Heterogeneity among the vaccine hesitant: A secondary analysis of the national CEAL Common Survey data

Vaccine hesitancy has been identified as a barrier to reducing COVID-19 morbidity and mortality. This study is a secondary analysis of factors related to vaccine hesitancy among a cohort of participants in the Community Engagement Alliance (CEAL) Common Survey 2. Administered by all 21 CEAL sites from November 2020 to November 2022, this survey included the responses from thousands of U.S. residents across multiple U.S. States. We hypothesized significant demographic differences in vaccine hesitancy, perceptions of trustworthiness of physicians and institutions (e.g. the Centers for Disease Control and Prevention), and reasons for vaccine refusal. Multiple variable logistic regression models were used to examine whether individual-level factors explained sociodemographic characteristics in vaccine hesitance. This large national sample included 13,802 participants; 31.30% Non-Hispanic Black, 36.70% Hispanic, and 27.75% Non-Hispanic White. Over 12% of sample respondents indicated they had not received any dose of the COVID-19 vaccine. NH White participants were most likely to be vaccinated (91.80%), while Non-Hispanic Black participants were least (81.78%). There were significant educational and age gradients related to vaccination; 20.78% of those with high school education were unvaccinated compared to 6.18% of those with a graduate degree. Participants 55 years and older were less likely to be unvaccinated compared to younger participants. Less than 5% of the participants distrusted their doctors in providing COVID-19 information, while approximately over 40% distrusted the FDA to ensure a safe pediatric vaccine. Among the unvaccinated, there were racial and educational differences in reasons for being unvaccinated, such as dislike of needles and belonging to communities that disproved of being vaccinated. Future vaccine campaigns will likely need different approaches to convince population sub-groups to be vaccinated. These results may underscore the need for continued improvements to vaccine initiatives to may improve vaccine uptake.