Masks, money, and mandates: A national survey on efforts to increase COVID-19 vaccination intentions in the United States

Abstract

Various efforts to increase COVID-19 vaccination rates have been employed in the United States. We sought to rapidly investigate public reactions to these efforts to increase vaccination, including self-reported responses to widespread reduced masking behavior, monetary incentive programs to get vaccinated, and work vaccination requirements. Using a unique method for data collection (Random Domain Intercept Technology), we captured a large (N = 14,152), broad-based sample of the United States Web-using population (data collected from June 30 –July 26, 2021). About 3/4 of respondents reported being vaccinated. The likelihood of vaccination and vaccination intention differed across various demographic indicators (e.g., gender, age, income, political leaning). We observed mixed reactions to efforts aimed at increasing vaccination rates among unvaccinated respondents. While some reported that specific efforts would increase their likelihood of getting vaccinated (between 16% and 32%), others reported that efforts would decrease their likelihood of getting vaccinated (between 17% and 42%). Reactions differed by general vaccination intention, as well as other demographic indicators (e.g., race, education). Our results highlight the need to fully understand reactions to policy changes, programs, and mandates before they are communicated to the public and employed. Moreover, the results emphasize the importance of understanding how reactions differ across groups, as this information can assist in targeting intervention efforts and minimizing potentially differential negative impact.

Coronavirus Disease-2019 Vaccine Hesitancy

“…Such mandates have been politically contentious and variably effective. A large survey found that cash incentives such as gift cards and entry into lotteries would have no effect on the intentions of roughly half of unvaccinated U.S. adults and would make 40% of those who were disinclined to get a COVID-19 vaccine even less likely to get one 36 . The same survey found that 64% of those unvaccinated Americans who were not inclined to get a COVID-19 vaccine would not get one despite workplace requirements 36 .…”

“…A large survey found that cash incentives such as gift cards and entry into lotteries would have no effect on the intentions of roughly half of unvaccinated U.S. adults and would make 40% of those who were disinclined to get a COVID-19 vaccine even less likely to get one 36 . The same survey found that 64% of those unvaccinated Americans who were not inclined to get a COVID-19 vaccine would not get one despite workplace requirements 36 . Despite opinion surveys suggesting that mandates may not be effective and vocal protests and legal actions against vaccine mandates, many entities, including corporations, colleges and universities, healthcare systems, and government agencies including the military saw significant increases in the numbers of vaccinated employees and students after the introduction of COVID-19 vaccine mandates 37 .…”

Spatial-temporal differences of COVID-19 vaccinations in the U.S.

“…Reitsma et al ( 2021 ) quantify how differential vaccine uptake by race and ethnicity within each U.S. state produced substantial vaccination coverage disparities during the initial scale-up among older adults. In terms of median household income, Sargent et al ( 2022 ) found those with annual household incomes greater than $50,001 were 1.5 times more likely to be vaccinated than those with lower incomes. A survey from Viswanath et al ( 2021 ) also showed that those with lower incomes were less likely to vaccinate people in their care than those with higher incomes.…”

Use of Random Domain Intercept Technology to Track COVID-19 Vaccination Rates in Real Time Across the United States: Survey Study

“…Accurate and timely COVID-19 vaccination coverage data are vital for informing targeted, effective messaging and outreach and identifying barriers to equitable health service access. The tracking of vaccination rates is needed in conjunction with effective COVID-19 case surveillance and death monitoring, as well as research on predictors of vaccination uptake and vaccine hesitancy, to optimize vaccine coverage in persons at disproportionate risk of COVID-19 and severe outcomes [ 1 - 5 ]. However, gathering such vaccination rate data is challenging, even in high-income countries such as the United States.…”