Population Attributable Fraction of Non-Vaccination of COVID-19 Due to Vaccine Hesitancy, United States, 2021


Understanding the extent of COVID-19 non-vaccination attributable to vaccine hesitancy versus other barriers can help prioritize approaches for increasing vaccination uptake. Using data from the CDC’s Research and Development Survey, a nationally representative survey fielded from May 17 – June 30, 2021 (n=5,458), we examined the adjusted population attribution fraction (PAF) of COVID-19 vaccine hesitancy attributed to non-vaccination by sociodemographic characteristics and health-related variables. Overall, the adjusted PAF of non-vaccination attributed to vaccine hesitancy was 76.1%. The PAF was highest among adults who were ≥50 years (87.9%), non-Hispanic White (83.7%), had a Bachelor’s degree or higher (82.7%), had an annual household income of ≥$75,000 (85.5%), were insured (82.4%), and had a usual place for health care (80.7%). The PAF was lower for those who were current smokers (65.3%) compared to never smokers (77.9%), those who had anxiety or depression (65.2%) compared to those who did not (80.1%), and those who had a disability (64.5%) compared to those who did not (79.2%). Disparities in PAF suggest areas for prioritization of efforts for intervention and development of messaging campaigns that address all barriers to uptake, including hesitancy and access, to advance health equity and protect individuals from COVID-19.