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Why some Americans are hesitant to receive the COVID-19 vaccine

Study finds likelihood of vaccine refusal highest among African Americans, women and conservatives

Recent polls suggest that a significant percentage of Americans are reluctant to receive the COVID-19 vaccine. The results of these polls have stimulated new questions, such as, “Who is most likely to refuse the COVID-19 vaccine?” and “What are their reasons for refusal?” Understanding the answers to these questions is critical in improving COVID-19 vaccination rates and ending the pandemic.

Timothy Callaghan, PhD, assistant professor at the Texas A&M University School of Public Health, led a research study published recently in Social Science and Medicine to better understand COVID-19 vaccination intentions in the American public and the reasons why many individuals intend to refuse a COVID-19 vaccine.

Callaghan and colleagues surveyed a demographically representative sample of more than 5,000 Americans. The results revealed that 31.1 percent of Americans do not intend to take the COVID-19 vaccine once it becomes available to them. The likelihood of vaccine refusal was highest for African Americans, women and conservatives.

Overall, the two most cited reasons for vaccine refusal were concerns about vaccine safety and effectiveness, but reasons for vaccine reluctance varied across sub-populations. For instance, women were likely to be hesitant based on concerns about safety and effectiveness, while African Americans were likely to be hesitant because of these same concerns as well as a lack of financial resources or health insurance to afford the vaccine. When it comes to COVID-19 hesitancy in conservatives, Callaghan explained that previous studies have shown that conservatives are generally less trusting of vaccines, as well as medical and scientific professionals.

The finding that most surprised Callaghan was that African Americans, who are being infected and dying at higher rates than the rest of the population, are one of the groups less likely to vaccinate because of a combination of concerns, including concerns related to safety and affordability.

“This points to the need for the medical community and policymakers to find ways to both build trust in the vaccine in the African American community and to ensure that it is delivered affordably,” Callaghan said. Callaghan also noted the importance of combatting messaging from anti-vaccine advocacy groups, which have sowed doubt among key groups—including African Americans—about the safety of the COVID-19 vaccine.

Now that COVID-19 vaccine-hesitant populations have been identified, Callaghan plans to explore what kind of health interventions and health promotion efforts are most effective in promoting the vaccine in these populations. Additionally, he notes that it is important to explore the similarities and differences between populations that are generally vaccine hesitant, and populations that are hesitant specifically toward the COVID-19 vaccine.

-by Callie Rainosek

Media contact: Dee Dee Grays,, 979.436.0611

Rae Lynn Mitchell

SPH - Director of Communications and Alumni Affairs

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