The KFF COVID-19 Vaccine Monitor is an ongoing research project tracking the public’s attitudes and experiences with COVID-19 vaccinations. Using a combination of surveys and qualitative research, this project follows the dynamic nature of public opinion as vaccine development and distribution unfolds, including vaccine trust and acceptance, information needs, trusted messengers and messages, as well as the experiences of the public with vaccination.
The data for this analysis comes from the October 2021 KFF COVID-19 Vaccine Monitor. See the first report for full methodological details of the study.
The KFF COVID-19 Vaccine Monitor and other studies have consistently shown a strong relationship between biased identification and how individuals view and experience the COVID-19 pandemic, on questions ranging from concerns about contamination to self-reported behaviors such as mask-wearing and social distancing. , to views on vaccinations. This new analysis shows that while COVID-19 vaccination rates have increased over time and the majority of partisan groups report being vaccinated, Republicans are an increasingly disproportionate share of those who remain unvaccinated and political bias is a stronger predictor of whether someone has been vaccinated than demographic factors such as age, race, education level, or insurance status. These results suggest significant challenges to any efforts to further increase vaccine uptake among U.S. adults, which could also impact the adoption of booster shots and COVID-19 vaccines for children as eligibility increases.
A large and growing proportion of unvaccinated adults identify as Republican or lean that way
Partisanship has been a strong predictor of views on the coronavirus from the early days of the pandemic. For example, KFF polls in May 2020 showed that Republicans were less likely than Democrats to report wearing masks and taking social distancing. Early views on the COVID-19 vaccine were similarly split along party lines, with a majority of Republicans saying they would not get vaccinated in September 2020 (compared to Democrats who were more evenly split on whether or not to get vaccinated). of a COVID-19 vaccine as soon as it became available).
By April 2021, a majority of US adults (56%) self-identified that they had already received at least one dose of a COVID-19 vaccine. Of the 43% adults who said they had not been vaccinated at the time, about four in ten (42%) identified as Republicans or Republican independents and about a third (36%) identified as Democrats or leaned that way, while 16% identified as independents who did not lean towards either party. The partisan divide between vaccinated and unvaccinated adults became even more apparent as more of the population received COVID-19 vaccines. Now, six months later, in October 2021, a quarter (27%) of U.S. adults say they have not received a COVID-19 vaccine, but the unvaccinated population is now disproportionately made up of those who identify as Republican or Republican . , with six in ten (60%) identifying as Republican or Republican oriented (compared to about four in ten of the total US adult population) and only one in six (17%) identifying themselves as Democratic or Democratic oriented . See Appendix Figure 1 for a complete demographic profile of unvaccinated adults from April to October 2021.
While the role of bias in predicting vaccination status has increased, our surveys and other KFF research have shown that racial and ethnic disparities in vaccine use have narrowed over time. And while other groups, such as the uninsured, younger adults, rural dwellers, and those with lower education levels, continue to be vaccinated at lower rates than their counterparts, multivariate analysis — a statistical model separating the influence of these different factors — gives bias to what sets it apart. as the strongest single identifying predictor of vaccine uptake. See Appendix Figure 2 for results of regression analyzes showing the relative magnitude of the effects of education, race and ethnicity, and bias, while keeping other variables (such as age, rural area, income, ideology) constant based on the population mean.
Demographic and Attitude Differences Between Vaccinated and Unvaccinated Republicans
While self-identification as a Republican or leaning Republican is one of the strongest identification predictors of remaining unvaccinated, it is important to note that a majority (59%) of this group (Republicans and Republicans) report having at least one dose received from a COVID-19 vaccine.
Like the general differences between unvaccinated and vaccinated adults, unvaccinated Republicans are younger and report lower educational attainment than their vaccinated counterparts. Higher numbers of unvaccinated Republicans identify as conservative (68% vs. 58%) and live in counties where former President Trump gained more votes in the 2020 election (65% vs. 52%), although this difference is not dramatic. Another geographical feature – urbanity – distinguishes the two groups, with 27% of unvaccinated Republicans living in rural areas compared to 16% of vaccinated Republicans (similar to the urban-rural gap in overall vaccination coverage).
Examining attitude differences through both bias and vaccination status reveals that there are some minor differences between vaccinated and unvaccinated Republicans in how they feel about the severity of the pandemic, their own personal risk, and how personal choice versus collective responsibility factors in vaccination decisions. However, the attitude of vaccinated Republicans is much more similar to that of unvaccinated Republicans than to vaccinated Democrats, highlighting the strong correlation between this attitude and partisanship regardless of vaccination status.
For example, vaccinated Republicans are slightly less likely than unvaccinated Republicans to say that the severity of the pandemic has been exaggerated in the news (88% vs. 54%), but both groups contrast with vaccinated Democrats, most of whom say the news generally correct (56%) or underestimate the severity of the pandemic (31%). An overwhelming majority of unvaccinated Republicans (96%) and a slightly smaller but still significant majority of vaccinated Republicans (73%) say vaccination against COVID-19 is a personal choice, while a large majority of vaccinated Democrats (81%) see it as everyone’s responsibility to protect the health of others. And while vaccinated Republicans are about twice as likely as unvaccinated Republicans to worry that they will personally get sick from COVID-19 (25% vs. 11%), the proportion who are concerned is still significantly less than among vaccinated Democrats (46%).
The increasing role of bias in determining individuals’ COVID-19 vaccination status poses a challenge to public health officials and messages related to efforts to further increase vaccine uptake among adults. The group that has yet to be convinced of the importance of receiving a COVID-19 vaccine is disproportionately represented by those who identify as Republican or lean. Compared to their vaccinated counterparts, these unvaccinated Republicans are distinguished by their neighbors’ voting habits, their sense that the pandemic is being exaggerated and their lack of personal risk: factors that can be extremely difficult to overcome in gaining acceptance from COVID-19 vaccines. These findings could also have implications as the vaccine rollout expands to younger children and the CDC recommends booster shots for some adult populations. With most vaccinated Republicans saying they’re not worried about getting sick and 38% of fully vaccinated Republicans saying they don’t plan on getting a booster shot when they qualify, it seems likely that bias will continue to play a role in vaccine roll-out after the first attempt to vaccinate the adult population.