Emergency

On May 11, 2023, the Biden administration intends to end the national emergency and public health declarations related to the COVID-19 pandemic. The emergency declarations, which were put in place by President Donald Trump in early 2020, giving the federal government flexibility to waive or modify certain requirements in a range of areas, including in the Medicare, Medicaid, and CHIP programs, and in private health insurance.

One in five adults have heard “nothing at all” when it comes to the Biden administration’s plan to end the COVID-19 public health emergency (PHE), with an additional 30% saying they’ve heard “not too much.” That leaves around half of adults saying they have heard at least “some” about the end of the PHE, including 10% who have heard “a lot.”

Older adults have been one of the most highly impacted groups by COVID-19 – adults ages 50 and older are more likely to have heard “a lot” or “some” about the end of the public health emergency, with 57% who say so, compared to 42% of those under 50.

Another impacted group by the pandemic, the uninsured, are less likely to have heard about the end of the PHE. Almost half (48%) of insured adults under the age of 65 have heard “a lot” or “some” about the plan to end the PHE, compared to 31% of those without insurance.

Less than half of Black adults (43%) and Hispanic adults (42%) have heard at least “some” about the end of the PHE, compared to half of White adults (51%). Similar shares of Democrats, Republicans, and independents have heard at least “some” about the end of the PHE.

Six in ten (59%) adults think the end of the COVID PHE will have “no impact” on them and their family and almost half (46%) say it won’t have an impact on the country overall.

Similar shares say they think the end of the public health emergency will have a “positive impact” (20%) or a “negative impact” (21%) on them and their family. About a quarter of the public (27%) say it will have a “positive impact” on the country, while another quarter (26%) think the end of the public health emergency will have a “negative impact” on the country overall.

The end of the PHE is a bigger concern to some groups who have been more negatively affected by the coronavirus pandemic, with around three in ten Black adults (29%) and one-third of Hispanic adults reporting that the end of the COVID-19 public health emergency will have a negative impact on them and their family, compared to 16% of White adults. Three in ten adults (31%) living in households with incomes of less than $40,000 say the end of the PHE will have a negative impact on them and their family, compared to one in ten of those with incomes of $90,000 or more.

The Future Of Bivalent Boosters in the U.S.

The latest KFF COVID-19 Vaccine Monitor reports a quarter of adults (23%) saying they have received the bivalent booster, the most recent version of the COVID-19 vaccine that became available in September 2022. Slightly more than half of the public say they have either received an older booster dose but not the most recent version (25%) or received initial full course of vaccines but no booster doses (25%). One in four adults in the U.S. report being unvaccinated or partially vaccinated.

Adults ages 65 and older and Democrats are among the groups with the largest shares saying they have gotten the bivalent booster dose, with around four in ten who report getting their shot (42% of those ages 65 and older, and 41% of Democrats).

The Food and Drug Administration has begun discussions of what the future of the COVID-19 vaccinations will look like for Americans and how often booster doses will be available. One possibility presented by the FDA would be for the COVID-19 vaccine to be offered annually, like the flu shot, as the impact of COVID-19 booster doses have been shown to fade after about six months.

About half of adults say they’re likely to get a COVID-19 vaccine annually if one was offered in that time frame, like a flu shot, including one in three (32%) who say they’re “very likely” to get an annual COVID-19 vaccine. Vaccinated adults, especially those who have received a booster dose, are among the most likely to say they’d get a COVID-19 vaccine annually. Eight in ten adults who have received a booster dose of the vaccine say they would be likely to get an annual vaccine, including more than half who say they are “very likely.” Among the vaccinated adults who have not received the suggested boosters, willingness to get an annual vaccine lags, with less than half (42%) saying they would be likely to get an annual COVID-19 vaccine. In addition, about one in ten of those who are only partially vaccinated or unvaccinated say they would be likely to get a COVID-19 vaccine annually.

Those who get annual flu shots are more likely than those who don’t normally get flu shots to say they would be likely to get an annual COVID-19 vaccine. Three-fourths (76%) of those who say they normally get an annual flu vaccine (which is about 53% of all adults) say they’d be likely to get one, compared to 26% who don’t normally get their annual flu shot. About half (51%) of those who don’t get an annual flu vaccine say they’re “not at all likely” to get an annual COVID-19 vaccine.

People Report Various Reasons For Never Having COVID-19

About two-thirds of U.S. adults say they have either tested positive for COVID-19 (55%) or thought they had it even if they didn’t test positive (13%). This leaves around one-third of adults who don’t think they have had COVID-19. The share of adults who don’t think they have had COVID-19 increases to nearly half of adults 65 and older, a group that had earlier access to vaccines and booster doses due to increased risks and complications from the virus.

A slightly larger share of Democrats compared to Republicans say they don’t think they have had COVID-19 (36% v. 25%), which may be related to both higher vaccination rates among Democrats as well as that group being more likely to report taking “a lot” of precautions (54% v. 24%) to not get sick.

Notably, there is no difference in the share who say they’ve had COVID between vaccinated and unvaccinated adults (68% v. 70%). There is also no difference in the share who say they’ve had COVID between groups who report taking “a lot” or “some” precautions against COVID-19 (such as wearing a mask or avoiding large crowds) versus those who report taking “not too many” or no precautions at all (69% v. 67%).

Most people (64%) who haven’t had COVID-19 think they have avoided the virus because they have been careful and taken precautions. This is more than twice the share who attribute their lack of illness to being lucky (29%). Less than one in ten (6%) say COVID isn’t really present in their area.

Most Democrats (72%), adults ages 50 and older (70%), and vaccinated adults (68%) who haven’t gotten sick attribute it to being careful and taking precautions. While half of Republicans who haven’t gotten sick also say it is because they have been careful, about four in ten (39%) cite being lucky as their reason for not getting COVID.

Larger shares of unvaccinated adults than those who are vaccinated say that COVID isn’t really present in their area (19% of unvaccinated adults v. 3% of vaccinated adults).

When those who haven’t gotten COVID were asked to provide what they think the main reason was in their own words, about a quarter (24%) offer responses related to avoiding other people and crowds or staying home. Another 14% attribute it to the fact that they’re generally healthy or have a good immune system. Around one in ten think they haven’t had COVID because they wore a mask (11%), they were vaccinated (10%), or they were generally careful and took hygiene precautions (10%). Fewer than one in ten (6%) offer responses related to them being lucky.

Similar shares across partisan lines cite avoiding people and staying home as their reasoning for never having COVID-19, but larger shares of Republicans than Democrats say they’re healthy with a good immune system (22% v. 5%) while larger shares of Democrats than Republicans say wearing a mask was the main reason they haven’t contracted the virus (20% v. 1%).