KFF COVID-19 Vaccine Monitor: March 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 share of U.S. adults who report being vaccinated for COVID-19 or intending to do so as soon as possible continues to rise (currently 61%) and the share taking a “wait and see” approach continues to shrink (now 17%), while the share who say they will “definitely not” get the vaccine (13%) has remained about the same since December, according to the latest KFF COVID-19 Vaccine Monitor. Black adults saw the largest increase in vaccine enthusiasm (55% of them now say they have either gotten vaccinated or want to as soon as possible), but one-quarter of Black adults say they still want to “wait and see” how the vaccine works for others before getting vaccinated, somewhat higher than the share of White adults who say the same. About three in ten Republicans and White Evangelicals say they will “definitely not” get the vaccine, as do one in five adults living in rural areas.
• While a growing share of adults say they now have enough information about where and when they will be able to get vaccinated, three in ten – including larger shares of Hispanic adults, young adults, and those with lower incomes – are unsure whether they’re currently eligible to receive the vaccine in their state. Among those who believe they are eligible, about one-third say they tried to make an appointment to get vaccinated and about half of this group says their attempt was unsuccessful. In a sign that the appointment process may be getting easier at least for older adults, the share of those ages 65 and over who say they tried but were unable to get an appointment declined from 16% in February to 7% this month.
• In the latest COVID-19 Vaccine Monitor, we tested a variety of potential incentives, messages, and pieces of information that might be used to increase vaccination uptake. We find there is a role for convenient access to vaccines in medical settings; about half of those in the “wait and see” group say they would be more likely to get vaccinated if the vaccine were offered to them during a routine medical appointment. Travel and freedom of movement may be incentives for others; about four in ten in both the “wait and see” and “only if required” groups say they would be more likely to get a shot if airlines required it of passengers or if the CDC said that vaccinated people could travel freely and would not have to wear masks in most situations. Employers also have a role to play, both in facilitating access and offering incentives. About four in ten employed adults in the “wait and see” group say they would be more likely to get the vaccine if their employer arranged for on-site vaccination or offered them a $200 incentive to get vaccinated.
• Among the pieces of information tested, the most impactful was that the vaccines are nearly 100% effective at preventing hospitalization and death from COVID-19 (two-thirds of those in the “wait and see” group said hearing this would make them more likely to get vaccinated). Other messages that were effective for at least four in ten of those in the “wait and see” group include that scientists have been working on the technology used in the new COVID-19 vaccines for 20 years, that more than 100,000 people from diverse backgrounds took part in the vaccine trials, that the vast majority of doctors who have been offered the vaccine have taken it, and that there is no cost to get the vaccine. However, while a variety of incentives, messages, and information may be helpful in swaying some in the “wait and see” and “only if required” groups to consider vaccination, none of them do much to sway those in the “definitely not” camp.
• With the introduction of the one-dose Johnson & Johnson (J&J) vaccine to the U.S. market, we find that about half of those who are open to getting vaccinated say they do not have a preference for which vaccine they would like to get, while about three in ten say they have a strong preference and about one-quarter have a slight preference. Among those who have not been vaccinated, just over half say they would probably or definitely get each of the three available brands (Pfizer, Moderna, and J&J), though a slightly larger share of those in the “wait and see” group say they would “definitely” get the one-dose J&J vaccine (16%) than says the same about the Pfizer or Moderna two-dose versions (8% and 7%, respectively). Among those who express a preference, the most common reason offered is that they prefer a one-dose vaccine (24%), suggesting that the convenience of a one-dose vaccine may make it easier to reach certain harder-to-convince populations to get vaccinated.

Trends In COVID-19 Vaccination Intentions

As states continue to expand eligibility for COVID-19 vaccination, the latest KFF COVID-19 Vaccine Monitor reports that the share of the public that has gotten the vaccine or is eager to do so continues to grow while the share that is waiting to see how the vaccine works for others continues to shrink. About six in ten adults (61%) say they have already gotten at least one dose of the vaccine (32%) or will get it as soon as they can (30%), up 6 percentage points since February. At the same time, the share taking a “wait and see” approach declined from 22% in February to 17% this month. A small but persistent share say they will get the vaccine only if they are required to do so for work, school, or other activities (7%) or that they will “definitely not” get the vaccine (13%), similar to the shares who have given those responses since January.

Enthusiasm for getting the COVID-19 vaccine continues to grow among people across racial and ethnic backgrounds, with the largest increase this month among Black adults. Over half of Black adults (55%) now say they’ve either gotten at least one dose of the vaccine or will get it as soon as they can, up from 41% in February and approaching the shares among Hispanic adults (61%) and White adults (64%). At the same time, the share of Black and Hispanic adults who say they will “wait and see” how the vaccine works for others before getting vaccinated themselves has fallen steadily since December. However, Black adults (24%) remain somewhat more likely than White adults (16%) to say they will “wait and see” before getting vaccinated.

While enthusiasm for getting the COVID-19 vaccine continues to inch up across partisan groups, a persistent divide remains, with about eight in ten Democrats (79%), almost six in ten independents (57%), and fewer than half of Republicans (46%) saying they have either received at least one dose of the vaccine or intend to do so as soon as possible. About three in ten Republicans (29%) say they will “definitely not” get vaccinated, similar to the share who said so in February.

Looking across various demographics, the groups most likely to say they’ve either already gotten the vaccine or will get it as soon as possible are adults ages 65 and over (82%), Democrats (79%), and college graduates (73%). Young adults ages 18-29 (25%) and Black adults (24%) continue to be among the groups most likely to say they want to “wait and see” before getting a COVID-19 vaccine. About three in ten Republicans (29%) and a similar share of White adults who identify as Evangelical Christians (28%) say they will definitely not get the vaccine, as do one in five rural residents (20%) and essential workers in fields other than health care (21%).

Information Needs And Experiences With Appointments

The share of unvaccinated adults who say they have enough information about when they will be able to get the COVID-19 vaccine increased from 36% in February to 53% in March, and the share who say they know enough about where they can get a vaccine increased from 55% to 67%. Still, that leaves almost half the public feeling like they don’t have enough information about when they can get the vaccine and one third saying they don’t know enough about where they can get it.

Further, three in ten of those who have not yet been vaccinated say they are not sure if they’re currently eligible to get a COVID-19 vaccine in their state or not. This share rises to about four in ten among Hispanic adults (45%), adults under age 30 (39%), those with household incomes under $40,000 (37%), and adults without a college degree (35%).

Among adults ages 65 and over, almost two-thirds (64%) say they’ve gotten at least one dose of the vaccine (up from 44% last month) and another 7% have scheduled an appointment to get vaccinated. Just 7% say they tried but were unable to get an appointment (down from 16% last month). The share of older adults who report receiving at least a first dose of the vaccine is somewhat higher among those ages 75 and over (72%) and college graduates (77%).

Among all adults who have not been vaccinated but believe they are eligible, about one-third say they tried to get an appointment to get the COVID-19 vaccine, including 16% who say they were able to schedule an appointment and another 17% who say they tried but were unable to get an appointment.

Among all adults who tried but were unable to get an appointment, 43% say they couldn’t get an appointment because they didn’t meet eligibility requirements, one-third say there were no appointments available, and smaller shares report that the vaccine was not available (6%), the available appointment times didn’t work for their schedule (5%), or they had technical difficulties (4%).

Concerns Among Those Who Have Not Yet Been Vaccinated

Among the 37% of adults who are not yet convinced to get the vaccine right away (defined as those who say they will “wait and see” before getting vaccinated, will get the vaccine “only if required” or will “definitely not” get it), side effects continue to be the top concern, with about seven in ten (70%) saying they are very or somewhat concerned that they might experience serious side effects from the vaccine. Just over six in ten (63%) are also concerned that the effects of the vaccine might be worse than if they actually got COVID-19 and the same share are concerned that they might be required to get the vaccine even if they don’t want to. About four in ten are concerned that they might have to miss work because of vaccine side effects (45%) or that they might get COVID-19 from the vaccine (39%), while fewer are concerned that they won’t be able to get the vaccine from a place they trust (21%), or they will have difficulty traveling to a vaccination site (10%).

The potential side effects of the vaccine continue to be the top concern across racial and ethnic groups. Among those who are not convinced to get vaccinated right away, about half of Black adults (50%) and Hispanic adults (52%) are concerned they might get COVID-19 from the vaccine, higher than the share of White adults who express this concern (33%). In addition, four in ten Black adults (38%) and one-quarter of Hispanic adults (27%) are concerned they won’t be able to get the vaccine from a place they trust, and about one in five (20% of Black adults and 22% of Hispanic adults) are concerned they will have difficulty traveling to a vaccination site.

Among those who are not convinced to get vaccinated right away, a larger share of Republicans (71%) compared to independents (57%) and Democrats (53%) say they are concerned that they might be required to get the vaccine even if they don’t want to.

While many vaccine outreach efforts are currently focused on the “wait and see” group – a group that has been shrinking over time – the share of the public who say they will “definitely not” get the vaccine has been about the same size since December 2020, representing about one in seven adults (13%). Understanding this group’s concerns about the vaccine will be crucial to any effort to ultimately convince them to get vaccinated.

When asked to say in their own words the main reason why the don’t want to get vaccinated, those in the “definitely not” group cite a range of concerns. The most frequently mentioned reason is feeling that the vaccines are too new or that there is not enough information about the long-term effects (mentioned by 17%), followed by concerns that the vaccines are not effective against COVID-19 (8%), a general sense that they don’t need the vaccine (8%), and concerns about the vaccines’ ingredients (8%). The range of reasons suggests that there is not a single message that will help sway these individuals to consider getting vaccinated, but that a range of strategies and conversations will be needed to move even some of them away from their “hard no” position.

Messages, Information, And Incentives That Might Increase Vaccination Uptake

In the latest COVID-19 Vaccine Monitor, we tested a variety of potential incentives, messages, and pieces of information that might be used to increase vaccination uptake. We find that while various incentives and messages may help convince people in the “wait and see” and “only if required” groups to get vaccinated, very few of them move people in the “definitely not” group.

Travel And Routine Medical Visits

About three in ten adults who are not convinced to get the vaccine right away say they would be more likely to get the COVID-19 vaccine if airlines required passengers to be vaccinated before they could fly (31%), if the CDC said vaccinated people could travel freely and would not need to wear masks in most situations (31%), or if the vaccine was offered to them during a routine medical visit (30%).

Notably, half of adults who want to “wait and see” before getting the vaccine say they would be more likely to get it if it was offered to them at a routine medical visit (50%). Those who say they would only get the vaccine if they are required are less motivated by having the vaccine offered at a routine appointment (32%), but about four in ten of this group says they would be more likely to get vaccianted if airlines required it of passengers and if the CDC said that vaccinated people could travel freely and not wear masks in most situations (similar to the share who say so among the “wait and see” group). Among those who say they will definitely not get the vaccine, fewer than one in ten are moved by any of these potential scenarios.

Across racial and ethnic groups, about half of Hispanic adults who are not yet convinced to get the vaccine right away say they would be more likely to get vaccinated if airlines required it to fly (49%) and if the CDC said vaccinated people could travel freely and not wear masks in most situations (47%). Fewer than three in ten White adults say they would be more likely to get vaccinated when presented with any of these scenarios.

The Role Of Employers

Employers also have a role to play in incentivizing their employees to get vaccinated and offering access to the vaccine on the job.

Among those who are employed and not yet convinced to get the vaccine right away, about one-quarter (25%) say they would be more likely to get the vaccine if their employer arranged for a medical provider to come to their place of work and administer it to employees, rising to 37% among employed people in the “wait and see” category. In addition, one in five say they would be more likely to get vaccinated if their employer offered them an extra $50 to get vaccinated (19%) while an additional 3% say they would be more likely to get the vaccine if their employer offered them $200, for a total of 22%. Among employed people in the “wait and see” group, 30% say they’d be more likely to get vaccinated if their employer offered them an extra $50 and a total of 38% say the same about a financial incentive of $200.

In a separate question, about half the public (51%) says that employers should be allowed to require certain employees to get vaccinated for COVID-19, while nearly half (45%) say this should not be allowed. There is a large partisan divide on this question that reflects the divide on many questions about the pandemic, with seven in ten Democrats (70%) saying employers should be allowed to require vaccination and a similar share of Republicans (71%) saying they should not.

Messages And Information

When those who are not yet convinced to get the COVID-19 vaccine right away are presented with messages and information that might encourage vaccination, the most effective piece of information is that the vaccines are nearly 100% effective at preventing hospitalization and death from COVID-19. Two-thirds (66%) of those in the “wait and see” group and about four in ten (42%) in the “only if required” group say hearing this would make them more likely to get vaccinated. In addition, hearing that scientists have been working on the technology used in the new COVID-19 vaccines for 20 years is an effective message for many, with half (49%) of the “wait and see” and about four in ten (39%) of the “only if required” group saying this would make them more likely to consider vaccination.

Three other pieces of information were convincing for about four in ten of the “wait and see” and at least three in ten of the “only if required groups: that more than 100,000 people from diverse backgrounds took part in the vaccine trials, that the vast majority of doctors who have been offered the vaccine have taken it, and that there is no cost to get the vaccine. About a third in both groups say they’d be more likely to get vaccinated after hearing that while the long-term effects of the vaccine are unknown, the long-term effects of COVID-19 could be worse. Somewhat fewer say they would be more likely to get the vaccine after hearing that some young and healthy people have been hospitalized and died from COVID-19 and that the reason the vaccines were approved so quickly was because red tape that is usually part of the process was removed, not because corners were cut.

Few of these messages or pieces of information were effective at moving those who say they will definitely not get vaccinated, with the share of that group saying they’d be more convinced after hearing each message in the single digits.

Among those not yet convinced to get the COVID-19 vaccine right away, few (15%) say they would be more likely to get the vaccine if former President Donald Trump came out with a message strongly urging people to get vaccinated. Indeed, even among Republicans, just one in five say they would be more likely to get vaccinated if former President Trump strongly urged people to get vaccinated.

Do People Have A Preference For A Specific Vaccine?

With the FDA granting emergency use authorization to the Johnson & Johnson (J&J) COVID-19 vaccine on February 27, the U.S. now has three highly effective vaccines available to the public. All three vaccines have been rigorously studied and proven to prevent hospitalization and death from COVID-19, though they use different technologies. While the Moderna and Pfizer vaccines that have been on the market since January require two doses administered several weeks apart, the J&J vaccine is administered as a single dose.

Despite the high efficacy of all three vaccines, there has been some confusion surrounding these different technologies and the different dosages. When asked if there are differences in how well the three COVID-19 vaccines available on the U.S. market work, half (52%) of the public say they are not sure. Fourteen percent think there are major differences in how well the vaccines work, about a quarter (26%) think there are minor differences, and 8% say there are no differences. As the vaccine roll-out continues, uptake may be dependent on how well the public trusts the safety and efficacy of the different vaccines.

Among U.S. adults who are at least somewhat open to getting the vaccine—expressed by saying they either want the vaccine as soon as possible, they want to wait and see how it works for others before getting it themselves, or they will get it if required to do so for work, school, or other activities—three in ten say that they have a “strong preference” for which vaccine they get (28%), while an additional one in four (24%) say they have a “slight preference”, and 46% say they do not have a preference. Younger adults are more likely to say it doesn’t matter which vaccine they get, with nearly six in ten willing 18-29 year-olds (56%) saying they have no preference, compared to four in ten of those ages 30-49 (43%) or 50-64 (41%) and one third of those ages 65 and over (33%). Four in ten (43%) of people ages 65 and over who have not yet been vaccinated say they have a strong preference for which vaccine they would like to get and 21% say they have a slight preference.

When asked separately about each of the three FDA authorized COVID-19 vaccines, majorities of those planning or considering getting vaccinated say they would be open to getting each one. About seven in ten say they would “probably” or “definitely” get each of the three vaccines, including at least one-third who say they would “definitely get” each. About one in seven say they would definitely not get each of the vaccines.

Among those who want to wait and see how the vaccines are working for other people before getting vaccinated, a larger share says they would definitely get the J&J one-dose vaccine compared to either of the two-dose options. One in six (16%) of those in the “wait and see” group say they would “definitely get” the J&J vaccine, compared to about one in ten who say the same about the Pfizer or Moderna vaccines (8% and 7%, respectively). This analysis shows that the convenience of a one-dose vaccine may make it easier to reach certain harder-to-convince populations to get vaccinated.

Among those who say they have a preference for one vaccine over another, the main reasons are that they prefer the ease of a one-dose vaccine (24%), their perceptions of the level of effectiveness of the different vaccines (14%), they have heard good or better things about one vaccine (7%), they are concerned about side effects or a reaction to a particular vaccine (7%), the ingredients or formulation of the vaccines (6%), or they say one vaccine would be more convenient or easier to obtain than others (6%).