Exploring lingering COVID-19 vaccine hesitancy in three diverse U.S. states: Alabama, Illinois, and Texas

During the COVID-19 pandemic, vaccine uptake was slower than expected, with some people experiencing concern about the safety and effectiveness of the COVID-19 vaccine even after being vaccinated. This manuscript explores a phenomenon called lingering hesitancy, or the concern that people experience even after receiving an initial dose of a vaccine. Leveraging survey findings from three individual Prevention Research Centers (PRCs) in Alabama, Illinois, and Texas, we compare the attitudes of individuals across three vaccine status groups: those who received their complete COVID-19 vaccine series, those who received an initial dose but no subsequent doses (lingering hesitancy), and those who remained unvaccinated. We compare these three groups using the 3C model, examining differences in their attitudes around concern, complacency, and convenience. We control for contextual factors, including geographic location, political view, rural/urban setting, and racial/ethnic composition, as we examine the relationship between vaccine status and lingering hesitancy. We find that the partially vaccinated individuals do not differ significantly from fully vaccinated individuals in their perceptions of social responsibility to get the vaccine or the vaccine's importance. However, there is a statistically significant difference between the fully and partially vaccinated individuals regarding their perceptions of vaccine safety. This suggests that partially vaccinated individuals may have different attitudes toward the vaccine than either fully or unvaccinated individuals. We offer recommendations for public health professionals as they develop messaging for ongoing and future vaccination efforts.