Highlights
- •15% are unvaccinated, 17% are not fully vaccinated, and 45% are not boosted
- •Vaccination coverage was lowest for younger age groups for all vaccination categories
- •Booster doses were lowest among adults with lower education and income
- •Frontline and family business workers were less likely to be vaccinated
- •Main reasons for not being vaccinated were concerns about side effects (53.4%)
Abstract
Keywords
Introduction
- Nguyen K.H.
- Srivastav A.
- Razzaghi H.
- Williams W.
- Lindley M.C.
- Jorgensen C.
- Abad N.
- Singleton J.A.
Methods
Results
Total | Not vaccinated (n=7314) | Not Fully vaccinated* (n=8076) | Not boosted (n=22904)† | |||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Unweighted (n) | % | 95%CI | % | 95% CI | aPR‡ | 95% CI | % | 95% CI | aPR‡ | 95% CI | % | 95% CI | aPR‡ | 95% CI | ||
All | 74995 | 14.9 | (14.4, 15.4) | 16.6 | (16.0, 17.2) | 44.9 | (44.1, 45.6) | |||||||||
Age Group (years) | ||||||||||||||||
65+ | 19593 | 22.2 | (22.1, 22.4) | 6.4 | (5.7, 7.2) | ref. | 7.3 | (6.3, 8.2) | ref. | 24.9 | (23.5, 26.2) | ref. | ||||
50-64 | 21413 | 25.5 | (25.3, 25.7) | 11.6 | (10.9, 12.2) | 1.94 | (1.69, 2.23) | 13 | (12.3, 13.8) | 1.9 | (1.65, 2.20) | 41.1 | (39.5, 42.8) | 1.65 | (1.54, 1.77) | |
40-49 | 14108 | 16.5 | (16.3, 16.8) | 18.7 | (17.5, 20.0) | 3.4 | (2.86, 4.03) | 20.5 | (19.2, 21.8) | 3.23 | (2.73, 3.82) | 51.4 | (49.4, 53.3) | 2.08 | (1.94, 2.23) | |
30-39 | 13455 | 18.7 | (18.3, 19.2) | 21.2 | (19.5, 22.8) | 3.93 | (3.31, 4.67) | 23.1 | (21.4, 24.8) | 3.7 | (3.12, 4.39) | 55 | (53.1, 56.9) | 2.31 | (2.16, 2.47) | |
18-29 | 6426 | 17 | (16.6, 17.3) | 20.5 | (18.7, 22.4) | 3.29 | (2.79, 3.87) | 23 | (21.2, 24.8) | 3.21 | (2.75, 3.76) | 64.7 | (62.8, 66.5) | 2.51 | (2.35, 2.68) | |
Gender | ||||||||||||||||
Male | 30672 | 48.4 | (48.4, 48.4) | 15.5 | (14.7, 16.3) | ref. | 17.1 | (16.2, 17.9) | ref. | 43.2 | (42.0, 44.4) | ref. | ||||
Female | 44323 | 51.6 | (51.6, 51.6) | 14.4 | (13.8, 15.0) | 0.95 | (0.89, 1.03) | 16.1 | (15.5, 16.8) | 0.98 | (0.91, 1.05) | 46.4 | (45.4, 47.4) | 1.07 | (1.03, 1.11) | |
Race/ethnicity | ||||||||||||||||
NH White | 54977 | 62.2 | (62.1, 62.3) | 15 | (14.5, 15.6) | ref. | 16.5 | (15.9, 17.1) | ref. | 39.8 | (39.0, 40.6) | ref. | ||||
NH Black | 5752 | 11.4 | (11.3, 11.5) | 18.2 | (16.6, 19.9) | 0.85 | (0.77, 0.94) | 21.1 | (19.3, 23.0) | 0.86 | (0.78, 0.94) | 57.9 | (55.8, 60.0) | 1.22 | (1.16, 1.29) | |
NH Asian | 4065 | 5.6 | (5.4, 5.7) | 3 | (1.9, 4.2) | 0.22 | (0.14, 0.36) | 3.4 | (2.2, 4.5) | 0.23 | (0.15, 0.35) | 34.4 | (32.2, 36.7) | 0.87 | (0.80, 0.95) | |
NH multi/other | 2734 | 3.5 | (3.3, 3.7) | 21.9 | (18.3, 25.5) | 1.11 | (0.96, 1.28) | 23.8 | (20.3, 27.3) | 1.09 | (0.95, 1.25) | 48.6 | (44.7, 52.4) | 1.04 | (0.96, 1.12) | |
Hispanic or Latino | 7467 | 17.3 | (17.1, 17.5) | 14.7 | (13.1, 16.4) | 0.55 | (0.47, 0.63) | 16.6 | (15.0, 18.2) | 0.56 | (0.49, 0.64) | 58.2 | (55.6, 60.8) | 1.03 | (0.97, 1.08) | |
Educational Attainment | ||||||||||||||||
High school or less | 10062 | 39 | (38.9, 39.0) | 22.1 | (21.0, 23.3) | 3.78 | (3.26, 4.37) | 24.6 | (23.2, 25.9) | 3.52 | (3.08, 4.02) | 54 | (52.2, 55.8) | 1.94 | (1.84, 2.05) | |
Some college and Associate degree | 22707 | 30.2 | (30.2, 30.2) | 15 | (14.2, 15.8) | 2.53 | (2.21, 2.89) | 16.7 | (15.8, 17.5) | 2.39 | (2.12, 2.69) | 49.9 | (48.9, 50.9) | 1.7 | (1.62, 1.78) | |
College graduate (Bachelor degree) | 22086 | 17.2 | (16.9, 17.4) | 6.7 | (6.2, 7.2) | 1.27 | (1.09, 1.49) | 7.6 | (7.1, 8.1) | 1.25 | (1.09, 1.44) | 36.4 | (35.3, 37.5) | 1.32 | (1.26, 1.38) | |
Above college graduate | 20140 | 13.7 | (13.5, 13.9) | 4.6 | (4.0, 5.1) | ref. | 5.2 | (4.6, 5.7) | ref. | 25 | (24.1, 25.9) | ref. | ||||
Annual Household Income | ||||||||||||||||
Less than $35,000 | 13116 | 22.1 | (21.5, 22.7) | 19.9 | (18.6, 21.1) | 1.48 | (1.34, 1.63) | 23 | (21.5, 24.5) | 1.6 | (1.45, 1.77) | 55.1 | (53.1, 57.0) | 1.29 | (1.23, 1.36) | |
$35,000 - $49,999 | 6831 | 9.8 | (9.3, 10.2) | 14.1 | (12.3, 15.9) | 1.15 | (1.01, 1.31) | 15.8 | (13.9, 17.7) | 1.21 | (1.07, 1.37) | 50.6 | (48.6, 52.6) | 1.23 | (1.17, 1.30) | |
$50,000 - $74,999 | 10605 | 13.7 | (13.1, 14.2) | 13.1 | (11.7, 14.6) | 1.19 | (1.04, 1.36) | 14.2 | (12.8, 15.6) | 1.2 | (1.06, 1.36) | 45.5 | (43.5, 47.4) | 1.2 | (1.14, 1.26) | |
$75,000 and above | 32795 | 33.8 | (33.4, 34.2) | 8.7 | (8.1, 9.3) | ref. | 9.3 | (8.7, 9.9) | ref. | 33.4 | (32.3, 34.4) | ref. | ||||
Did not report | 11648 | 20.7 | (20.0, 21.3) | 21.6 | (19.8, 23.3) | 1.39 | (1.15, 1.67) | 24 | (22.2, 25.8) | 1.44 | (1.23, 1.69) | 53.4 | (51.2, 55.5) | 1.18 | (1.10, 1.26) | |
Health Insurance | ||||||||||||||||
Yes | 63922 | 91.4 | (91.0, 91.8) | 11.9 | (11.4, 12.4) | ref. | 13.1 | (12.6, 13.7) | ref. | 41.3 | (40.5, 42.0) | ref. | ||||
No | 3281 | 8.6 | (8.2, 9.0) | 28 | (24.6, 31.4) | 1.46 | (1.27, 1.69) | 32.7 | (29.0, 36.4) | 1.54 | (1.36, 1.75) | 69.3 | (66.0, 72.6) | 1.17 | (1.11, 1.24) | |
Previous COVID-19 infection | ||||||||||||||||
Yes | 14682 | 23.6 | (23.1, 24.2) | 21.2 | (20.0, 22.5) | 1.6 | (1.46, 1.77) | 23.8 | (22.6, 25.1) | 1.63 | (1.50, 1.77) | 62.6 | (61.1, 64.2) | 1.39 | (1.34, 1.43) | |
No | 58529 | 76.4 | (75.8, 76.9) | 11.9 | (11.4, 12.5) | ref. | 13.3 | (12.7, 13.9) | ref. | 39.8 | (39.0, 40.6) | ref. | ||||
HHS region§ | ||||||||||||||||
1 | 7853 | 4.6 | (4.6, 4.6) | 8.1 | (7.1, 9.2) | ref. | 9.3 | (8.2, 10.5) | ref. | 38.1 | (36.2, 40.0) | ref. | ||||
2 | 3093 | 8.6 | (8.6, 8.6) | 8.7 | (6.9, 10.5) | 1.09 | (0.82, 1.43) | 10.4 | (8.3, 12.4) | 1.08 | (0.84, 1.41) | 44.6 | (41.6, 47.5) | 1.1 | (1.01, 1.20) | |
3 | 8775 | 9.4 | (9.4, 9.4) | 13.4 | (11.6, 15.2) | 1.69 | (1.40, 2.04) | 14.7 | (12.9, 16.6) | 1.61 | (1.33, 1.94) | 42 | (40.0, 44.0) | 1.07 | (1.00, 1.15) | |
4 | 10259 | 20.8 | (20.8, 20.8) | 18.3 | (17.0, 19.7) | 2.15 | (1.87, 2.46) | 20.7 | (19.2, 22.2) | 2.09 | (1.82, 2.39) | 49.2 | (47.5, 51.0) | 1.21 | (1.13, 1.28) | |
5 | 9471 | 15.9 | (15.9, 15.9) | 16.9 | (15.7, 18.1) | 1.88 | (1.60, 2.20) | 18.5 | (17.3, 19.7) | 1.81 | (1.53, 2.13) | 41.4 | (39.5, 43.3) | 1.06 | (0.98, 1.14) | |
6 | 7714 | 12.8 | (12.8, 12.8) | 17.6 | (16.0, 19.3) | 1.85 | (1.54, 2.22) | 19.6 | (17.8, 21.4) | 1.78 | (1.50, 2.11) | 50.6 | (48.6, 52.5) | 1.15 | (1.07, 1.23) | |
7 | 4627 | 4.2 | (4.2, 4.2) | 16.7 | (14.9, 18.4) | 1.92 | (1.59, 2.31) | 18.5 | (16.8, 20.2) | 1.81 | (1.52, 2.16) | 43.9 | (41.2, 46.6) | 1.11 | (1.01, 1.21) | |
8 | 6752 | 3.7 | (3.7, 3.7) | 16.8 | (15.2, 18.3) | 2 | (1.69, 2.38) | 18.5 | (16.9, 20.0) | 1.92 | (1.63, 2.26) | 41.6 | (39.6, 43.6) | 1.04 | (0.96, 1.13) | |
9 | 9770 | 15.6 | (15.6, 15.6) | 12.2 | (10.4, 14.1) | 1.58 | (1.25, 1.99) | 13.3 | (11.4, 15.2) | 1.49 | (1.19, 1.86) | 44.1 | (41.9, 46.3) | 1.07 | (1.00, 1.15) | |
10 | 6681 | 4.5 | (4.5, 4.5) | 12.9 | (11.6, 14.2) | 1.57 | (1.30, 1.88) | 13.7 | (12.4, 15.1) | 1.44 | (1.20, 1.72) | 42.6 | (40.8, 44.4) | 1.1 | (1.03, 1.18) |

Overall | Not vaccinated | Not Fully vaccinated* | Not boosted † | |||||
---|---|---|---|---|---|---|---|---|
% (95%CI) | % (95%CI) | aPR‡ (95%CI) | % (95%CI) | aPR‡ (95%CI) | % (95%CI) | aPR‡ (95%CI) | ||
Employed | ||||||||
No | 44.4 (43.7, 45.0) | 15.4 (14.5, 16.4) | ref. | 17.3 (16.2, 18.4) | ref. | 42.5 (41.4, 43.7) | ref. | |
Yes | 55.6 (55.0, 56.3) | 13.1 (12.4, 13.8) | 0.83 (0.76, 0.89) | 14.5 (13.8, 15.2) | 0.82 (0.76, 0.89) | 46.2 (45.3, 47.2) | 1.00 (0.96, 1.04) | |
Essential Worker Group | ||||||||
Non-essential Worker | 64.8 (63.9, 65.8) | 12.3 (11.5, 13.1) | ref. | 13.5 (12.7, 14.3) | ref. | 46.0 (44.7, 47.2) | ref. | |
Healthcare personnel | 8.9 (8.4, 9.4) | 5.9 (4.7, 7.0) | 0.54 (0.45, 0.67) | 7.9 (6.6, 9.1) | 0.65 (0.55, 0.77) | 40.6 (37.5, 43.8) | 0.86 (0.79, 0.83) | |
School | 4.7 (4.4, 5.0) | 7.5 (5.9, 9.1) | 0.91 (0.74, 1.12) | 8.9 (7.1, 10.7) | 0.96 (0.79, 1.17) | 36.2 (32.8, 39.7) | 0.88 (0.79, 0.98) | |
Frontline Worker | 9.5 (9.0, 10.0) | 21.5 (19.2, 23.8) | 1.36 (1.19, 1.56) | 22.8 (20.4, 25.1) | 1.32 (1.16, 1.49) | 53.6 (50.4, 56.8) | 1.03 (0.96, 1.11) | |
Other Essential Worker | 12.0 (11.3, 12.7) | 17.7 (15.3, 20.2) | 1.15 (0.96, 1.39) | 19.8 (17.3, 22.2) | 1.78 (1.00, 1.38) | 50.0 (46.6, 53.4) | 0.98 (0.91, 1.06) | |
Employment type | ||||||||
Non-profit | 9.3 (8.8, 9.8) | 6.1 (4.7, 7.6) | ref. | 6.7 (5.3, 8.1) | ref. | 35.2 (32.7, 37.8) | ref. | |
Private | 63.4 (62.6, 64.1) | 13.4 (12.5, 14.3) | 1.37 (1.06, 1.76) | 14.9 (13.9, 15.9) | 1.42 (1.13, 1.78) | 48.5 (47.2, 49.7) | 1.18 (1.09, 1.27) | |
Government | 14.0 (13.5, 14.6) | 9.6 (8.1, 11.1) | 1.24 (0.91, 1.69) | 10.7 (9.1, 12.2) | 1.28 (0.95, 1.71) | 43.2 (40.8, 45.6) | 1.11 (1.01, 1.22) | |
Family business (including self-employment) | 13.2 (12.6, 13.9) | 19.5 (17.1, 21.9) | 2.26 (1.69, 3.03) | 21.2 (18.7, 23.7) | 2.29 (1.76, 2.98) | 45.5 (42.9, 48.0) | 1.15 (1.06, 1.26) | |
Disability status | ||||||||
No | 86.0 (85.4, 86.5) | 12.9 (12.3, 13.5) | ref. | 14.3 (13.6, 15.0) | ref. | 42.4 (41.5, 43.3) | ref. | |
Yes | 14.0 (13.5, 14.6) | 16.1 (14.2, 17.9) | 0.97 (0.87, 1.09) | 18.4 (16.6, 20.1) | 0.99 (0.91, 1.09) | 48.4 (46.1, 50.7) | 1.03 (0.98, 1.08) | |
Mental health symptoms | ||||||||
None | 67.9 (67.2, 68.7) | 13.0 (12.4, 13.6) | ref. | 14.3 (13.6, 14.9) | ref. | 39.9 (39.0, 40.8) | ref. | |
Anxiety or depression | 32.1 (31.3, 32.8) | 14.6 (13.7, 15.5) | 0.79 (0.72, 0.87) | 16.7 (15.7, 17.8) | 0.83 (0.76, 0.90) | 50.9 (49.3, 52.5) | 1.02 (0.97, 1.06) | |
Households with children | ||||||||
None | 63.3 (62.6, 64.1) | 10.8 (10.3, 11.4) | ref. | 12.1 (11.6, 12.7) | ref. | 39.5 (38.6, 40.4) | ref. | |
<5 years old | 7.1 (6.7, 7.5) | 24.9 (21.5, 28.2) | 1.75 (1.48, 2.06) | 28.8 (25.0, 32.5) | 1.86 (1.63, 2.13) | 55.5 (52.6, 58.4) | 1.13 (1.05, 1.21) | |
5-11 years old | 10.9 (10.5, 11.4) | 22.0 (20.4, 23.6) | 1.53 (1.37, 1.72) | 24.1 (22.5, 25.7) | 1.51 (1.37, 1.67) | 56.3 (54.3, 58.2) | 1.16 (1.11, 1.22) | |
12-17 years old | 18.7 (18.1, 19.3) | 20.8 (19.3, 22.3) | 1.51 (1.37, 1.68) | 22.5 (21.0, 24.1) | 1.48 (1.34, 1.62) | 56.3 (53.7, 58.8) | 1.12 (1.06, 1.19) | |
Food Sufficiency | ||||||||
Enough food to eat | 89.8 (89.4, 90.3) | 12.5 (11.9, 13.0) | ref. | 13.7 (13.2, 14.3) | ref. | 41.4 (40.6, 42.2) | ref. | |
Sometimes | 7.9 (7.5, 8.4) | 22.2 (19.3, 25.1) | 1.14 (0.98, 1.32) | 26.4 (23.3, 29.4) | 1.21 (1.06, 1.38) | 65.3 (62.4, 68.3) | 1.12 (1.07, 1.18) | |
Often not enough to eat | 2.2 (2.0, 2.5) | 29.4 (24.6, 34.3) | 1.33 (1.08, 1.66) | 33.4 (28.3, 38.4) | 1.34 (1.11, 1.62) | 72.2 (66.9, 77.5) | 1.16 (1.07, 1.27) | |
Housing type | ||||||||
Single-family home | 66.4 (65.7, 67.1) | 12.5 (11.8, 13.2) | ref. | 13.9 (13.1, 14.7) | ref. | 39.8 (38.8, 40.7) | ref. | |
Townhouse/condo | 7.6 (7.2, 7.9) | 9.3 (7.8, 10.9) | 0.69 (0.57, 0.84) | 10.4 (8.8, 12.0) | 0.69 (0.58, 0.82) | 45.1 (41.9, 48.2) | 1.01 (0.94, 1.09) | |
Multi-unit home | 20.5 (19.9, 21.2) | 13.3 (11.7, 14.9) | 0.84 (0.74, 0.95) | 14.9 (13.3, 16.4) | 0.84 (0.75, 0.94) | 49.9 (48.0, 51.8) | 1.00 (0.96, 1.05) | |
Other- including mobile home, boat, van, RV | 5.5 (5.1, 5.9) | 26.9 (23.8, 30.1) | 1.26 (1.09, 1.45) | 30.8 (27.4, 34.3) | 1.27 (1.13, 1.43) | 56.5 (52.5, 60.4) | 1.11 (1.03, 1.19) |

Conclusion and Discussion
- Nguyen K.H.
- Srivastav A.
- Razzaghi H.
- Williams W.
- Lindley M.C.
- Jorgensen C.
- Abad N.
- Singleton J.A.
Declaration of Competing Interest
Funding/Support
References
- Centers for Disease Control and Prevention. 2021; (Accessed on December 12https://www.cdc.gov/vaccines/hcp/acip-recs/vacc-specific/covid-19.html)
COVID Data Tracker. Centers for Disease Control and Prevention. Assessed March 2, 2022. https://covid.cdc.gov/covid-data-tracker/#vaccinations_vacc-total-admin-rate-pop18
People with Certain Medical Conditions. Centers for Disease Control and Prevention. Assessed March 2, 2022. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html
- COVID-19 vaccination intent, perceptions, and reasons for not vaccinating among groups prioritized for early vaccination—United States, September and December 2020.MMWR Morb Mortal Wkly Rep 2021. 2021; 70: 217-222
- Centers for Disease Control and Prevention. 2022; (Assessed March 2https://covid.cdc.gov/covid-data-tracker/#trends_dailycases)
- Trends in COVID-19 vaccination receipt and intention to vaccinate, United States, April–August, 2021.American journal of infection control. 2021;
Source of the Data and Accuracy of the Estimates for the Household Pulse Survey – Phase 3.3. Assessed March 2, 2022. https://www2.census.gov/programs-surveys/demo/technical-documentation/hhp/Phase3-3_Source_and_Accuracy_Week41.pdf
- Design and Operation of the 2020 Household Pulse Survey.U.S. Census Bureau. 2020; (Assessed September 9, 2021. https://www2.census.gov/programs-surveys/demo/technical-documentation/hhp/2020_HPS_Background.pdf)
- Census Bureau. 2022; (Available at: https://www2.census.gov/programs-surveys/demo/technical-documentation/hhp/2020_HPS_NR_Bias_Report-final.pdf)
- WebMD. February 23, 2022; (https://www.webmd.com/lung/news/20220223/mask-mandates-ending-all-but-one-state)