Among vaccine-hesitant adults, most were concerned about side effects and vaccine effectiveness.
Vaccination is widely viewed as an end-game stage in the coronavirus pandemic. One of the primary goals of vaccination is to achieve herd immunity—a point at which enough of the country's population will have immunity to the coronavirus that community spread is unlikely. In December, leading infectious disease expert Anthony Fauci, MD, said herd immunity for the coronavirus will require 70% to 75% of the population having immunity.
The Urban Institute survey report, which was funded by the Robert Wood Johnson Foundation, features data collected from more than 7,500 adults ages 18 to 64. The survey report has several key findings:
- 35% of survey respondents said they were unlikely to get vaccinated, with 19% who said they would probably not get vaccinated and 16% who said they would definitely not get vaccinated
- 49% of Black adults said they were unlikely to get vaccinated, with 28% who said they would probably not get vaccinated and 21% who said they would definitely not get vaccinated
- 47% of Republicans said they would probably not or definitely not get vaccinated
- 25% of Democrats said they would probably not or definitely not get vaccinated
- Among vaccine-hesitant adults, most were concerned about side effects and vaccine effectiveness
- Among vaccine-hesitant adults, 57% said they did not need the vaccine
- Among vaccine-hesitant adults who were Republicans, 63% said they did not need the vaccine
- Among vaccine-hesitant adults, 51% said they trust their healthcare providers about the vaccine
Addressing concerns about safety and effectiveness of vaccines
When it comes to the safety and efficacy of vaccines, a primary concern is the speedy development and production processes, says Julie Morita, MD, executive vice president of the Robert Wood Johnson Foundation.
"The survey done by Urban Institute made it clear that there were some people who had concerns about the short timeframe in which the vaccines were developed and produced as well as concerns about the safety of the vaccines and how effective they could be given that the vaccines were produced so quickly," she says.
"You can address those kinds of concerns by talking through the manufacturing process. The reason that these vaccines were developed so quickly was because billions of dollars were pumped into the development and manufacturing. There was incredible coordination between the manufacturers, government agencies, and academic institutions to have these vaccines produced," Morita says.
Concerns about safety and efficacy also can be addressed by highlighting the review process, she says.
"The process for reviewing the vaccines was comprehensive and rigorous. The Food and Drug Administration has a process and an external body for reviewing the safety and efficacy of vaccines before they authorize them. The Centers for Disease Control and Prevention has a process and an external body that reviews the vaccines before making recommendations about them. So, the vaccines that are currently available have been demonstrated to have strong clinical trial data that supports the vaccine safety and efficacy."
Addressing concerns among Black Americans
To address vaccination hesitancy among Black Americans, the reasons for the hesitancy should be recognized, Morita says.
"It goes to the deep-seated distrust of the healthcare system and government based on historic and ongoing mistreatment and lack of access to services. There also has been a poor history of experimentation in the past. Those kinds of things are things that we need to confront and acknowledge when we are working with the African American community," she says.
"We need to say, 'We know that there have been reasons in the past for mistrust. You may not have gotten the services you needed. You may have mistrust because of historic or ongoing discrimination that you faced.' Then you need to listen to them and engage with them."
Building trust among Black Americans will take effort, Morita says. "Earning trust after years of discrimination and years of mistreatment cannot be done overnight. You need to work with the community and get information into the hands of people they do trust, so they can have confidence and faith in the vaccines."
Addressing concerns of Republicans
Skepticism about the severity of COVID-19 is a root cause of vaccination hesitancy among Republicans, she says.
"A high proportion of Republicans reported that they did not feel they needed to get the vaccine. That would suggest that they do not necessarily recognize the benefits of the vaccine versus the risk of the disease. That is where healthcare providers can play an important role in terms of making it clear that what we know about COVID-19 is that it can cause serious infections and it can cause long-term illness."
How healthcare providers can address vaccination hesitancy
Healthcare providers need to be good communicators to address vaccination hesitancy among their patients, Morita says.
"It is important for healthcare providers to listen. Healthcare providers are trained to listen to their patients in terms of understanding what their symptoms are, what they are experiencing, and why they are in for a visit. Healthcare providers need to ask questions. If you are offering the vaccine, and people refuse the vaccine, then you need to ask why. You need to spend the time to understand what the questions or the concerns are. You need to spend the time to find out what information is needed to reduce the vaccine hesitancy."
Christopher Cheney is the senior clinical care editor at HealthLeaders.
Half of Black adults said they were unlikely to get vaccinated, with 28% who said they would probably not get vaccinated and 21% who said they would definitely not get vaccinated.
Among vaccine-hesitant adults, 57% said they did not need the vaccine.