KFF COVID-19 Vaccine Monitor November 2023: With COVID Concerns Lagging, Most People Have Not Gotten Latest Vaccine And Half Say They Are Not Taking Precautions This Holiday Season

Key Takeaways

The latest KFF COVID-19 Vaccine Monitor survey suggests the lack of public concern about getting sick from COVID-19 may be why many people have not gotten the latest vaccine and why half of the public are not planning on taking precautions to limit the spread of the virus during the coming months.

• As the public heads into the fourth holiday season with the virus, about half of adults say they do not plan to get the latest vaccine which became publicly available nearly two months ago. This includes three in ten of those who were previously vaccinated. A quarter of the public say that while they have not gotten the latest vaccine, they intend to do so.
• That leaves about two in ten adults reporting having gotten the latest COVID-19 vaccine. Consistent with demographic differences across other COVID-related behaviors, uptake of the new vaccine is highest among those ages 65 and older (34%) and Democrats (32%). Smaller shares of younger adults ages 18-29 (18%), Republicans (11%) and independents (16%) report getting the latest vaccine. Similar shares across racial and ethnic groups say they have gotten the updated vaccine, including 26% of Black adults, 20% of Hispanic adults, and 19% of White adults. However, when combining the shares who have gotten the shot and those who intend to get it, Black adults (59%) and Hispanic adults (59%) both outpace White adults (42%).
• The latest COVID-19 Vaccine Monitor survey explores why previously vaccinated people haven’t received the latest vaccine and finds decreasing concerns around the virus tops the list of reasons. About half (52%) of those who were previously vaccinated but haven’t gotten the latest shot say lack of worry about COVID-19 is a reason why they haven’t gotten the vaccine. Getting vaccinated is also seemingly not the priority it once was, with many also saying they haven’t gotten it because they have been too busy (37%) or that they are waiting to get it a later date (32%).
• With the upcoming winter holidays, small shares of the public are worried COVID-19 will impact their holiday plans. About three in ten are worried they will spread COVID-19 to people close to them (31%) or that they will get seriously sick from COVID-19 (28%), and about a quarter (26%) worry they will get COVID-19 over the holidays. A larger share of the public is worried about increased hospitalizations, with almost half (46%) saying they are “very” or “somewhat worried” that there will be an increase in hospitalizations in the U.S. this winter.
• The public is divided on precautions this upcoming season, with half of adults saying they are planning to take at least one of several precautions to limit the spread of COVID this fall and winter, while the other half are not planning to take any of the precautions asked about in the survey. The most common precautions people say they plan to take are avoiding large gatherings (35%) or wearing a mask in crowded places (30%). Smaller shares say they are avoiding travel this fall and winter (25%), avoiding dining indoors at restaurants (19%), or taking a COVID-19 test before visiting with friends or family (18%). Some groups are more likely to report taking such precautions including majorities of Black adults (72%), Hispanic adults (68%), Democrats (66%), and just over half (53%) of vaccinated adults. 

The Latest COVID-19 Vaccine Uptake And Intentions

The November KFF COVID-19 Vaccine Monitor investigates uptake for the new, updated COVID-19 vaccine, which has been recommended by the CDC for people ages 6 months and older. Two months after the vaccine became available, about half of adults say they have gotten or will get the shot, but another half say they won’t get the latest shot and a third seem steadfast in that decision.

One in five (20%) adults now say they have received the new, updated COVID-19 vaccine that became available in September. An additional one in four adults say they will “definitely get” (13%) or “probably get” (15%) the updated shot. Consistent with demographic differences across other COVID-related behaviors, uptake is highest among those ages 65 and older (34%) and Democrats (32%). This is meaningful given that those ages 65 and older are more vulnerable to COVID-19, as they’re more likely to get seriously sick and experience complications that could result in hospitalization. This is in comparison to smaller shares of younger adults ages 18-29 (18%), Republicans (12%) and independents (16%) who report getting the latest vaccine. Similar shares across racial and ethnic groups report having gotten the updated vaccine, including 26% of Black adults, 20% of Hispanic adults, and 19% of White adults. However, when combining the shares who have gotten the shot and those who intend to get it, Black adults (59%) and Hispanic adults (59%) both outpace White adults (42%).

Uptake of the newest vaccine matches closely to uptake of the updated bivalent booster measured in December 2022, just after the updated bivalent COVID-19 booster had become available for use. About two in ten adults said they had received the booster dose (22%).

One in three (34%) adults say they will “definitely not” get the new COVID-19 vaccine, and another 17% say they will “probably not” get the vaccine. The share who say they “probably” or “definitely” won’t get the new COVID-19 vaccination has remained unchanged from the September COVID-19 Vaccine Monitor, which was fielded immediately prior to when the vaccine became available.

Majorities of those who have never received any COVID-19 vaccine (94%), Republicans (77%), independents (59%), those who live in rural areas (65%), White adults (58%), and those under the age of 65 (55%) continue to say they will not get the updated COVID-19 vaccine.

The survey finds that partisanship is continuing to play an outsized role in vaccine attitudes. While nearly six in ten White adults say they do not plan to get the new vaccine, this increases to eight in ten among White adults who self-identify as Republicans. This is more than twice the share of White adults who are Democrats (29%) who say they will either “definitely not” or “probably not” get the vaccine. In fact, three in ten (31%) White adults who are Democrats have already gotten the new vaccine, compared to 11% of their Republican counterparts.

Most adults (79%) say they have heard at least “a little” about the updated COVID-19 vaccine, with one in five (22%) saying they have heard “a lot.” A small share (21%) say they have heard “nothing at all” about the updated vaccine.

Awareness is high across demographic groups, including the vast majority (92%) of adults ages 65 and older who have heard at least “a little” about the updated vaccine compared to a somewhat smaller share, but still a majority, of younger adults, including six in ten of those ages 18 to 29. Larger shares of Democrats are also more aware of the vaccine, with 86% who have heard at least “a little” compared to three-quarters (74%) of Republicans.

With most people aware of the latest vaccine, many, including large shares of previously vaccinated adults, have not yet received the updated shot and some don’t plan to. About six in ten (58%) adults are previously vaccinated and have yet to get the updated vaccine. This group is roughly divided between people who say they will get the vaccine and those who say they are not planning to get the latest shot. The latest COVID-19 Vaccine Monitor survey explores why this group of previously vaccinated people have not gotten the latest dose.

Around half of adults (47%) have both previously received a COVID-19 vaccine and also say they will get or have already gotten the updated vaccine. On the other hand, one in five (20%) adults are previously unvaccinated and say they will not get the updated vaccine. That leaves three in ten (31%) who have previously been vaccinated but now say they will not get the updated shot.

More than four in ten Republicans (43%) and one in three independents (35%) say they are previously vaccinated but won’t get the updated shot, compared to 19% of Democrats. A larger share of White adults (34%) also report being previously vaccinated but not planning on getting the latest shot compared to Black adults (20%). Around a quarter of Hispanic adults (26%) are previously vaccinated but now do not plan to get the latest vaccine.

Decreasing Concerns About COVID top The Reasons for Not Getting the Latest Vaccine

In 2021, KFF surveys examining initial vaccine rollout found that concerns about vaccine safety were the driving reason why people didn’t get vaccine. Even as those concerns dissipated among most of the public, a small share of the public remained steadfast and never received a COVID-19 vaccine. Yet, subsequent booster never reached the same uptake levels as seen in the initial vaccine rollout. And as the country enters its fourth year of COVID-19 concerns, it appears this trend continues.

When asked about a series of reasons that could explain why people are not getting the latest vaccine, not being worried about getting COVID-19 tops the list. About half (52%) of those who were previously vaccinated say lack of worry about COVID-19 is at least a minor reason why they haven’t gotten the vaccine, including a quarter who say it is a “major reason.” Getting vaccinated may also not be a priority for some with around four in ten (37%) saying being too busy is at least a minor reason why they have not gotten it yet, and another third saying they are waiting to get it a later date. Experiences from previous doses may also be keeping people from getting the new vaccine with about a quarter saying that bad side effects from a previous COVID-19 vaccine dose is a reason why they have not gotten the new vaccine.

Small shares say there are other barriers to getting the vaccine including 16% who say they cannot take the time off work and 13% who say they haven’t been able to get an appointment. One in ten (11%) say their doctor told them to wait or to not to get the updated vaccine.

Among Hispanic adults who were previously vaccinated but have not gotten the new shot, about half (55%) say they aren’t worried about getting COVID-19, they are too busy (51%), or they are waiting to get it at a later date (48%). In addition, a third (35%) of Hispanic adults as well as a quarter (22%) of Black adults cite not being able to take time off work, compared to just one in ten (9%) White adults.

Democrats’ top reasons for not getting the updated COVID-19 vaccine suggests there will likely still be additional uptake in this group, while Republicans’ top reasons may indicate more resistance to the latest vaccine. Among those who were previously vaccinated but haven’t gotten the new shot, half of Democrats (49%) say being too busy is a “major” or “minor” reason they haven’t gotten the updated vaccine yet, compared to 22% of Republicans and 35% of independents. On the other hand, two-thirds of Republicans (66%) and more than half of independents (57%) say not being worried about getting COVID is at least a minor reason why they have not gotten the updated vaccine, compared to a third of Democrats (35%).

Half Of The Public Says COVID-19 Isn’t Changing Their Holiday Plans

With fall and winter holidays coming up, the possibility of a further wave of COVID-19 infections is looming with increased indoor gatherings and time with friends and family. Yet, most of the public is not worried about spreading or catching COVID-19 over the coming months. About three in ten adults are worried they will spread COVID-19 to people close to them (31%) or they will get seriously sick from COVID-19 (28%), and about a quarter (26%) are worried they will get COVID-19 over the holidays. A larger share of the public is worried about increased hospitalizations, with almost half (46%) saying they are “very” or “somewhat worried” that there will be an increase in hospitalizations in the U.S. this winter.

Older adults are not more worried than younger adults about the spread of COVID-19 this holiday season except for concerns about increases in cases and hospitalizations. Around half (53%) of adults ages 65 and older say they are worried that there will be an increase in COVID-19 cases and hospitalizations this winter, compared to smaller shares (44%) of those under the age of 65.

Around the same share say they are “very” or “somewhat worried” about an increase in COVID-19 cases and hospitalizations this winter as were in December of last year when there was a similar uptick in COVID-19 cases.

Precautions Against COVID-19

In addition to not being worried about COVID-19 during the upcoming holidays, the public is divided on precautions, with half of adults saying they aren’t planning to take any of the precautions asked about in the survey, while the other half report they plan to take at least one precaution this fall and winter. The most common precautions people said they planned to take were avoiding large gatherings (35%) or wearing a mask in crowded places (30%). Smaller shares say they are avoiding travel this fall and winter as a precaution against COVID-19 (25%), avoiding dining indoors at restaurants (19%), or taking a COVID-19 test before visiting with friends or family (18%).

The share who say they plan to take precautions to limit the spread of COVID is similar to the share of the public who said they were taking precautions because of the “tripledemic” back in January of this year. Back then, about half (46%) of adults said the news of COVID-19, RSV, and the flu spreading that winter had made them more likely to take a precaution, including three in ten (31%) who said they were more likely to wear a mask in public and a quarter (26%) who were more likely to avoid large gatherings.

While four in ten (39%) White adults say they will take at least one precaution, majorities of Black adults (72%) and Hispanic adults (68%) report they are planning to take any of the precautions mentioned.

Similarly, partisanship and previous vaccine uptake continue to be strong predictors of whether people plan to take precautions to limit the spread of the virus. Two thirds (66%) of Democrats and half (48%) of independents say they plan to take at least one precaution, compared to three in ten (29%) Republicans who say the same. Just over half (53%) of vaccinated adults say they are taking any of the precautions, compared to four in ten (39%) unvaccinated adults.

Similar shares of younger and older adults report that they will be taking at least one precaution during the fall and winter. However, four in ten (41%) adults ages 65 and older say they plan to avoid large gatherings, compared to a third (33%) of those under the age of 65. While younger adults are less likely to say they will avoid large gatherings, larger shares of younger adults say they will take a test for COVID-19 before spending time with friends of family, with 21% who say so (including 25% of those ages 18-29), compared to one in ten (10%) of those ages 65 and older.