Intent to Receive COVID-19 Vaccine and Behavioral and Social Drivers of Vaccination by Race and Ethnicity, National Immunization Survey Adult COVID Module — United States, October 31–December 31, 2021

Jennifer L. Kriss, PhD1,2; Mei-Chuan Hung, PhD1,2,3; Anup Srivastav, PhD1,2,3; Carla L. Black, PhD1,2; Peng-jun Lu, MD1,2; David Yankey, PhD1,2; Laurie D. Elam-Evans, PhD2; James A. Singleton, PhD1,2

1CDC COVID-19 Response Team

2Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC

3Leidos, Inc., Atlanta, Georgia

Summary

The COVID-19 pandemic has disproportionately affected racial and ethnic minority groups [1,2]. Equitable vaccination can reduce disparities in COVID-19-related morbidity and mortality [3]. Disparities in initiation of COVID-19 vaccination were present for racial and ethnic minority groups early in the rollout of COVID-19 vaccine, but several of these disparities have since narrowed or disappeared [4]. For example, at the end of April 2021, vaccination coverage with ≥1 dose of COVID-19 vaccine was 10-15 percentage points lower among Hispanic, Black non-Hispanic (Black), and Native Hawaiian or other Pacific Islander* (NH/OPI) adults than it was among White non-Hispanic (White) adults, and was 15-25 percentage points lower among multiple or other race and American Indian or Alaska Native (AI/AN) adults than among White adults. By the end of November 2021, Hispanic and Asian adults had higher vaccination coverage (≥1 dose) than White adults. Black and NH/OPI adults’ vaccination coverage was not significantly different than that of White adults. Disparities had narrowed, but remained, for AI/AN and multiple/other race adults nationally and for Black, Hispanic, and NH/OPI adults in some geographic areas and sociodemographic categories [4].

This report assesses the sociodemographic characteristics, vaccination intent, and behavioral and social drivers (BeSD) of vaccination among adults, during October 31-December 31, 2021. The objective of this report is to describe the characteristics associated with being unvaccinated and either having intent to get vaccinated or being reluctant to get vaccinated, and to examine the potential reasons for non-vaccination.

During October 31-December 31, 2021, a higher proportion of NH/OPI (12.8%), Black (11.2%), AI/AN (10.3%), multiple/other race (9.4%), and Hispanic (9.3%) adults were unvaccinated but reported they definitely or probably will get vaccinated or were unsure (‘reachable’), compared with White adults (6.2%), indicating potential for vaccination coverage to continue to increase among these populations. Within most races and ethnicities, the proportion who were reachable was highest among those who lived in the Midwest or South, were 18-29 years of age, had household incomes below poverty, or were uninsured. Reluctance to get vaccinated (reported they probably will not or definitely will not get vaccinated) was highest among AI/AN (29.1%), multiple/other race (23.5%), and White (14.8%) adults, and lowest among Black (10.2%), Hispanic (8.9%), and Asian (2.3%) adults. A substantial proportion of unvaccinated but reachable adults of all races/ethnicities were concerned about getting COVID-19 (24.1%–48.1%) and thought that the vaccine was important (41.3%–68.6%) and safe (23.0%–47.1%).

Methods

The National Immunization Survey Adult COVID Module (NIS-ACM) is a random-digit-dialed cellular telephone survey of adults age ≥18 years in all 50 states, the District of Columbia, and selected local areas and U.S. territories. Survey respondents from October 31, 2021 through December 31, 2021, who reported their race/ethnicity (97.3%) were included in this analysis. Monthly survey response rates were 23.4% (October 31-November 27) and 23.0% (November 28-December 31).

Measures. The survey included questions about COVID-19 vaccination status and intent, behavioral and social drivers of vaccination, and sociodemographic characteristics. COVID-19 vaccination status and intent were assessed by two questions: “Have you received at least one dose of a COVID-19 vaccine?” and if not, “How likely are you to get a COVID-19 vaccine? Would you say you would definitely get a vaccine, probably get a vaccine, probably not get a vaccine, definitely not get a vaccine, or are not sure?” Two vaccination intent categories were created: (1) reachable, combining those who reported they definitely will get vaccinated, probably will get vaccinated, or were unsure, and (2) reluctant to get vaccinated, combining those who reported they probably will not or definitely will not get vaccinated. Behavioral and social drivers of vaccination were assessed among respondents who were classified as reachable, and among all respondents who were unvaccinated. Behavioral and social drivers of vaccination include topics in the key domains of thinking and feeling (concern about getting COVID-19, confidence in COVID-19 vaccine importance, confidence in COVID-19 vaccine safety), social processes (healthcare provider recommended COVID-19 vaccine, friends and family are vaccinated), and practical issues (difficulty getting a COVID-19 vaccine, work or school requires a COVID-19 vaccine) [5]. Race/ethnicity was self-reported and based on the questions “Are you of Hispanic or Latino origin?” and “Please choose one or more of the following categories to describe your race. Are you White, Black or African American, American Indian, Alaska Native, Asian, Native Hawaiian or other Pacific Islander?” Persons were categorized into mutually exclusive categories of race and ethnicity; persons not reporting they were Hispanic were categorized by their reported race(s).

Analysis. Weighted proportions and 95% confidence intervals (CIs) were estimated for each race/ethnicity category overall, and by U.S. Census region, urbanicity, age group, annual household income, and health insurance. Data were weighted to represent the non-institutionalized U.S. adult population and calibrated to state-level vaccine administration data reported to CDC. Analyses were conducted using SAS (version 9.4) and SUDAAN (version 11; RTI International).

Results

Vaccination Intent. Overall, a higher proportion were unvaccinated but reachable among NH/OPI (12.8%), Black non-Hispanic (11.2%), AI/AN (10.3%), multiple/other race (9.4%), and Hispanic (9.3%) adults, compared with White non-Hispanic adults (6.2%) [Table 1], indicating potential for vaccination coverage to continue to increase among these populations. The proportion who were reachable was lower among Asian adults (2.2%); most Asian adults were already vaccinated (95.5%).

Within most races/ethnicities, the proportion who were reachable was highest among those living in the Midwest (range: 6.1% Asian to 21.8% NH/OPI) or South (range: 2.4% Asian to 16.0% NH/OPI), in the 18-29 age group (range: 3.5% Asian to 22.2% Black), with household incomes below poverty (range: 1.6% Asian to 15.7% multiple/other race), or who were uninsured (range: 9.5% AI/AN to 29.6% NH/OPI). Across all races/ethnicities, the smallest reachable proportion was among adults ages ≥65 years (range: 0.3% Asian to 3.0% Black).

Vaccination Reluctance. Reluctance to get vaccinated (those who said they probably will not or definitely will not get vaccinated) differed by race and ethnicity, and was highest among AI/AN (29.1%) and multiple/other race (23.5%) adults. Vaccine reluctance was lower among Black (10.2%), Hispanic (8.9%), and Asian (2.3%) adults than among White (14.8%) adults.

Across all races and ethnicities, vaccine reluctance was lowest among adults ages ≥65 years (range: 0.0% NH/OPI to 16.9% AI/AN); age was inversely associated with vaccine reluctance, with the highest reluctance among AI/AN adults ages 18–29 years (33.6%) and 30–49 years (35.4%), and NH/OPI adults ages 18–29 years (32.1%). Across all races and ethnicities, vaccine reluctance was lowest in the Northeast, and was highest in the Midwest (White, Black, Hispanic, AI/AN, NH/OPI) or South (Asian, multiple/other race). Asian adults in most sociodemographic groups had very low reluctance (0.1%-3.6%), except in non-metropolitan statistical areas (MSAs) (22.7%) and among those who were uninsured (6.2%). Reluctance to get vaccinated was higher among AI/AN adults than among all other races and ethnicities overall and in all sociodemographic categories except non-MSAs and below poverty. Vaccine reluctance was higher in non-MSAs than in MSAs among White (22.7%), Asian (22.7%), and multiple/other race (40.5%) adults, but not among Black (10.0%) or AI/AN adults (19.9%).

Behavioral and Social Drivers of Vaccination. Among those who were reachable, the proportions of adults perceiving risk of COVID-19 and confidence in COVID-19 vaccine safety and importance varied by races/ethnicities: 24.1% to 48.1% were very or moderately concerned about getting COVID-19; 41.3% to 68.6% thought the vaccine is very or somewhat important; and 23.0% to 47.1% thought the vaccine is completely or very safe [Table 2]. Black adults who were reachable were the most concerned about getting COVID-19 (48.1% very or moderately concerned) and the most likely to think the vaccine is important (68.6% very or somewhat important). AI/AN adults who were reachable were most likely to think the vaccine is safe (47.1% completely or very safe) and to have received a healthcare provider recommendation for the vaccine (48.9%). NH/OPI adults who were reachable report the most anticipated difficulty getting a vaccine (20.5% very or somewhat difficult); anticipated difficulty varies for other race/ethnicity groups (range: 11.3% among Asian to 17.4% among multiple/other race adults).

Table 3 shows the behavioral and social drivers of vaccination by race/ethnicity among all unvaccinated adults. These results can be used to understand the attitudes and experiences among the combined group of unvaccinated persons across levels of intent.

Discussion

This analysis found that substantial proportions of adults were concerned about getting COVID-19 and think the vaccine is important and safe, yet remain unvaccinated. Adults of all races and ethnicities who were reachable were more concerned about getting COVID-19, more likely to think that a COVID-19 vaccine was important and safe, and were more likely to have friends and family who were vaccinated, compared with those who were reluctant to get vaccinated. Public health efforts might have more impact among the reachable population. There is potential for vaccination coverage to increase among racial/ethnic minority groups; compared with White adults, more Black, Hispanic, AI/AN, and NH/OPI adults were still reachable as of October-December 2021. In particular, in the sociodemographic groups where disparities in vaccination coverage remain (such as the Midwest, urban areas, and the 18-29 age group) [4], fewer Black and Hispanic than White adults reported that they probably will not or definitely will not get vaccinated; there is the potential for improvements in vaccination coverage among these groups if evidence-based interventions are implemented [6]. Across all races/ethnicities and sociodemographic groups, the largest proportion of unvaccinated but reachable adults tended to be in the sociodemographic categories that are most marginalized (below poverty, uninsured), suggesting these populations may face barriers to vaccine access. Continued efforts to improve vaccination should seek to understand and address barriers among reachable adults and ways to improve vaccine confidence among those who remain reluctant to get vaccinated.

Limitations

The findings in this report are subject to several limitations. First, response rates for NIS-ACM were relatively low, although similar to other NIS surveys. Data were weighted to mitigate possible bias resulting from incomplete sample frame (exclusion of households with no phone service or only landline telephones) or non-response, but some selection bias may persist. Second, all responses are self-reported. Vaccination receipt and intent may be subject to recall or social desirability bias. Third, the survey sampled U.S. adults who were non-institutionalized, so adults who are incarcerated or nursing home residents may not be represented.

Disclaimer

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Statement on Research Determination

This activity was reviewed by CDC and was conducted consistent with applicable federal law and CDC policy. C.F.R. part 46.102(l)(2), 21 C.F.R. part 56; 42 U.S.C. Sect. 241(d); 5 U.S.C. Sect. 552a; 44 U.S.C. Sect. 3501 et seq.

References

  1. Mackey K, Ayers CK, Kondo KK, et al. Racial and ethnic disparities in COVID-19-related infections, hospitalizations, and deaths: a systematic review. Ann Intern Med. 2021 Mar;174(3):362-73.
  2. Bilal U, Jemmott JB, Schnake-Mahl A, et al. Racial/ethnic and neighbourhood social vulnerability disparities in COVID-19 testing positivity, hospitalization, and in-hospital mortality in a large hospital system in Pennsylvania: A prospective study of electronic health records. Lancet Reg Health Am. 2022 Jun;10:100220.
  3. Truman BI, Chang M, Moonesinghe R. Provisional COVID-19 Age-Adjusted Death Rates, by Race and Ethnicity — United States, 2020–2021. MMWR Morb Mortal Wkly Rep. 2022;71(17):601-5.
  4. Kriss JL, Hung M-C, Srivastav A, et al. COVID-19 Vaccination Coverage, by Race and Ethnicity — National Immunization Survey Adult COVID Module, United States, December 2020–November 2021. MMWR Morb Mortal Wkly Rep. 2022;71(23).
  5. Brewer N. What Works to Increase Vaccination Uptake. Acad Pediatr. 2021;May-Jun(16):S9-S16.
  6. CDC. 12 COVID-19 Vaccination Strategies for Your Community: A Guide to Support the Work of Health Departments and Community Organizations Across the United States. https://www.cdc.gov/vaccines/covid-19/vaccinate-with-confidence/community.html.

* Race/ethnicity was assessed by the following two questions: “Are you of Hispanic or Latino origin?” and “Now, I am going to read a list of categories. Please choose one or more of the following categories to describe your race. Are you White, Black or African American, American Indian, Alaska Native, Asian, Native Hawaiian or other Pacific Islander?” Persons were categorized into mutually exclusive categories of race and ethnicity; persons not reporting they were Hispanic were categorized by their reported race(s).

https://www.cdc.gov/vaccines/imz-managers/nis/data-tables.html

TABLE 1. COVID-19 vaccination* status and intent by race/ethnicity and sociodemographic characteristics among adults ≥18 years— National Immunization Survey Adult COVID Module, United States, October 31-December 31, 2021

TABLE 1. COVID-19 vaccination* status and intent by race/ethnicity† and sociodemographic characteristics among adults ≥18 years— National Immunization Survey Adult COVID Module, United States, October 31-December 31, 2021
White, non-Hispanic (n=67,641) Black, non-Hispanic (n=12,582) Hispanic
(n=14,242)
AI/AN
(n=1,066)
Vaccinated
(≥1 dose)
Definitely will get vaccinated, probably will get vaccinated, or unsure (Reachable) Probably or definitely will not get vaccinated (Reluctant) Vaccinated
(≥1 dose)
Definitely will get vaccinated, probably will get vaccinated, or unsure (Reachable) Probably or definitely will not get vaccinated (Reluctant) Vaccinated
(≥1 dose)
Definitely will get vaccinated, probably will get vaccinated, or unsure (Reachable) Probably or definitely will not get vaccinated (Reluctant) Vaccinated
(≥1 dose)
Definitely will get vaccinated, probably will get vaccinated, or unsure (Reachable) Probably or definitely will not get vaccinated (Reluctant)
% (95% CI)
Overall 79.1 (78.4-79.8) 6.2 (5.7-6.6) 14.8 (14.1-15.4) 78.7 (76.9-80.3) 11.2 (10.0-12.5) 10.2 (8.9-11.6) 81.8 (80.4-83.1) 9.3 (8.3-10.4) 8.9 (8.0-10.0) 60.6 (53.3-67.5) 10.3 (7.0-14.8) 29.1 (22.3-37.0)
Sociodemographic Characteristics
U.S. Census region
Northeast 89.3 (88.0-90.4) 3.5 (2.9-4.4) 7.2 (6.3-8.2) 86.4 (83.3-89.1) 6.7 (5.0-8.9) 6.9 (4.9-9.5) 86.3 (83.3-88.8) 8.6 (6.6-11.2) 5.1 (3.7-7.0) 79.0 (54.7-92.2) 2.8 (1.1-7.0) 18.2 (5.8-44.5)
Midwest 72.9 (71.2-74.5) 8.4 (7.3-9.6) 18.7 (17.3-20.3) 69.0 (63.8-73.9) 13.3 (10.2-17.0) 17.7 (13.5-22.9) 70.1 (65.3-74.5) 16.7 (13.2-20.9) 13.2 (9.9-17.4) 41.4 (26.9-57.5) 15.7 (8.5-27.2) 42.9 (24.9-63.0)
South 75.2 (73.9-76.5) 6.8 (6.0-7.6) 18.0 (16.9-19.2) 79.0 (76.8-81.1) 12.2 (10.5-14.1) 8.8 (7.4-10.3) 78.5 (75.8-81.0) 10.1 (8.3-12.2) 11.4 (9.5-13.7) 48.2 (37.5-59.0) 10.8 (5.9-19.0) 41.1 (29.7-53.4)
West 84.6 (83.3-85.8) 4.6 (3.9-5.5) 10.8 (9.8-11.9) 81.1 (75.2-86.0) 8.2 (5.1-12.7) 10.7 (7.0-16.0) 84.0 (81.6-86.1) 8.0 (6.4-9.9) 8.0 (6.6-9.7) 74.8 (62.6-84.0) 9.5 (4.3-19.6) 15.7 (8.3-27.8)
Urbanicity§
MSA, principal city 83.4 (82.1-84.6) 5.5 (4.8-6.4) 11.1 (10.1-12.2) 77.2 (74.5-79.8) 11.1 (9.5-13.1) 11.6 (9.6-14.1) 82.6 (80.4-84.6) 8.4 (7.1-10.1) 8.9 (7.5-10.7) 62.4 (49.1-74.1) 10.4 (6.4-16.4) 27.2 (15.9-42.4)
MSA, non-principal city 80.2 (79.2-81.1) 5.8 (5.2-6.4) 14.0 (13.2-14.9) 79.8 (77.3-82.1) 11.4 (9.5-13.6) 8.8 (7.3-10.6) 82.5 (80.5-84.3) 9.0 (7.7-10.6) 8.5 (7.2-10.0) 51.5 (40.2-62.8) 11.7 (5.7-22.6) 36.7 (25.4-49.7)
Non-MSA 69.0 (67.1-70.9) 8.3 (7.1-9.6) 22.7 (21.0-24.4) 79.8 (74.4-84.4) 10.2 (7.2-14.2) 10.0 (6.7-14.7) 71.8 (65.9-77.0) 16.0 (11.8-21.3) 12.3 (8.8-16.8) 72.4 (62.5-80.6) 7.7 (4.1-13.9) 19.9 (12.6-29.9)
Age group, yrs
18-29 62.7 (60.7-64.6) 13.2 (11.8-14.7) 24.2 (22.4-26.1) 60.9 (56.2-65.4) 22.2 (18.5-26.4) 16.9 (13.4-21.1) 71.6 (68.5-74.4) 15.6 (13.3-18.2) 12.8 (10.7-15.3) 44.9 (29.8-61.0) 21.6 (10.5-39.1) 33.6 (17.4-54.7)
30-49 71.2 (69.8-72.7) 7.9 (7.0-9.0) 20.8 (19.6-22.2) 70.9 (67.7-73.9) 13.2 (11.1-15.5) 15.9 (13.4-18.8) 81.2 (78.9-83.3) 8.9 (7.4-10.7) 9.9 (8.4-11.7) 55.8 (45.3-65.9) 8.8 (5.3-14.2) 35.4 (25.5-46.8)
50-64 83.6 (82.4-84.8) 4.0 (3.4-4.8) 12.3 (11.3-13.4) 88.9 (86.0-91.2) 7.2 (5.2-9.9) 3.9 (2.8-5.4) 90.4 (88.3-92.2) 4.5 (3.3-6.0) 5.1 (3.8-6.8) 62.9 (50.2-74.1) 10.4 (5.0-20.2) 26.7 (16.4-40.3)
65+ 94.8 (94.0-95.5) 1.5 (1.1-2.0) 3.7 (3.1-4.3) 94.8 (92.5-96.4) 3.0 (1.9-4.8) 2.2 (1.2-4.1) 96.8 (95.3-97.9) 1.9 (1.1-3.3) 1.3 (0.8-2.2) 81.3 (50.4-94.9) 1.9 (0.6-6.0) 16.9 (3.9-50.1)
Household income
Below poverty 65.4 (62.2-68.4) 14.0 (11.8-16.7) 20.6 (18.1-23.3) 73.6 (68.7-77.9) 14.9 (11.6-19.1) 11.5 (8.6-15.3) 79.8 (76.4-82.8) 13.6 (11.0-16.7) 6.6 (4.9-8.7) 73.1 (57.9-84.3) 10.0 (5.1-18.7) 16.9 (7.5-33.7)
Above poverty, <$75K 76.4 (75.0-77.7) 7.2 (6.4-8.1) 16.4 (15.2-17.6) 76.8 (73.6-79.7) 10.7 (8.8-12.8) 12.5 (10.1-15.5) 82.0 (79.6-84.2) 9.0 (7.3-11.1) 9.0 (7.5-10.8) 54.4 (43.1-65.3) 14.8 (7.6-27.0) 30.7 (20.5-43.2)
Above poverty, ≥$75K 84.7 (83.7-85.7) 3.5 (3.1-4.1) 11.7 (10.9-12.6) 85.4 (82.1-88.1) 8.4 (6.2-11.3) 6.2 (4.6-8.4) 84.1 (81.2-86.7) 5.6 (4.1-7.6) 10.3 (8.2-12.9) 71.8 (60.8-80.6) 7.2 (3.4-14.8) 21.0 (13.1-32.0)
Unknown income 77.9 (76.3-79.5) 6.5 (5.5-7.6) 15.6 (14.3-17.1) 77.9 (74.5-80.9) 12.3 (9.9-15.1) 9.8 (7.8-12.4) 80.6 (77.6-83.2) 9.9 (8.1-12.0) 9.5 (7.5-12.0) 51.9 (36.7-66.8) 7.3 (3.9-13.4) 40.7 (25.6-57.9)
Health insurance
Insured 81.2 (80.5-81.9) 5.6 (5.2-6.0) 13.2 (12.6-13.9) 80.9 (79.1-82.6) 10.2 (9.0-11.6) 8.9 (7.7-10.2) 84.2 (82.6-85.6) 7.4 (6.4-8.6) 8.4 (7.4-9.6) 63.5 (55.6-70.6) 10.5 (6.9-15.6) 26.1 (19.2-34.4)
Not insured 53.0 (49.7-56.2) 13.4 (11.1-16.0) 33.6 (30.6-36.9) 59.9 (53.6-65.8) 19.2 (15.0-24.2) 21.0 (15.7-27.4) 73.5 (70.1-76.7) 15.7 (13.3-18.5) 10.7 (8.5-13.5) 38.3 (21.1-58.9) 9.5 (4.3-19.9) 52.2 (31.2-72.4)
TABLE 1. COVID-19 vaccination* status and intent by race/ethnicity† and sociodemographic characteristics among adults ≥18 years— National Immunization Survey Adult COVID Module, United States, October 31-December 31, 2021
Asian
(n=5,135)
NH/OPI
(n=504)
Multiple/other race
(n=3,695)
Vaccinated
(≥1 dose)
Definitely will get vaccinated, probably will get vaccinated, or unsure (Reachable) Probably or definitely will not get vaccinated (Reluctant) Vaccinated
(≥1 dose)
Definitely will get vaccinated, probably will get vaccinated, or unsure (Reachable) Probably or definitely will not get vaccinated (Reluctant) Vaccinated
(≥1 dose)
Definitely will get vaccinated, probably will get vaccinated, or unsure (Reachable) Probably or definitely will not get vaccinated (Reluctant)
% (95% CI)
Overall 95.5 (93.7-96.8) 2.2 (1.4-3.6) 2.3 (1.4-3.8) 73.2 (61.9-82.1) 12.8 (7.1-21.9) 14.0 (7.4-25.1) 67.2 (63.5-70.6) 9.4 (7.4-11.9) 23.5 (20.3-27.0)
Sociodemographic Characteristics
U.S. Census region
Northeast 96.7 (94.1-98.1) 2.1 (1.0-4.4) 1.2 (0.4-3.3) 93.4 (70.5-98.8) 5.6 (0.8-31.4) 1.0 (0.2-4.0) 82.1 (74.7-87.7) 4.2 (2.1-8.4) 13.6 (8.6-20.9)
Midwest 91.8 (79.8-96.9) 6.1 (1.7-19.2) 2.2 (0.5-9.0) 40.7 (17.5-68.9) 21.8 (4.5-62.2) 37.5 (13.5-69.7) 57.7 (49.4-65.6) 11.2 (7.1-17.4) 31.1 (23.4-39.9)
South 94.5 (91.0-96.8) 2.4 (1.3-4.6) 3.0 (1.4-6.5) 54.3 (27.0-79.2) 16.0 (5.1-40.4) 29.7 (8.2-66.7) 55.3 (49.1-61.4) 11.8 (8.5-16.1) 32.9 (26.9-39.5)
West 96.2 (93.2-97.9) 1.2 (0.5-2.8) 2.6 (1.2-5.6) 78.7 (64.9-88.1) 11.9 (5.3-24.4) 9.4 (3.7-22.1) 77.0 (70.2-82.6) 8.3 (4.8-14.2) 14.7 (10.4-20.5)
Urbanicity
MSA, principal city 96.0 (93.7-97.5) 2.4 (1.4-4.0) 1.6 (0.7-3.8) 82.0 (67.7-90.8) 5.2 (2.5-10.3) 12.8 (5.3-27.8) 70.8 (64.8-76.1) 11.2 (7.9-15.7) 18.0 (13.5-23.6)
MSA, non-principal city 95.8 (92.9-97.6) 2.1 (0.9-5.0) 2.0 (1.0-4.1) 70.0 (54.1-82.2) 19.2 (9.6-34.6) 10.8 (3.9-26.7) 69.5 (63.9-74.5) 7.2 (4.7-10.9) 23.3 (18.6-28.7)
Non-MSA 77.2 (50.6-91.8) 0.0 (0.0-0.3) 22.7 (8.2-49.4) 63.4 (27.3-88.9) 4.9 (1.6-13.8) 31.7 (7.8-71.8) 48.2 (39.7-56.8) 11.3 (6.7-18.4) 40.5 (31.9-49.7)
Age group, yrs
18-29 93.1 (88.5-96.0) 3.5 (1.6-7.6) 3.4 (1.6-7.1) 47.7 (27.4-68.8) 20.2 (9.1-39.0) 32.1 (13.3-59.2) 64.1 (56.9-70.6) 11.1 (7.2-16.8) 24.8 (18.9-31.8)
30-49 95.3 (92.7-97.1) 2.1 (1.2-3.6) 2.6 (1.3-5.2) 71.0 (53.5-83.9) 18.1 (7.1-39.0) 10.9 (5.9-19.3) 59.4 (53.1-65.3) 12.1 (8.5-16.9) 28.5 (22.9-34.9)
50-64 98.5 (97.1-99.2) 1.0 (0.4-2.3) 0.5 (0.2-1.3) 90.8 (79.2-96.2) 3.2 (1.0-10.3) 6.0 (1.8-17.7) 68.7 (60.9-75.5) 7.4 (4.1-12.9) 23.9 (17.6-31.6)
65+ 99.6 (98.8-99.8) 0.3 (0.1-1.1) 0.1 (0.0-0.5) 99.6 (98.2-99.9) 0.4 (0.1-1.8) 0.0 (0.0-0.0) 91.7 (87.0-94.7) 1.7 (0.8-3.2) 6.7 (3.9-11.3)
Household income
Below poverty 97.1 (95.1-98.3) 1.6 (0.8-3.2) 1.3 (0.5-2.9) 54.1 (26.0-79.8) 15.2 (4.6-40.0) 30.7 (8.1-68.9) 53.4 (42.9-63.7) 15.7 (8.9-26.2) 30.9 (21.4-42.3)
Above poverty, <$75K 94.8 (91.1-97.0) 3.1 (1.6-5.7) 2.1 (0.7-5.8) 77.7 (57.0-90.1) 4.1 (1.5-10.9) 18.2 (6.8-40.4) 67.3 (61.2-72.8) 11.0 (7.7-15.5) 21.7 (16.8-27.5)
Above poverty, ≥$75K 97.4 (95.7-98.4) 0.8 (0.3-1.7) 1.9 (1.0-3.5) 84.2 (67.1-93.3) 10.0 (3.0-28.4) 5.9 (2.1-15.2) 73.1 (66.4-78.9) 6.7 (4.1-10.7) 20.2 (14.8-26.9)
Unknown income 92.4 (86.1-95.9) 4.1 (1.7-9.4) 3.6 (1.4-9.0) 64.7 (42.6-82.0) 26.4 (11.2-50.7) 8.8 (2.1-30.8) 67.8 (60.2-74.6) 6.7 (3.6-12.1) 25.5 (19.3-32.8)
Health insurance
Insured 96.4 (94.8-97.5) 1.6 (1.0-2.5) 2.0 (1.1-3.5) 75.3 (63.3-84.4) 10.2 (5.5-18.1) 14.5 (7.1-27.4) 71.4 (67.7-74.8) 8.8 (6.7-11.4) 19.8 (16.8-23.2)
Not insured 83.8 (69.3-92.2) 10.0 (3.4-25.9) 6.2 (2.2-16.3) 61.6 (29.7-85.8) 29.6 (8.2-66.4) 8.8 (2.4-27.8) 34.1 (24.9-44.8) 14.3 (7.6-25.4) 51.6 (39.3-63.7)

AI/AN = American Indian or Alaska Native; CI = confidence interval; MSA = metropolitan statistical area; NH/OPI = Native Hawaiian or other Pacific Islander.

* The estimates of proportions vaccinated based on October-December 2021 data may not match the Kaplan-Meier vaccination coverage estimates shown in reference 4, which use more months of data and a different analytic method.

† Persons were categorized into mutually exclusive categories of race and ethnicity; persons not reporting they were Hispanic were categorized by their reported race(s).

§ MSA status was determined based on household reported city and county of residence and was grouped into three categories: MSA principal city (urban), MSA non-principal city (suburban), and non-MSA (rural). MSAs and principal cities were as defined by the U.S. Census Bureau (https://www.census.gov/programs-surveys/metro-micro.html). Non-MSA areas include urban populations not located within an MSA as well as completely rural areas.

TABLE 2. BeSD variables among adults ≥18 years who were unvaccinated but reachable*, stratified by sociodemographic characteristics — National Immunization Survey Adult COVID Module, United States, October 31-December 31, 2021

TABLE 2. BeSD variables among adults ≥18 years who were unvaccinated but reachable*, stratified by sociodemographic characteristics — National Immunization Survey Adult COVID Module, United States, October 31-December 31, 2021
Concerned about getting COVID
(very or moderately concerned)
Thinks a COVID-19 vaccine is important
(very or somewhat important)
Thinks a COVID-19 vaccine is safe
(completely or very safe)
Healthcare provider recommended COVID-19 vaccine Friends and family vaccinated
(almost all or many)
Difficulty getting a COVID-19 vaccine
(very or somewhat difficult)
Work or school requires COVID-19 vaccine
n % (95% CI)
Overall 4,350 37.4 (34.8-40.0) 60.8 (58.1-63.5) 25.4 (22.9-28.1) 36.7 (34.1-39.3) 43.0 (40.3-45.7) 14.3 (12.5-16.3) 10.4 (8.9-12.1)
White, non-Hispanic 2,173 33.5 (29.8-37.3) 55.7 (51.7-59.5) 26.4 (22.8-30.3) 36.1 (32.5-40.0) 40.4 (36.7-44.3) 12.5 (10.3-15.1) 7.8 (6.0-10.2)
U.S. Census region
Northeast 425 27.4 (19.0-37.8) 41.6 (31.6-52.3) 21.8 (14.2-32.0) 41.7 (31.7-52.3) 45.9 (35.7-56.5) 18.9 (10.8-31.0) 10.1 (5.4-18.2)
Midwest 539 32.9 (26.2-40.4) 59.2 (52.1-66.0) 26.6 (20.7-33.4) 42.2 (35.1-49.5) 39.9 (33.2-47.0) 13.1 (9.3-18.1) 8.0 (4.9-12.8)
South 811 35.4 (29.9-41.4) 54.3 (48.1-60.4) 26.8 (21.0-33.4) 31.4 (26.2-37.1) 37.5 (31.8-43.5) 10.7 (7.9-14.2) 6.6 (4.1-10.3)
West 388 34.0 (26.0-43.0) 60.9 (52.1-69.1) 28.5 (19.9-39.1) 30.7 (23.2-39.4) 45.8 (37.0-54.9) 11.2 (6.7-18.0) 8.9 (4.6-16.6)
Urbanicity§
MSA, principal city 523 37.1 (30.2-44.7) 61.6 (54.3-68.5) 28.7 (22.2-36.1) 34.4 (27.9-41.6) 37.3 (30.7-44.3) 15.9 (11.1-22.2) 7.0 (4.3-11.0)
MSA, non-principal city 1,002 32.5 (27.4-38.0) 53.8 (48.2-59.2) 25.5 (20.5-31.3) 38.0 (32.8-43.6) 43.6 (38.3-49.1) 12.0 (9.0-15.8) 7.7 (5.2-11.3)
Non-MSA 648 32.0 (24.9-40.0) 53.9 (45.7-61.9) 26.1 (19.3-34.4) 33.6 (26.4-41.7) 36.3 (28.7-44.8) 10.1 (6.9-14.5) 8.9 (5.1-15.1)
Age group, yrs
18-29 646 29.3 (24.0-35.2) 58.3 (52.3-64.2) 29.9 (24.4-36.0) 31.7 (26.4-37.6) 37.4 (31.7-43.4) 10.2 (7.2-14.2) 9.3 (6.4-13.4)
30-49 829 33.7 (27.6-40.5) 53.4 (46.7-60.1) 25.3 (19.4-32.2) 35.8 (29.8-42.3) 42.9 (36.6-49.4) 9.4 (6.3-13.9) 8.1 (5.0-12.8)
50-64 481 41.6 (32.8-51.0) 55.2 (46.1-63.9) 17.1 (11.2-25.3) 44.6 (35.6-53.9) 42.3 (33.8-51.4) 20.9 (14.8-28.7) 6.8 (3.7-12.3)
65+ 217 35.1 (23.4-48.9) 54.6 (39.6-68.9) 35.0 (20.5-53.1) 42.4 (28.2-57.9) 38.9 (25.4-54.4) 22.4 (13.3-35.3) 0.1 (0.0-0.2)
Household income
Below poverty 361 46.5 (36.9-56.3) 65.7 (56.6-73.8) 18.6 (12.5-26.7) 34.1 (25.2-44.3) 42.4 (32.9-52.6) 20.8 (14.4-29.2) 3.9 (2.0-7.4)
Above poverty, <$75K 784 31.3 (25.6-37.6) 62.8 (56.6-68.6) 29.5 (23.4-36.4) 39.5 (33.4-46.0) 39.3 (33.3-45.8) 12.2 (9.0-16.4) 7.4 (4.7-11.5)
Above poverty, ≥$75K 529 30.0 (23.2-37.9) 41.0 (33.8-48.7) 23.5 (17.8-30.4) 34.7 (27.9-42.1) 44.8 (37.6-52.3) 5.5 (3.1-9.7) 10.4 (6.0-17.6)
Unknown income 499 30.6 (23.7-38.5) 50.4 (41.8-58.9) 30.4 (22.3-40.0) 33.6 (26.3-41.8) 36.4 (29.1-44.3) 13.3 (8.7-19.8) 9.0 (5.5-14.5)
Health insurance
Insured 1,842 35.1 (31.1-39.4) 56.1 (51.8-60.3) 25.3 (21.6-29.5) 38.8 (34.7-43.1) 42.1 (38.0-46.4) 12.7 (10.2-15.6) 8.5 (6.4-11.2)
Not insured 300 24.6 (17.1-34.1) 53.7 (43.4-63.6) 33.4 (23.4-45.2) 20.9 (14.2-29.7) 29.5 (21.9-38.4) 11.9 (7.4-18.5) 3.8 (1.3-10.2)
Black, non-Hispanic 858 48.1 (42.0-54.3) 68.6 (62.5-74.1) 23.0 (17.5-29.7) 44.6 (38.5-50.8) 43.1 (37.2-49.3) 15.6 (11.0-21.6) 15.7 (11.6-20.9)
U.S. Census region
Northeast 109 46.8 (32.2-61.9) 69.8 (53.4-82.3) 32.4 (17.3-52.4) 46.6 (32.1-61.7) 51.4 (36.1-66.4) 16.5 (8.1-30.7) 29.6 (17.3-45.7)
Midwest 96 52.0 (38.6-65.1) 74.2 (60.8-84.2) 20.6 (11.2-35.0) 56.7 (43.3-69.2) 38.3 (25.4-53.0) 18.0 (8.3-34.6) 6.4 (3.1-12.6)
South 453 48.2 (40.4-56.2) 67.0 (58.9-74.2) 20.5 (14.0-29.0) 40.6 (32.8-48.8) 43.0 (35.4-50.9) 15.1 (9.5-23.1) 17.3 (11.7-24.8)
West 40 36.1 (18.0-59.4) 65.0 (41.2-83.1) 44.4 (22.8-68.4) 47.8 (26.0-70.4) 12.1 (2.8-39.2) 7.8 (2.1-24.9)
Urbanicity
MSA, principal city 377 49.8 (41.2-58.4) 69.3 (60.7-76.6) 27.0 (18.1-38.1) 43.8 (35.4-52.6) 40.8 (32.5-49.6) 15.3 (9.8-23.1) 18.7 (12.0-27.9)
MSA, non-principal city 270 47.3 (37.9-57.0) 70.0 (60.1-78.3) 21.2 (14.0-30.6) 49.0 (39.6-58.5) 46.2 (36.9-55.8) 17.0 (9.8-27.8) 13.5 (8.6-20.6)
Non-MSA 211 43.3 (27.9-60.1) 55.9 (37.6-72.7) 11.8 (5.4-24.1) 22.2 (13.2-35.1) 37.8 (23.5-54.6) 8.7 (4.2-17.2) 12.5 (5.6-25.7)
Age group, yrs
18-29 217 40.0 (30.7-50.2) 73.0 (63.3-81.0) 23.8 (15.3-35.3) 37.4 (28.0-47.8) 43.9 (34.2-54.1) 8.9 (4.9-15.8) 18.7 (11.6-28.7)
30-49 358 51.8 (42.7-60.7) 60.3 (50.7-69.2) 15.9 (10.2-24.0) 42.4 (33.5-51.7) 41.3 (32.8-50.3) 16.8 (10.3-26.1) 14.0 (8.9-21.4)
50-64 188 58.6 (41.4-74.0) 82.9 (68.5-91.6) 47.0 (27.5-67.4) 57.5 (41.1-72.4) 48.4 (32.0-65.2) 29.5 (14.6-50.7) 17.9 (8.0-35.5)
65+ 95 42.2 (22.0-65.4) 60.2 (34.0-81.6) 21.5 (8.2-45.6) 69.4 (48.5-84.5) 35.1 (16.8-59.2) 8.6 (3.1-21.7) 2.7 (0.4-14.9)
Household income
Below poverty 180 45.0 (32.2-58.5) 79.4 (67.8-87.5) 39.2 (24.7-56.0) 52.9 (39.6-65.8) 31.8 (21.5-44.3) 12.9 (7.1-22.2) 17.8 (8.6-33.3)
Above poverty, <$75K 305 57.9 (48.1-67.2) 65.6 (55.7-74.4) 18.9 (10.5-31.6) 37.6 (28.4-47.9) 52.5 (42.7-62.2) 15.0 (8.3-25.7) 15.5 (9.6-24.2)
Above poverty, ≥$75K 121 36.0 (21.7-53.3) 54.1 (37.8-69.6) 18.1 (8.4-34.8) 50.0 (34.5-65.5) 45.2 (30.4-60.9) 13.5 (4.1-36.5) 9.8 (3.8-23.2)
Unknown income 252 46.5 (35.4-58.0) 73.9 (62.8-82.7) 20.3 (12.3-31.6) 43.7 (32.7-55.3) 38.7 (28.2-50.3) 19.2 (10.8-31.9) 18.1 (10.7-28.9)
Health insurance
Insured 667 46.9 (40.0-53.9) 67.0 (59.9-73.4) 22.0 (16.1-29.3) 47.5 (40.5-54.5) 41.6 (35.0-48.6) 17.9 (12.3-25.2) 12.2 (8.3-17.4)
Not insured 176 53.6 (40.4-66.4) 74.9 (63.0-83.9) 27.5 (14.9-45.1) 33.3 (21.5-47.8) 51.8 (38.5-64.9) 6.3 (3.4-11.5) 27.6 (16.3-42.8)
Hispanic 740 37.6 (32.1-43.4) 67.4 (61.3-73.0) 23.3 (18.6-28.7) 30.9 (25.9-36.4) 48.3 (42.4-54.2) 16.9 (12.8-21.9) 9.0 (6.7-12.0)
U.S. Census region
Northeast 121 35.5 (24.1-48.8) 67.7 (52.8-79.6) 29.3 (17.7-44.4) 31.3 (20.5-44.7) 51.4 (37.2-65.3) 15.1 (7.6-27.7) 9.8 (5.5-16.9)
Midwest 96 41.8 (29.8-54.7) 77.1 (65.0-85.9) 22.0 (13.5-33.7) 41.4 (29.6-54.2) 39.8 (28.2-52.7) 22.0 (13.0-34.7) 11.1 (5.8-20.2)
South 270 31.4 (23.0-41.2) 63.5 (52.6-73.2) 26.0 (18.4-35.4) 28.5 (20.7-37.8) 42.9 (33.5-52.9) 14.5 (8.5-23.7) 7.3 (4.2-12.3)
West 175 43.5 (32.6-54.9) 67.9 (56.2-77.7) 18.0 (10.4-29.2) 27.1 (18.2-38.3) 55.7 (44.3-66.6) 18.8 (11.3-29.5) 8.7 (4.7-15.7)
Urbanicity
MSA, principal city 283 35.9 (27.7-44.9) 70.8 (61.7-78.5) 23.5 (16.4-32.6) 35.7 (27.4-45.0) 52.8 (43.6-61.9) 14.2 (9.2-21.4) 10.5 (6.7-16.2)
MSA, non-principal city 345 40.8 (32.7-49.5) 65.0 (55.8-73.2) 24.0 (17.4-32.2) 27.5 (21.1-35.0) 47.7 (39.2-56.2) 19.8 (13.5-28.2) 8.5 (5.6-12.9)
Non-MSA 112 29.3 (16.8-45.9) 68.0 (50.8-81.4) 19.3 (10.5-32.8) 30.8 (17.7-48.1) 37.1 (23.2-53.5) 12.2 (5.4-25.4) 6.5 (2.4-16.2)
Age group, yrs
18-29 295 34.8 (27.1-43.5) 70.1 (61.5-77.5) 20.2 (14.5-27.6) 25.8 (19.4-33.4) 49.9 (41.3-58.4) 19.2 (13.2-27.2) 9.5 (6.2-14.4)
30-49 289 41.5 (32.5-51.2) 64.9 (54.2-74.4) 25.3 (17.3-35.5) 34.1 (25.7-43.6) 44.2 (34.8-54.0) 14.0 (8.5-22.3) 8.3 (5.2-12.9)
50-64 117 32.4 (21.0-46.3) 59.4 (43.5-73.5) 31.9 (19.4-47.8) 46.3 (32.2-61.1) 60.5 (45.6-73.7) 17.5 (8.6-32.4) 10.7 (4.9-21.9)
65+ 39 54.3 (28.7-77.8) 83.4 (59.0-94.6) 24.0 (8.9-50.5) 27.1 (12.4-49.3) 28.7 (12.2-53.7) 10.2 (3.2-28.1) 0.2 (0.0-1.4)
Household income
Below poverty 191 45.9 (34.8-57.4) 68.2 (55.9-78.3) 26.7 (18.0-37.6) 27.1 (18.9-37.3) 47.0 (36.0-58.2) 15.1 (8.9-24.5) 11.8 (6.9-19.4)
Above poverty, <$75K 232 31.7 (22.9-42.1) 61.0 (49.7-71.1) 19.0 (12.0-28.6) 32.3 (23.2-43.1) 50.1 (39.3-60.8) 17.2 (10.2-27.6) 7.0 (4.1-11.7)
Above poverty, ≥$75K 107 37.8 (24.1-53.7) 67.8 (49.4-81.9) 20.2 (10.0-36.8) 34.9 (22.2-50.1) 48.8 (33.4-64.5) 8.0 (3.7-16.5) 5.4 (2.0-13.8)
Unknown income 210 35.9 (26.7-46.2) 75.9 (66.9-83.1) 27.5 (18.6-38.7) 31.2 (22.8-41.0) 46.9 (36.6-57.5) 24.0 (15.1-35.8) 10.7 (6.3-17.5)
Health insurance
Insured 453 38.8 (31.4-46.7) 63.9 (55.6-71.6) 22.2 (16.2-29.7) 36.4 (29.4-44.0) 55.1 (47.1-62.7) 18.3 (12.8-25.6) 6.5 (4.2-10.0)
Not insured 256 37.9 (29.7-46.9) 71.9 (62.9-79.4) 25.3 (18.2-33.9) 21.8 (15.8-29.4) 38.8 (30.3-47.9) 15.8 (10.4-23.2) 12.8 (8.4-19.0)
AI/AN 87 46.7 (28.6-65.8) 59.2 (38.2-77.4) 47.1 (26.7-68.4) 48.9 (30.3-67.9) 41.1 (23.7-61.1) 12.7 (5.7-25.9) 23.2 (8.0-51.2)
U.S. Census region
Northeast <30
Midwest <30
South 33 48.5 (21.2-76.7) 78.9 (51.4-93.0) 43.9 (17.2-74.7) 54.9 (26.1-80.8) 18.1 (6.4-42.0) 10.8 (2.4-36.7)
West <30
Urbanicity
MSA, principal city 35 53.4 (31.7-73.8) 51.0 (29.1-72.5) 28.5 (13.0-51.7) 40.3 (20.1-64.4) 15.7 (4.7-41.2) 23.0 (8.7-48.4)
MSA, non-principal city <30
Non-MSA <30
Age group, yrs
18-29 <30
30-49 36 70.0 (48.1-85.5) 68.4 (44.4-85.4) 41.0 (20.5-65.2) 41.6 (20.0-66.9) 12.8 (3.3-38.6) 19.3 (6.7-44.5)
50-64 <30
65+ <30
Household income
Below poverty <30
Above poverty, <$75K 32 34.5 (10.8-69.8) 56.0 (21.6-85.5) 70.2 (42.6-88.3) 38.6 (12.5-73.4) 13.2 (4.1-35.2) 36.0 (9.0-76.2)
Above poverty, ≥$75K <30
Unknown income <30
Health insurance
Insured 67 49.7 (29.1-70.4) 57.0 (34.4-77.0) 47.5 (25.3-70.6) 52.3 (32.0-71.9) 43.2 (24.1-64.6) 8.0 (2.6-22.2) 25.4 (8.5-55.4)
Not insured <30
Asian 78 24.1 (12.4-41.7) 67.8 (43.0-85.5) 31.6 (15.1-54.4) 29.0 (14.5-49.7) 70.8 (48.7-86.1) 11.3 (3.9-28.4) 34.8 (17.1-58.0)
U.S. Census region
Northeast <30
Midwest <30
South <30
West <30
Urbanicity
MSA, principal city 37 24.5 (11.4-44.9) 49.0 (25.0-73.5) 27.7 (11.3-53.4) 28.9 (12.8-53.0) 58.1 (32.4-80.1) 16.0 (4.5-43.4) 42.7 (20.2-68.6)
MSA, non-principal city 38 23.5 (6.8-56.2) 89.1 (63.2-97.5) 35.8 (9.8-74.2) 29.0 (8.5-64.4) 85.9 (63.8-95.5) 5.9 (1.4-21.2) 25.8 (7.0-61.8)
Non-MSA <30
Age group, yrs
18-29 <30
30-49 <30
50-64 <30
65+ <30
Household income
Below poverty <30
Above poverty, <$75K <30
Above poverty, ≥$75K <30
Unknown income <30
Health insurance
Insured 60 26.1 (13.2-45.0) 56.6 (31.9-78.4) 40.4 (20.5-64.1) 40.3 (21.4-62.5) 67.5 (42.5-85.3) 13.8 (4.1-37.5) 45.1 (24.1-67.9)
Not insured <30
NH/OPI 38 32.3 (11.4-63.7) 41.3 (17.8-69.5) 40.6 (16.5-70.4) 26.2 (9.1-55.7) 29.3 (12.8-54.1) 20.5 (7.2-46.0) 8.1 (2.8-21.7)
U.S. Census region
Northeast <30
Midwest <30
South <30
West <30
Urbanicity
MSA, principal city <30
MSA, non-principal city <30
Non-MSA <30
Age group, yrs
18-29 <30
30-49 <30
50-64 <30
65+ <30
Household income
Below poverty <30
Above poverty, <$75K <30
Above poverty, ≥$75K <30
Unknown income <30
Health insurance
Insured <30
Not insured <30
Multiple/other race 216 42.4 (30.2-55.6) 66.6 (54.7-76.7) 25.1 (15.7-37.5) 35.4 (24.1-48.7) 47.0 (34.1-60.3) 17.4 (9.5-29.9) 20.4 (11.2-34.2)
U.S. Census region
Northeast 30 65.6 (31.3-88.9)
Midwest 34 43.9 (22.3-68.0) 55.7 (32.5-76.6) 19.6 (7.3-43.2) 36.9 (17.7-61.5) 24.4 (9.6-49.6) 12.3 (2.8-40.1)
South 101 42.9 (26.9-60.5) 71.1 (54.8-83.4) 30.7 (16.8-49.2) 33.3 (19.8-50.2) 41.3 (25.5-59.1) 13.3 (6.5-25.1) 18.1 (8.5-34.2)
West 40 35.6 (13.1-67.0) 70.9 (45.7-87.6) 43.5 (18.8-72.0) 62.5 (32.5-85.2) 21.4 (5.4-56.3) 32.5 (11.4-64.5)
Urbanicity
MSA, principal city 82 43.2 (26.0-62.1) 61.3 (43.2-76.8) 24.8 (12.2-43.7) 28.7 (15.9-46.1) 53.4 (34.9-70.9) 10.6 (4.5-22.8) 16.5 (6.4-36.3)
MSA, non-principal city 79 33.6 (16.0-57.3) 70.9 (50.5-85.3) 21.2 (9.2-41.8) 49.0 (28.2-70.2) 41.9 (21.7-65.2) 31.8 (13.9-57.5) 28.2 (11.3-54.7)
Non-MSA 55 60.3 (35.2-80.9) 70.9 (47.0-86.9) 36.2 (14.0-66.4) 24.9 (9.1-52.5) 40.5 (19.3-65.9) 7.1 (2.1-21.4) 14.3 (3.6-42.9)
Age group, yrs
18-29 58 48.0 (26.6-70.1) 66.2 (46.0-81.8) 31.7 (16.0-53.0) 36.3 (17.5-60.6) 39.4 (19.6-63.5) 9.5 (3.0-26.7) 8.4 (2.7-23.3)
30-49 85 37.0 (21.8-55.3) 71.1 (54.6-83.4) 20.0 (8.4-40.4) 36.5 (20.7-56.0) 50.2 (31.8-68.5) 22.4 (9.7-43.8) 30.1 (14.5-52.2)
50-64 46 47.0 (20.8-74.9) 57.7 (26.5-83.8) 32.6 (12.0-63.1) 51.2 (22.8-78.8) 16.4 (4.2-46.5) 18.1 (4.7-49.6)
65+ <30
Household income
Below poverty 43 32.7 (11.3-64.9) 83.6 (60.6-94.4) 39.8 (15.8-69.9) 71.4 (47.4-87.4) 25.6 (6.3-63.6) 29.3 (8.6-64.5)
Above poverty, <$75K 79 50.9 (32.9-68.7) 56.1 (37.1-73.5) 29.8 (15.3-50.0) 32.5 (17.8-51.8) 35.5 (19.6-55.4) 14.9 (6.5-30.7) 12.7 (4.7-29.7)
Above poverty, ≥$75K 45 31.0 (13.7-55.9) 53.9 (30.7-75.4) 22.1 (7.1-51.3) 31.6 (14.2-56.2) 56.1 (32.7-77.0) 7.7 (2.5-21.1) 27.2 (8.9-58.8)
Unknown income 49 52.0 (23.6-79.2) 84.4 (67.3-93.4) 40.8 (14.2-74.1) 17.6 (6.6-38.9) 23.7 (8.0-52.8) 15.8 (3.8-46.9)
Health insurance
Insured 179 40.8 (27.7-55.3) 68.4 (55.8-78.7) 26.2 (16.0-39.9) 37.3 (24.7-51.9) 46.3 (32.3-60.9) 18.1 (9.0-33.1) 24.9 (13.9-40.6)
Not insured 32 48.5 (19.8-78.3) 55.6 (24.6-82.8) 28.5 (8.6-62.7) 51.0 (20.9-80.3) 15.4 (5.2-37.9) 0.1 (0.0-0.9)
AI/AN = American Indian or Alaska Native; BeSD = behavioral and social drivers of vaccination; CI = confidence interval; MSA = metropolitan statistical area; NH/OPI = Native Hawaiian or other Pacific Islander.
* Respondents who reported they definitely will get vaccinated, probably will get vaccinated, or are unsure.
Persons were categorized into mutually exclusive categories of race and ethnicity; persons not reporting they were Hispanic were categorized by their reported race(s).
§ MSA status was determined based on household reported city and county of residence and was grouped into three categories: MSA principal city (urban), MSA
non-principal city (suburban), and non-MSA (rural). MSAs and principal cities were as defined by the U.S. Census Bureau (https://www.census.gov/programs-surveys/
metro-micro.html). Non-MSA areas include urban populations not located within an MSA as well as completely rural areas.
Cells with denominator n<30 are not shown.

TABLE 3. BeSD variables among adults ≥18 years who were unvaccinated*, stratified by sociodemographic characteristics — National Immunization Survey Adult COVID Module, United States, October 31-December 31, 2021

TABLE 3. BeSD variables among adults ≥18 years who were unvaccinated*, stratified by sociodemographic characteristics — National Immunization Survey Adult COVID Module, United States, October 31-December 31, 2021
Concerned about getting COVID (very or moderately concerned) Thinks a COVID-19 vaccine is important (very or somewhat important) Thinks a COVID-19 vaccine is safe (completely or very safe) Healthcare provider recommended COVID-19 vaccine Friends and family vaccinated (almost all or many) Difficulty getting a COVID-19 vaccine (very or somewhat difficult) Work or school requires COVID-19 vaccine
n % (95% CI)
Overall 12,674 20.7 (19.4-22.0) 28.1 (26.6-29.6) 10.8 (9.9-11.9) 31.7 (30.3-33.2) 28.3 (26.9-29.8) 11.9 (10.9-12.9) 7.6 (6.8-8.5)
White, non-Hispanic 7,817 16.1 (14.5-17.7) 22.2 (20.5-24.0) 9.9 (8.7-11.2) 30.9 (29.0-32.8) 24.8 (23.1-26.6) 10.2 (9.1-11.5) 5.7 (4.9-6.7)
U.S. Census region
Northeast 1,308 12.9 (9.3-17.6) 20.8 (16.4-26.1) 9.4 (6.6-13.3) 34.1 (28.8-39.7) 31.9 (26.6-37.7) 16.1 (11.8-21.5) 9.0 (6.3-12.8)
Midwest 1,826 18.7 (15.5-22.5) 24.3 (21.0-28.0) 10.7 (8.6-13.2) 34.1 (30.5-38.0) 24.9 (21.7-28.4) 9.8 (7.9-12.2) 6.0 (4.5-8.0)
South 3,169 15.1 (13.2-17.3) 20.4 (18.0-23.0) 9.3 (7.5-11.5) 29.2 (26.6-32.0) 22.4 (20.0-25.1) 9.1 (7.6-10.8) 4.2 (3.2-5.5)
West 1,494 14.9 (11.9-18.5) 23.2 (19.1-27.8) 10.0 (7.2-13.8) 26.2 (22.6-30.2) 27.3 (23.4-31.6) 10.4 (7.7-13.7) 7.4 (5.3-10.3)
Urbanicity§
MSA, principal city 1,653 19.5 (16.1-23.6) 26.4 (22.7-30.4) 12.3 (9.7-15.4) 32.8 (28.8-36.9) 27.0 (23.6-30.7) 11.8 (9.5-14.7) 5.9 (4.4-7.8)
MSA, non-principal city 3,715 15.3 (13.2-17.6) 21.5 (19.1-24.0) 9.7 (7.9-11.7) 31.5 (28.9-34.2) 26.2 (23.8-28.8) 9.8 (8.3-11.6) 5.7 (4.5-7.1)
Non-MSA 2,449 14.9 (12.3-18.1) 20.2 (17.1-23.7) 8.4 (6.5-10.8) 27.9 (24.6-31.4) 20.3 (17.1-23.8) 9.7 (7.6-12.2) 5.8 (4.2-7.9)
Age group, yrs
18-29 1,799 13.7 (11.4-16.4) 28.5 (25.3-31.8) 14.3 (11.9-17.1) 26.9 (23.8-30.2) 23.7 (20.8-26.8) 11.1 (9.1-13.4) 8.4 (6.6-10.6)
30-49 3,148 15.8 (13.4-18.7) 19.2 (16.6-22.2) 8.5 (6.7-10.7) 31.3 (28.5-34.4) 25.6 (22.9-28.5) 8.5 (6.9-10.3) 5.0 (3.8-6.5)
50-64 2,025 19.1 (15.9-22.9) 18.3 (15.0-22.1) 5.3 (3.8-7.3) 35.0 (31.0-39.3) 25.5 (21.9-29.5) 11.0 (8.8-13.8) 3.9 (2.8-5.4)
65+ 845 19.5 (14.0-26.6) 22.5 (16.3-30.2) 11.2 (6.7-18.1) 34.0 (27.4-41.3) 23.4 (17.6-30.5) 14.9 (9.7-22.3) 3.4 (1.3-8.6)
Household income
Below poverty 912 26.2 (21.0-32.0) 32.5 (27.0-38.6) 9.4 (6.6-13.2) 32.9 (27.5-38.8) 26.4 (21.1-32.5) 16.3 (12.7-20.6) 2.7 (1.5-4.8)
Above poverty, <$75K 2,719 16.2 (13.7-19.0) 25.3 (22.3-28.5) 11.2 (9.0-13.8) 32.3 (29.1-35.6) 24.6 (21.8-27.7) 10.8 (8.9-13.0) 5.5 (4.2-7.1)
Above poverty, ≥$75K 2,418 12.6 (10.2-15.6) 15.7 (13.1-18.8) 8.2 (6.6-10.3) 31.5 (28.2-34.9) 27.9 (24.9-31.1) 6.2 (4.7-8.2) 7.4 (5.7-9.7)
Unknown income 1,768 14.7 (11.7-18.2) 19.8 (16.6-23.3) 10.1 (7.6-13.4) 26.8 (23.3-30.7) 20.6 (17.4-24.2) 10.8 (8.6-13.6) 5.7 (4.1-7.9)
Health insurance
Insured 6,600 17.1 (15.3-19.0) 22.5 (20.6-24.5) 9.4 (8.1-10.8) 32.9 (30.8-35.0) 25.9 (24.0-27.9) 9.3 (8.2-10.7) 6.2 (5.3-7.3)
Not insured 1,122 11.4 (8.8-14.8) 20.8 (16.8-25.4) 13.2 (9.6-17.9) 20.2 (16.5-24.6) 19.5 (15.9-23.8) 14.3 (11.3-18.0) 3.4 (2.1-5.5)
Black, non-Hispanic 1,597 35.8 (31.6-40.3) 44.7 (40.1-49.4) 12.9 (9.8-16.7) 39.7 (35.2-44.3) 33.8 (29.7-38.1) 16.2 (13.0-20.1) 11.5 (8.9-14.7)
U.S. Census region
Northeast 203 35.1 (25.2-46.4) 40.0 (29.4-51.7) 15.5 (8.0-28.0) 49.8 (38.5-61.2) 48.3 (36.8-60.0) 14.3 (8.4-23.1) 25.5 (16.3-37.7)
Midwest 209 32.4 (23.9-42.3) 45.9 (35.4-56.8) 9.3 (5.2-16.1) 46.9 (36.5-57.6) 26.4 (18.6-36.0) 16.2 (9.9-25.3) 5.7 (2.9-10.8)
South 821 38.6 (33.0-44.6) 45.7 (39.9-51.7) 13.0 (9.0-18.4) 36.3 (30.7-42.3) 34.5 (29.2-40.1) 16.8 (12.5-22.3) 12.0 (8.4-16.9)
West 98 26.5 (15.4-41.6) 39.4 (24.3-56.9) 20.6 (8.6-41.7) 29.8 (17.3-46.2) 34.2 (20.8-50.7) 14.7 (7.3-27.4) 7.5 (3.3-16.2)
Urbanicity
MSA, principal city 694 38.9 (32.7-45.6) 45.4 (38.5-52.4) 14.2 (9.5-20.8) 38.9 (32.4-45.8) 32.8 (26.9-39.3) 17.0 (12.6-22.6) 12.9 (8.9-18.4)
MSA, non-principal city 526 32.4 (26.2-39.2) 45.9 (39.0-52.9) 12.3 (8.3-17.9) 42.1 (35.4-49.2) 35.3 (29.1-42.0) 16.3 (11.3-23.0) 10.8 (7.4-15.6)
Non-MSA 377 35.8 (24.0-49.7) 34.9 (23.6-48.3) 8.4 (3.9-16.9) 31.1 (19.7-45.2) 31.2 (21.2-43.5) 11.6 (6.5-19.8) 6.5 (3.0-13.7)
Age group, yrs
18-29 398 29.2 (22.9-36.5) 53.2 (45.1-61.0) 15.5 (10.0-23.2) 36.0 (28.3-44.6) 36.2 (29.1-43.9) 15.8 (11.1-21.9) 14.6 (9.8-21.2)
30-49 719 37.0 (30.8-43.6) 34.0 (28.3-40.2) 8.7 (5.7-13.0) 36.0 (29.9-42.5) 30.0 (24.7-36.0) 14.5 (10.3-20.1) 10.2 (7.0-14.7)
50-64 320 48.3 (36.1-60.8) 63.8 (51.9-74.3) 24.9 (13.4-41.5) 56.0 (43.7-67.5) 40.2 (28.2-53.5) 26.8 (15.6-42.0) 12.0 (5.5-24.4)
65+ 160 34.4 (19.6-52.9) 43.9 (26.1-63.4) 10.0 (3.9-23.6) 55.7 (37.0-72.9) 36.9 (21.0-56.4) 7.8 (3.2-17.8) 1.6 (0.3-8.5)
Household income
Below poverty 304 31.0 (22.8-40.5) 55.6 (45.0-65.7) 21.9 (13.1-34.2) 40.9 (31.2-51.4) 29.3 (21.4-38.7) 16.0 (10.4-23.8) 13.5 (7.3-23.7)
Above poverty, <$75K 580 40.9 (33.6-48.8) 43.5 (35.6-51.7) 10.4 (6.2-16.8) 36.3 (28.9-44.4) 38.4 (31.3-46.1) 14.1 (9.4-20.6) 10.1 (6.8-14.9)
Above poverty, ≥$75K 255 31.7 (21.7-43.7) 33.2 (23.9-44.2) 12.4 (6.3-23.0) 46.0 (34.9-57.4) 36.8 (26.9-47.9) 15.1 (7.8-27.3) 12.2 (6.3-22.1)
Unknown income 458 34.3 (27.0-42.5) 46.4 (38.0-55.0) 11.1 (6.8-17.8) 39.8 (31.9-48.2) 28.4 (21.5-36.4) 20.0 (13.6-28.4) 11.5 (7.0-18.2)
Health insurance
Insured 1,222 35.7 (31.0-40.8) 43.9 (38.8-49.1) 12.8 (9.5-17.0) 42.0 (37.0-47.1) 33.9 (29.3-38.9) 17.0 (13.2-21.7) 9.9 (7.3-13.4)
Not insured 342 36.5 (27.4-46.8) 48.1 (37.3-59.1) 13.3 (6.9-24.2) 31.4 (21.2-43.8) 34.7 (25.9-44.7) 13.6 (8.7-20.8) 16.1 (9.8-25.3)
Hispanic 1,511 27.0 (23.4-31.0) 41.0 (37.0-45.2) 13.2 (10.7-16.2) 29.9 (26.4-33.7) 38.2 (34.2-42.4) 13.8 (11.2-16.9) 9.5 (7.4-12.2)
U.S. Census region
Northeast 217 29.3 (21.1-39.0) 47.4 (36.7-58.3) 19.6 (12.1-30.2) 37.7 (28.1-48.4) 46.9 (36.3-57.9) 15.3 (9.2-24.5) 9.7 (6.0-15.3)
Midwest 187 29.0 (21.3-38.1) 49.1 (39.0-59.2) 14.3 (9.1-21.5) 40.5 (31.5-50.3) 35.9 (27.4-45.3) 18.8 (12.1-27.9) 10.8 (6.5-17.5)
South 563 23.1 (17.5-29.8) 36.4 (30.1-43.2) 14.0 (10.1-19.0) 25.5 (20.2-31.6) 32.0 (25.9-38.8) 10.6 (7.2-15.3) 6.8 (4.0-11.5)
West 406 30.2 (23.5-37.8) 41.1 (33.7-48.9) 9.9 (6.0-15.9) 27.1 (20.8-34.4) 42.6 (35.1-50.5) 15.8 (10.9-22.2) 11.8 (7.6-17.8)
Urbanicity
MSA, principal city 597 27.1 (21.6-33.4) 42.1 (35.7-48.8) 12.7 (9.0-17.7) 32.9 (27.1-39.2) 43.6 (37.0-50.4) 13.2 (9.6-17.8) 13.6 (9.2-19.7)
MSA, non-principal city 696 27.8 (22.6-33.7) 39.5 (33.7-45.5) 14.0 (10.4-18.6) 27.0 (22.4-32.1) 36.5 (31.0-42.4) 14.4 (10.6-19.3) 6.8 (4.9-9.5)
Non-MSA 218 23.0 (14.6-34.5) 44.4 (32.8-56.7) 11.4 (6.5-19.3) 33.1 (22.5-45.8) 27.2 (18.3-38.4) 13.4 (7.3-23.3) 7.8 (3.9-15.1)
Age group, yrs
18-29 557 26.2 (20.8-32.3) 44.9 (38.5-51.5) 13.5 (9.9-18.0) 26.0 (21.0-31.8) 39.0 (32.9-45.5) 16.8 (12.6-22.1) 11.1 (7.5-15.9)
30-49 619 29.1 (23.5-35.5) 37.7 (31.6-44.2) 12.5 (8.6-17.9) 32.0 (26.5-38.1) 35.8 (29.8-42.3) 10.7 (7.4-15.2) 8.5 (5.9-12.2)
50-64 260 20.8 (14.4-29.2) 34.1 (25.3-44.2) 14.4 (8.8-22.6) 38.3 (29.0-48.5) 46.2 (36.0-56.7) 12.4 (7.1-20.7) 7.9 (3.9-15.4)
65+ 75 36.4 (18.4-59.1) 54.9 (35.6-72.8) 14.1 (5.9-30.0) 34.1 (19.7-52.2) 27.4 (14.5-45.5) 18.6 (8.2-36.9) 0.1 (0.0-0.7)
Household income
Below poverty 311 36.0 (27.7-45.3) 47.8 (38.9-56.9) 18.4 (12.6-26.0) 24.7 (18.3-32.3) 40.3 (31.8-49.3) 14.0 (9.3-20.6) 8.6 (5.2-14.0)
Above poverty, <$75K 510 23.2 (17.9-29.7) 38.3 (31.5-45.7) 11.6 (7.8-17.0) 31.1 (25.0-38.0) 39.4 (32.4-46.9) 13.5 (9.3-19.2) 9.1 (5.6-14.6)
Above poverty, ≥$75K 286 22.9 (15.4-32.6) 28.0 (20.5-36.8) 8.2 (4.3-15.0) 29.9 (22.3-38.9) 34.7 (26.3-44.2) 10.5 (5.9-18.1) 6.5 (3.8-10.9)
Unknown income 404 27.8 (21.0-35.8) 50.5 (42.4-58.6) 15.2 (10.3-21.9) 33.0 (26.0-40.8) 37.8 (30.4-45.9) 17.1 (11.7-24.2) 13.3 (8.4-20.5)
Health insurance
Insured 1,037 26.9 (22.4-31.9) 36.8 (31.9-42.0) 11.3 (8.4-15.1) 33.5 (29.0-38.4) 41.0 (36.0-46.2) 13.4 (10.2-17.3) 9.3 (6.7-12.8)
Not insured 417 29.1 (23.0-36.2) 49.6 (42.1-57.1) 17.5 (12.8-23.5) 21.6 (16.3-28.1) 33.3 (26.8-40.6) 15.8 (11.3-21.8) 8.7 (5.9-12.7)
AI/AN 260 27.4 (17.8-39.8) 24.8 (15.0-38.3) 15.2 (8.5-25.9) 31.3 (21.1-43.6) 24.1 (15.4-35.7) 13.1 (7.3-22.4) 11.7 (5.2-24.1)
U.S. Census region
Northeast <30
Midwest 45 22.1 (8.8-45.4) 19.5 (8.0-40.0) 11.5 (3.9-29.6) 41.3 (19.1-67.8) 19.6 (6.8-45.0) 15.3 (5.7-35.1) 4.6 (1.0-18.4)
South 126 28.2 (14.2-48.2) 30.2 (14.0-53.5) 14.6 (5.7-32.5) 19.3 (9.8-34.5) 25.8 (13.2-44.3) 12.8 (5.0-29.1) 14.5 (5.3-34.2)
West 55 18.9 (8.4-37.1) 15.5 (6.3-33.1) 11.5 (3.4-32.5) 38.4 (17.4-64.8) 21.3 (9.0-42.5) 5.8 (1.6-18.5) 16.4 (3.1-54.2)
Urbanicity
MSA, principal city 79 17.3 (8.5-31.9) 30.5 (12.1-58.5) 12.3 (4.8-28.3) 16.4 (7.5-32.2) 15.1 (7.2-28.9) 8.3 (3.3-19.3) 10.5 (3.8-25.8)
MSA, non-principal city 101 31.1 (15.9-51.9) 19.6 (9.2-36.9) 16.0 (6.1-35.9) 44.4 (26.2-64.2) 27.6 (14.1-46.9) 10.2 (3.8-24.7) 14.7 (4.3-39.8)
Non-MSA 80 38.3 (19.5-61.5) 27.7 (14.1-47.0) 18.1 (7.0-39.2) 25.0 (13.6-41.4) 33.5 (14.9-59.2) 32.1 (13.4-59.1) 5.7 (1.6-18.6)
Age group, yrs
18-29 44 15.4 (4.9-39.2) 48.8 (22.5-75.9) 29.5 (11.9-56.5) 20.0 (5.4-52.5) 18.5 (6.3-43.3) 16.1 (5.2-40.0) 14.8 (2.6-52.8)
30-49 117 30.1 (17.0-47.4) 15.7 (8.5-27.2) 10.8 (4.7-23.2) 32.2 (19.8-47.7) 23.7 (12.3-40.8) 17.4 (7.7-34.5) 9.6 (3.8-22.0)
50-64 67 41.9 (21.4-65.8) 20.3 (7.4-45.0) 16.1 (4.2-45.8) 46.8 (25.7-69.0) 37.3 (18.4-61.0) 5.1 (1.7-14.6) 15.7 (3.7-47.1)
65+ 32 9.0 (1.3-42.7) 13.9 (2.1-54.7) 5.8 (1.0-27.5) 6.4 (0.6-44.0) 0.4 (0.0-4.0)
Household income
Below poverty 45 37.9 (16.5-65.3) 39.8 (17.1-67.9) 23.3 (7.5-53.3) 29.9 (13.4-54.2) 33.1 (13.9-60.2) 11.1 (3.9-28.1) 19.2 (5.7-48.0)
Above poverty, <$75K 104 22.3 (9.3-44.4) 20.9 (10.2-38.0) 14.7 (5.4-34.2) 38.2 (21.2-58.6) 22.7 (10.3-42.8) 11.3 (5.4-22.2) 23.0 (8.5-48.7)
Above poverty, ≥$75K 50 15.7 (6.1-34.9) 11.4 (4.2-27.5) 14.0 (5.1-33.2) 27.1 (12.0-50.2) 18.7 (7.7-38.7) 9.4 (2.5-29.2) 2.6 (0.7-9.3)
Unknown income 61 33.1 (14.9-58.3) 28.4 (9.5-60.0) 12.7 (3.2-38.9) 26.2 (10.9-50.6) 24.3 (9.6-49.4) 17.2 (5.4-43.0) 0.6 (0.1-3.3)
Health insurance
Insured 214 28.2 (17.6-41.8) 20.6 (12.5-32.1) 16.5 (8.7-29.1) 35.6 (23.7-49.6) 24.5 (15.1-37.1) 8.6 (4.1-17.2) 14.2 (6.2-29.1)
Not insured 44 24.6 (7.3-57.3) 41.6 (14.2-75.4) 8.3 (2.7-22.8) 13.7 (3.6-40.5) 22.8 (6.7-54.8) 31.9 (11.5-62.9) 1.8 (0.4-8.0)
Asian 129 20.3 (10.1-36.6) 35.7 (20.7-54.1) 17.2 (9.2-30.0) 40.4 (25.1-57.8) 51.2 (34.0-68.1) 7.8 (3.5-16.4) 31.1 (17.9-48.2)
U.S. Census region
Northeast <30
Midwest <30
South 36 14.8 (5.8-33.0) 37.0 (17.3-62.3) 28.7 (10.5-58.2) 46.1 (21.9-72.2) 36.0 (16.7-61.1) 5.2 (1.6-15.3) 22.1 (7.4-50.1)
West 44 26.5 (7.7-60.9) 13.4 (5.5-29.1) 5.4 (1.1-21.9) 28.7 (9.3-61.4) 41.2 (17.1-70.3) 1.6 (0.3-7.6) 34.8 (13.5-64.7)
Urbanicity
MSA, principal city 53 14.8 (6.9-28.8) 32.7 (17.2-53.1) 16.1 (6.4-34.8) 48.6 (26.5-71.3) 66.9 (44.4-83.6) 10.9 (3.4-29.8) 35.4 (16.8-59.9)
MSA, non-principal city 66 31.4 (11.6-61.4) 47.9 (22.1-74.8) 21.0 (8.1-44.4) 33.6 (15.5-58.3) 49.7 (23.8-75.8) 6.8 (2.6-16.4) 24.0 (10.1-47.1)
Non-MSA <30
Age group, yrs
18-29 39 18.7 (5.0-50.1) 34.0 (12.6-64.7) 7.2 (2.8-17.1) 27.9 (11.8-52.9) 45.3 (20.9-72.3) 5.6 (1.0-26.8) 40.9 (18.7-67.5)
30-49 56 17.3 (8.5-32.0) 34.3 (17.7-55.9) 25.5 (11.2-48.2) 55.1 (33.1-75.2) 57.2 (34.5-77.2) 9.4 (4.2-19.8) 18.6 (8.0-37.5)
50-64 <30
65+ <30
Household income
Below poverty <30
Above poverty, <$75K 38 13.5 (4.9-32.1) 36.4 (16.7-62.0) 49.1 (23.5-75.2) 40.0 (17.2-68.1) 5.7 (1.6-17.9) 8.7 (2.2-28.5)
Above poverty, ≥$75K 41 9.3 (3.8-21.3) 14.0 (6.3-28.4) 8.8 (3.4-20.9) 44.3 (21.0-70.4) 56.0 (31.1-78.3) 17.0 (4.9-45.2) 57.4 (33.1-78.6)
Unknown income 31 33.1 (12.0-64.2) 54.4 (24.5-81.4) 30.9 (10.9-62.1)
Health insurance
Insured 100 23.3 (10.6-44.0) 28.4 (16.6-44.0) 19.2 (9.6-34.6) 49.7 (31.6-68.0) 50.8 (32.4-69.1) 8.6 (3.4-20.4) 28.9 (15.4-47.7)
Not insured <30
NH/OPI 82 29.9 (12.7-55.6) 35.2 (16.8-59.4) 43.1 (21.6-67.6) 25.8 (12.4-46.3) 30.4 (13.9-54.2) 17.8 (7.3-37.4) 4.9 (2.1-11.0)
U.S. Census region
Northeast <30
Midwest <30
South <30
West 52 39.4 (14.2-71.8) 18.4 (7.8-37.3) 43.2 (15.8-75.5) 21.9 (9.6-42.7) 20.3 (8.8-40.2) 9.2 (3.3-22.9) 8.0 (3.0-19.4)
Urbanicity
MSA, principal city <30
MSA, non-principal city 35 38.4 (14.0-70.4) 22.3 (7.3-51.1) 46.0 (19.5-75.0) 20.9 (7.1-48.0) 16.6 (6.2-37.4) 14.3 (4.6-36.7) 2.0 (0.5-7.9)
Non-MSA <30
Age group, yrs
18-29 <30
30-49 35 25.9 (7.3-60.9) 8.6 (3.2-21.2) 23.0 (5.4-61.1) 23.0 (9.6-45.6) 16.3 (5.9-37.6) 9.5 (2.4-31.2) 3.6 (1.0-12.3)
50-64 <30
65+ <30
Household income
Below poverty <30
Above poverty, <$75K <30
Above poverty, ≥$75K <30
Unknown income <30
Health insurance
Insured 65 34.7 (14.0-63.5) 39.2 (17.5-66.3) 51.2 (26.7-75.2) 28.4 (12.5-52.4) 32.6 (13.4-60.1) 21.5 (8.4-45.0) 5.1 (2.0-12.0)
Not insured <30
Multiple/other race 745 23.3 (17.7-30.0) 26.3 (20.4-33.2) 7.3 (4.8-11.1) 29.4 (23.4-36.3) 31.4 (24.8-38.9) 15.3 (10.7-21.5) 10.2 (6.1-16.6)
U.S. Census region
Northeast 100 29.3 (15.0-49.4) 18.4 (7.5-38.5) 22.8 (9.4-45.5) 39.0 (21.1-60.4) 44.4 (25.6-64.9) 2.9 (0.9-8.8) 13.0 (3.3-40.1)
Midwest 129 18.2 (9.8-31.2) 19.8 (11.2-32.7) 4.5 (1.2-15.5) 26.2 (16.0-39.8) 20.8 (11.8-34.1) 18.0 (10.0-30.1) 11.2 (2.8-35.7)
South 345 25.4 (17.2-35.8) 25.7 (18.4-34.6) 6.9 (3.7-12.5) 29.8 (21.3-40.0) 30.6 (21.3-41.8) 15.1 (9.1-24.1) 5.7 (2.9-10.8)
West 148 21.7 (10.7-39.3) 35.9 (21.1-53.9) 4.6 (2.3-9.1) 28.4 (16.0-45.3) 37.9 (22.9-55.7) 17.3 (7.4-35.4) 17.0 (7.3-34.7)
Urbanicity
MSA, principal city 235 30.9 (20.5-43.7) 24.3 (15.5-36.0) 7.1 (3.6-13.6) 24.5 (16.1-35.5) 36.8 (24.8-50.7) 19.0 (11.3-30.1) 9.6 (4.4-19.8)
MSA, non-principal city 306 16.6 (9.8-26.7) 26.9 (17.9-38.5) 6.8 (3.3-13.3) 35.1 (25.1-46.6) 33.3 (23.4-45.0) 16.2 (9.0-27.4) 12.0 (5.3-24.9)
Non-MSA 204 24.3 (14.4-38.2) 28.2 (17.7-41.8) 8.8 (3.7-19.3) 26.0 (16.1-39.1) 18.8 (11.5-29.1) 7.1 (3.5-13.8) 7.3 (2.3-20.4)
Age group, yrs
18-29 166 17.0 (8.5-31.1) 30.8 (19.5-44.9) 14.4 (8.1-24.2) 18.6 (10.6-30.8) 28.7 (18.1-42.2) 22.3 (12.7-36.1) 5.9 (2.2-15.0)
30-49 311 28.7 (19.9-39.5) 26.5 (18.3-36.7) 5.0 (2.2-10.9) 36.5 (26.8-47.6) 36.1 (25.7-48.0) 15.6 (9.1-25.4) 11.8 (6.0-22.0)
50-64 184 22.1 (12.2-36.6) 21.7 (11.7-36.6) 4.0 (1.6-9.7) 30.0 (18.6-44.6) 24.2 (13.9-38.9) 6.5 (2.6-15.1) 13.8 (4.2-36.8)
65+ 84 12.8 (5.6-26.5) 12.0 (5.2-25.2) 1.3 (0.2-7.8) 21.9 (9.6-42.6) 33.7 (13.2-63.0) 6.0 (2.1-15.7) 3.9 (0.7-19.0)
Household income
Below poverty 130 15.8 (7.0-31.8) 40.5 (24.1-59.4) 8.3 (3.5-18.6) 23.4 (12.1-40.3) 35.2 (19.6-54.7) 22.3 (9.6-43.7) 18.1 (6.2-42.3)
Above poverty, <$75K 264 34.5 (23.7-47.1) 24.3 (16.2-34.7) 7.6 (3.8-14.5) 37.3 (26.6-49.4) 30.1 (20.2-42.3) 9.1 (5.2-15.4) 7.1 (2.9-16.4)
Above poverty, ≥$75K 178 14.7 (8.1-25.4) 22.0 (12.6-35.4) 10.9 (4.9-22.6) 23.1 (14.2-35.1) 40.5 (26.7-55.9) 11.6 (5.7-22.1) 10.1 (4.3-22.1)
Unknown income 173 23.9 (12.9-40.0) 21.4 (11.6-36.0) 2.2 (0.6-7.4) 30.8 (18.5-46.6) 19.2 (10.4-32.8) 21.9 (12.2-36.1) 7.4 (2.5-19.8)
Health insurance
Insured 610 24.1 (17.8-31.6) 29.4 (22.5-37.4) 7.5 (4.8-11.6) 32.4 (25.5-40.1) 31.0 (24.0-39.0) 16.6 (11.0-24.2) 11.0 (6.6-17.7)
Not insured 119 21.3 (10.4-38.8) 15.8 (7.6-30.1) 7.1 (2.2-21.1) 19.7 (9.4-36.7) 34.6 (19.0-54.5) 9.5 (5.0-17.3) 7.8 (1.2-37.2)

AI/AN = American Indian or Alaska Native; BeSD = behavioral and social drivers of vaccination; CI = confidence interval; MSA = metropolitan statistical area; NH/OPI = Native Hawaiian or other Pacific Islander.* Includes respondents who reported they definitely will get vaccinated, probably will get vaccinated, are unsure, probably will not get vaccinated, and definitely will not get vaccinated.

† Persons were categorized into mutually exclusive categories of race and ethnicity; persons not reporting they were Hispanic were categorized by their reported race(s).

§ MSA status was determined based on household reported city and county of residence and was grouped into three categories: MSA principal city (urban), MSA
non-principal city (suburban), and non-MSA (rural). MSAs and principal cities were as defined by the U.S. Census Bureau (https://www.census.gov/programs-surveys/
metro-micro.html). Non-MSA areas include urban populations not located within an MSA as well as completely rural areas.

Cells with denominator n<30 are not shown

Page last reviewed: June 8, 2022