Increasing COVID-19 Vaccine Uptake in the United States: Addressing Reasons for Vaccine Hesitancy through Effective Communications & Reform

Abstract

The COVID-19 pandemic has and is still adding tremendous morbidity and mortality globally. Although vaccines are a major component in combatting COVID-19 and are widely available in the U.S., vaccine uptake is a major hurdle with 24% of the population having not received any dose of a COVID-19 vaccine. Literature review of reasons for COVID-19 vaccine hesitancy among adults in the United States. 27 articles included from PubMed and analyzed to find date of study, method of survey, population studied and generalization ability, and reasons for vaccine hesitancy or refusal. Most studies were cross-sectional surveys (88.89%) and conducted online (59.25%). Sample size ranged from 58 to 458,235. Populations studied include nationally representative U.S. (25.9%), specific populations within the U.S. (37.0%), specific locations within the U.S. (22.2%), and healthcare workers (14.8%). The most common reason for COVID-19 vaccine hesitancy is concern about side effects and general safety concerns (57.14%). Other significant reasons include: additional information needed (21.42%), distrust (14.28%), no reason/don’t know (3.57%), and antivaccine beliefs (3.57%). Just over half (51.8%) of studies were conducted before the FDA EUA of the Pfizer-BioNTech COVID-19 vaccine, while 37.0% were after, and 11.1% spanned the time period or had follow-up surveys. To increase uptake among those who are still hesitant of COVID-19 vaccines, the American healthcare and education system must go through reform to ensure healthcare for all and address systemic racism. While increasing representation in health fields, already working clinicians can promote vaccinations through strengthening their patient relationships, following up on vaccination status, sharing educational resources and personal stories, and promoting community efforts. Teachers and schools can implement lessons on immunizations and disease. Communication efforts from institutions and local community organizations must work to increase trust, address fear of side effects, and combat misinformation. Promotion of social values and self-efficacy, as well as authentic community investment and engagement, can increase trust and vaccination levels.