Determinants of COVID-19 vaccine hesitancy and vaccine uptake in a national cohort of U.S. adults

Rane, M. S.; Kochhar, S.; Poehlein, E.; You, W.; Robertson, M.; Zimba, R.; Westmoreland, D.; Romo, M.; Kulkarni, S.; Chang, M.; Berry, A.; Grov, C.; Nash, D.

Background Vaccine hesitancy in the U.S. may limit the potential to alleviate the public health threat caused by the COVID-19 pandemic. Methods We estimated trends in and correlates of vaccine hesitancy, and its association with subsequent vaccine uptake among 5,085 United States adults from the CHASING COVID Cohort study, a national longitudinal study. Trends in willingness to vaccinate were examined longitudinally in three rounds of interviews from September to December 2020. We assessed correlates of willingness to vaccinate in December 2020. We also estimated the association between willingness to vaccinate in December 2020 and subsequent vaccine uptake in February 2021. Results Vaccine hesitancy and resistance decreased from 51% and 8% in September 2020 to 35% and 5% in December 2020, respectively. Compared to Non-Hispanic (NH) White participants, NH Black and Hispanic participants had higher adjusted odds ratios (aOR) for both vaccine hesitancy (aOR: 3.3 [95% CI: 2.6, 4.2] for NH Black and 1.8 [95% CI: 1.5, 2.2] for Hispanic) and vaccine resistance (aOR: 6.4 [95% CI: 4.3, 9.4] for NH Black and 1.9 [95% CI: 1.3, 2.7] for Hispanic). Willingness to vaccinate was associated with lower odds of vaccine uptake among 65+ year olds (aOR: 0.4, 95% CI: 0.3, 0.6 for hesitancy; aOR: 0.1, 95% CI: 0.01, 0.6 for resistance) and healthcare workers (aOR: 0.2, 95% CI: 0.1, 0.3 for hesitancy; aOR: 0.04, 95% CI: 0.006, 0.2 for resistance). Conclusions Awareness and distribution efforts should focus on vaccine hesitant vulnerable populations.