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More than half unlikely to get COVID-19 vaccine under emergency use authorization

Concerns about side effects were also a significant barrier that could dampen vaccination rates.

Jeff Lagasse, Associate Editor

The first COVID-19 vaccine has received emergency use authorization. Yet a key question remains: Will U.S. adults be willing to get it?

A new study led by a Virginia Commonwealth University professor is among the first to examine the psychological and social predictors of adults' willingness to get a future COVID-19 vaccine and whether these predictors differ under an emergency use authorization release of the vaccine.

"Willingness to Get the COVID-19 Vaccine with and without Emergency Use Authorization," published in the American Journal of Infection Control, involved a survey of 788 U.S. adults, and found that 59.9% of respondents were definitely or probably planning to receive a future coronavirus vaccine, while 18.8% were neutral and 21.3% were probably or definitely not planning to get it.

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When asked if they would get the vaccine under an emergency use authorization, 46.9% of respondents said they were definitely, likely or somewhat willing to do so, while 53.1% said they were definitely, likely or somewhat unwilling to do so.

This indicated trepidation among patients when it comes to vaccines approved under emergency use authorization. Concerns about side effects were also a significant barrier, and given that there have been side effects reported in some people with both the Pfizer and Moderna vaccines, that may signal further hesitancy.

There were also troubling disparities among demographic groups. For example, younger respondents were more likely than older respondents to express a willingness to get the vaccine. And the study found that white respondents were more likely than Black respondents to be willing to get the vaccine, either under emergency use authorization or regular Food and Drug Administration approval.

What makes that particularly worrying is that Black Americans are infected with COVID-19 significantly more frequently than white Americans, and are also more likely to die from the virus – byproducts of what the authors suggest is a history of medical mistreatment of African Americans.

This history leads to a wariness of the vaccine that the authors say is understandable, and necessitates a communication campaign to alleviate mistrust and any other additional concerns.

Significant predictors of a willingness to get the coronavirus vaccine included education level and having health insurance, as well as a high perceived susceptibility to COVID-19. Predictors of a willingness to get the vaccine under an emergency use authorization included age and race/ethnicity.

The findings could help shape health communications and messaging as the distribution of the vaccines begins across the country. It suggests that messages should address concerns about the COVID-19 vaccine and its development – and reinforce its benefits. It also suggests that these efforts may need to go beyond just communications campaigns that correct misinformation about a vaccine to focus on re-establishing public trust in government agencies and medicine.


Distribution of the Pfizer/BioNTech vaccine began in the United States yesterday and had already begun in the United Kingdom, with a focus on inoculating healthcare workers. While some with a significant history of allergic reactions have had adverse reactions to the vaccine, the effect is mild on most people and is compared to the feeling one gets after receiving a flu shot.

As a vaccine becomes available, more than a third of adults say they are unwilling to take it, according to the private nonprofit Employee Benefit Research Institute and independent research firm Greenwald Research, which released their annual Consumer Engagement in Health Care Survey.

The CEHCS found that only 55% of the adult population was willing to receive a COVID-19 vaccine, and 24% said they would not get the vaccine. Nine percent said that it depends, and 12% were unsure.

Twitter: @JELagasse
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