COVID-19 vaccine hesitancy in the United States

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Anti Vax-Mask protester - Worthington, Ohio - August 14, 2021 Anti Vax or mask IMG 3966 (51380804053).jpg
Anti Vax-Mask protester - Worthington, Ohio - August 14, 2021

COVID-19 vaccine hesitancy in the United States is the sociocultural phenomenon of individuals refusing or displaying hesitance towards receiving the COVID-19 vaccine. COVID-19 vaccine hesitancy in the United States can be considered as part of the broader history of vaccine hesitancy.



Vaccine hesitancy in the United States towards the COVID-19 vaccines has existed since the early stages of the vaccines' development. [1] [2] COVID-19 vaccine-hesitant people are not necessarily anti-vaccine. [3]

Soon after the start of the COVID-19 pandemic, preexisting anti-vaxxer social networks started online and in-person campaigns to discredit the developing COVID-19 vaccines targeting United States citizens. [4] Anti-vaccination influencers used Twitter and other social media platforms to spread vaccine misinformation. [4] Some in the medical field have given false credibility to vaccine hesitant beliefs. This caused the Federation of State Medical Boards to issue a statement in July 2021 that any physicians who generate and spread vaccine misinformation or disinformation would risk disciplinary action. [5] [6]

President Donald Trump's initial public vaccine hesitancy fueled vaccine skepticism among Republican voters. [7] White House sources revealed in March 2021 that Trump and his wife, Melania, had secretly received the COVID-19 vaccine in January. [8] [7] In April 2021, Trump referred to the COVID-19 vaccine as a 'true miracle' and encouraged his supporters to take it. [9] In September 2021, Trump revealed to journalist Adam Shapiro that he received the Pfizer version of the vaccine and encouraged the general public to take the vaccine. [10] In the same interview, Trump blamed president Biden for the public's lack of trust in the vaccine: "When I was president, everybody wanted to get the vaccine... after I left, people don't want to take it and... I think it's because they don't trust Biden." [10]

Ipsos polling data shows that vaccine hesitancy dropped from 63% in September 2020 to 20% in September 2021. The change was accompanied by COVID-19 fatigue, the Delta variant surge, and the FDA's formal approval of the Pfizer vaccine. [11]

Anti-vaccine public figures who died from COVID-19

Many news reports in 2021 noted when those who opposed the use of the vaccine died from COVID-19, though some criticized the practice as celebrating the suffering of others. [12]

In August 2021, a number of conservative talk radio hosts who had discouraged COVID-19 vaccination, or expressed skepticism toward the COVID-19 vaccine, died from COVID-19 complications. [13] [14] These included Marc Bernier (self-nicknamed "Mr. Antivax") from Daytona, Florida; [15] Dick Farrel, an anti-vaccine activist who referred to the pandemic as a "SCAM DEMIC"; [15] Jimmy DeYoung Sr.; [16] and Phil Valentine. [17] In September 2021, another anti-vaccine conservative radio host, Bob Enyart, died of COVID-19. [18]


The reasons for hesitancy towards COVID-19 vaccine are complex and vary between individuals. They include concerns about side effects of the vaccination, [19] wanting to wait to see if the vaccine is safe, [19] misinformation about COVID-19 vaccines [7] promulgated by conspiracy theories, including incorrect beliefs about vaccines containing microchips, intentional side effects, infertility, and permanent genetic alteration. [7] The belief that previous exposure to virus leads "natural immunity" is also common. [20] [21] Additional reasons for COVID-19 vaccine hesitancy include fears about long-term health risks of vaccination, [7] belief in the strength of the body's immune system without the vaccine, [21] mistrust in government, [22] and mistrust in mainstream medicine and institutions. [23] Gubernatorial edicts against vaccine mandates, as in Texas, also play a role. [24]

There have been many lawsuits seen throughout the United States aimed against the vaccine mandates that were implemented in 2021. Two Staff Sergeants, one from the Army the other from the Marines, sued three federal agencies against their plans to conduct mandatory vaccination of all military troops, as military regulations state that troops can be exempted from vaccination showing documented previous infection. [25] After the announcement of President Joe Biden of a country wide vaccine mandate in September 2021, many organizations and politicians such as the Republican National Committee, South Dakota Governor Kristi Noem, and Arizona Attorney General Mark Brnovich stated they would sue the administration. [26]

Generally litigation for vaccine injury claims against manufacturers are filed with the United States Court of Federal Claims, sitting without a jury and compensation is provided by the National Vaccine Injury Compensation Program. The Public Readiness and Emergency Preparedness Act (PREP Act) was invoked for Medical Countermeasures Against COVID–19 on March 17, 2020. [27] Under the PREP Act the HHS secretary provides legal protection to manufacturers of vaccines and treatments, unless there’s willful misconduct, [28] [29] barring liability cases from vaccine injury despite low payout rates from the National Vaccine Injury Compensation Program. [30]

By profession

Medical professionals

Survey research of medical professionals in the United States shows a majority of the medical community accepts and trusts the COVID-19 vaccines. [31] [32] Medical professionals in the United States are vaccinated at a higher rate than the general public they serve. [33] For example, in August 2021 in Alabama, it was estimated 50-60% of hospital staff were vaccinated compared to a <35% vaccination rate for the total state population. [34] Regional vaccination rate in health care professionals parallels that of the local community, where states with higher vaccination rates have higher instances of vaccinated health care workers. [33] In July 2021, the Mayo Clinic, a nonprofit American academic medical center with over 60,000 employees, announced they would require staff to get vaccinated. [35]

A group of physicians joined parents and disability advocates in 2021 to form the No License for Disinformation group, which files complaints to the corresponding states medical boards against doctors who have spread false Covid statements. [6]


Active duty and reserve forces

From December 2020 through March 2021, 361,538 service members, or 27.2 percent of the active-duty military, received at least one dose of the COVID-19 vaccine. [36] As of August 2021, over 1,000,000 active-duty and reserve forces were at least partially vaccinated. [37] Throughout the Coronavirus pandemic, vaccination rates have varied between the branches of the United States Armed Forces from the 74% rate in the Navy to the closer to 50% rate in the Army. On August 25, 2021, Defense Secretary Lloyd Austin, ordered mandatory vaccinations for most of the country's active duty and reserve forces, directing each branch "to impose ambitious timelines for implementation and to report regularly on vaccination completion using established systems for other mandatory vaccine reporting." [38] The US military will require service members to get the COVID-19 vaccine by September 15, 2021.

In response to the vaccine mandate, an Army staff sergeant and a Marine staff sergeant sued various federal government agencies to grant exemptions on mandatory COVID vaccinations for those who've had the virus. [20] As of September 2021, a judge did not grant a temporary block on mandatory vaccinations and the suit will continue through normal court procedures. [20]


In July 2021, the Department of Veterans Affairs mandated the coronavirus vaccines for its more than 100,00 front-line workers, becoming the first federal agency to do so. [35] The VA is working with the American Legion on COVID-19 vaccine hesitancy outreach. [39] On August 28, 2021, during the national convention of the American Legion, speaker Carolyn Clancy, the VA's Assistant Under Secretary for Health, described COVID-19 as an unprecedented public health emergency and encouraged vaccinated veterans to reach out to their peers who are vaccine-hesitant. [39] Clancy also described how 70 VA facilities were part of the vaccine trials during Operation Warp Speed, participation, she said, veterans should be "quite proud of." [39]

As of July 1, 2021, of the 380,000 people who work for the Department of Veterans Affairs, 298,186 are fully vaccinated, or 78 percent, a percentage higher than the national average but below what VA officials want for those providing health care. [40] As of July 1, 2021, 20,300 V.A. employees have contracted the coronavirus since March 2020. [40] In late July 2021, Department of Veterans Affairs Secretary Denis McDonough released a press release announcing he will make COVID-19 vaccines mandatory for Title 38 VA health care personnel. [40]

Professional athletes

In Spring 2021, as vaccines became available to professional athletes, several professional leagues encountered substantial vaccine hesitancy among players. [41] [42] In August 2021 the Atlanta Falcons, a football team located in Atlanta, Georgia, became the first NFL team to report being fully vaccinated. [43] In September, the Tampa Bay Buccaneers became the second NFL team to report being fully vaccinated. [44] In July 2021, the National Basketball Association announced that 90% of NBA players were vaccinated. [45] At least one player refused vaccination and was barred from participating. [46] In June 2021, Major League Baseball announced that two-thirds of the MLB teams had reached 85% vaccination rate. [47]

Federal employees

In July 2021, the state of California and the city of New York announced a requirement for state employees to either get vaccinated or face weekly testing. [44] As of July 2021, the Biden administration seeks to increase the vaccination rate of federal employees. [48] As part of this vaccination effort, the administration required all contractors working for the federal government to get vaccinated or submit to regular testing and masking. [49]

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Vaccine Choice Canada (VCC) is Canada's main anti-vaccination group. It was founded in the 1980s under the name Vaccination Risk Awareness Network (VRAN) and adopted its current name in 2014. The group has been contributing to vaccine hesitancy in Canada, encouraging citizens to forgo immunization and legislators to support anti-vaccine regulations and legislation.

COVID-19 pandemic in the United States Ongoing COVID-19 viral pandemic in the United States

The COVID-19 pandemic in the United States is part of the worldwide pandemic of coronavirus disease 2019. Since January 2020, 45,427,464 confirmed cases have been reported with 735,800 deaths, the most of any country, and the twentieth-highest per capita worldwide. As many infections have gone undetected, the Centers for Disease Control and Prevention (CDC) estimated that, as of May 2021, there could be a total 120.2 million infections in the United States, or more than a third of the total population. COVID-19 is the deadliest pandemic in U.S. history; it was the third-leading cause of death in the U.S. in 2020, behind heart disease and cancer. From 2019 to 2020, U.S. life expectancy dropped by 3 years for Hispanic Americans, 2.9 years for African Americans, and 1.2 years for white Americans. These effects have persisted as U.S. deaths due to COVID-19 in 2021 exceeded those in 2020.

Operation Warp Speed American public–private partnership designed to accelerate COVID-19 vaccine development

Operation Warp Speed (OWS) was a public–private partnership initiated by the United States government to facilitate and accelerate the development, manufacturing, and distribution of COVID-19 vaccines, therapeutics, and diagnostics. The first news report of Operation Warp Speed was on April 29, 2020, and the program was officially announced on May 15, 2020. It was headed by Moncef Slaoui from May 2020 to January 2021 and by David A. Kessler from January to February 2021. At the end of February 2021, Operation Warp Speed was transferred into the responsibilities of the White House COVID-19 Response Team.

The COVID-19 pandemic in American Samoa is part of the ongoing worldwide pandemic of coronavirus disease 2019 caused by severe acute respiratory syndrome coronavirus 2. The COVID-19 pandemic was confirmed to have reached the unincorporated United States territory of American Samoa on 9 November 2020.

Face masks during the COVID-19 pandemic in the United States Use of face coverings during the Coronavirus pandemic in the United States

The wearing of non-medical face masks in public to lessen transmission of COVID-19 in the United States was first recommended by the CDC on April 3, 2020 as supplemental to hygiene and appropriate social distancing. Over the course of the pandemic, various states, counties, and municipalities have issued health orders requiring the wearing of non-medical face coverings — such as cloth masks — in spaces and/or businesses accessible to the public, especially when physical distancing is not possible. Some areas only mandated their use by public-facing employees of businesses at first, before extending them to the general public.

COVID-19 vaccination in the United Kingdom Immunisation against COVID-19

The COVID-19 vaccination programme in the United Kingdom is an ongoing mass immunisation campaign for coronavirus disease 2019 (COVID-19) during the COVID-19 pandemic in the United Kingdom. The UK's vaccination rollout was the world's first mass immunisation programme for the disease when it began on 8 December 2020 after Margaret Keenan received her first dose of two. As of 6 October 2021, 49,068,705 first doses and 45,078,529 second doses of a vaccine had been administered across the UK.

COVID-19 vaccination in Switzerland Plan to immunize against COVID-19

COVID-19 vaccination in Switzerland is an ongoing immunization campaign against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19), in response to the ongoing pandemic in the country.

COVID-19 vaccination in Sweden

Vaccination against COVID-19 in Sweden started on 27 December 2020 after the approval of the Pfizer–BioNTech vaccine by the European Commission. In Sweden, the Public Health Agency has been commissioned by the government to create a vaccination plan. Sveriges riksbank, the central bank of Sweden, predicts that efficient vaccination against COVID-19 has macroeconomic benefits. As of 1 September 2021, 82.0% of adults in Sweden have received at least one dose, with a total of 12,700,896 administered.

COVID-19 vaccination in Israel

Israel's COVID-19 vaccination programme, officially named "Give a Shoulder", began on 19 December 2020, and has been praised for its speed, having given twenty percent of the Israeli population the first dose of the vaccines' two dose regimen in the span of three weeks.

COVID-19 vaccination in India Immunisation programme against COVID-19 in India

India began administration of COVID-19 vaccines on 16 January 2021. As of 24 October 2021, India has administered over 1.02 billion doses overall, including first and second doses of the currently-approved vaccines. In India, nearly half the eligible population has got at least one shot, and 19 per cent received both nine months after the vaccine rollout.

COVID-19 vaccination in Canada COVID-19 vaccination programme in Canada

The COVID-19 vaccination program in Canada is an ongoing, intergovernmental effort coordinated between the bodies responsible in the Government of Canada to acquire and distribute vaccines to individual provincial and territorial governments who in turn administer authorized COVID-19 vaccines during the COVID-19 pandemic in Canada. Some provinces have asked local municipal governments, hospital systems, family doctors and independently owned pharmacies to aid in part, or in full with vaccination rollout. The vaccination effort in full is the largest such immunization effort in the nation's history; it started in mid-December 2020 and is currently ongoing.

COVID-19 vaccination in Russia

The COVID-19 vaccination campaign in Russia is an ongoing mass immunization campaign against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19), in response to the ongoing pandemic in the country. Mass vaccinations began in December 2020, starting with primarily doctors, medical workers and teachers, and in January 2021, this was extended to the entire population.

COVID-19 vaccination in the United States Plan to immunize against COVID-19

The COVID-19 vaccination campaign in the United States is an ongoing mass immunization campaign for the COVID-19 pandemic in the United States. The Food and Drug Administration (FDA) first granted emergency use authorization to the Pfizer–BioNTech vaccine on December 10, 2020; mass vaccinations began on December 14, 2020. The Moderna vaccine was granted emergency use authorization on December 17, 2020, and the Janssen vaccine was granted emergency use authorization on February 27, 2021. By April 19, 2021, all U.S. states had opened vaccine eligibility to residents aged 16 and over. On May 10, 2021, the FDA approved the Pfizer-BioNTech vaccine for adolescents aged 12 to 15. On August 23, 2021, the FDA granted full approval to the Pfizer–BioNTech vaccine for individuals aged 16 and over.

The COVID-19 vaccination program in Colombia is an ongoing effort of mass immunization put in place by the Colombian government in order to respond to the ongoing COVID-19 pandemic. The COVID-19 virus was confirmed to have reached Colombia on 6 March 2020. Colombia's preparation and readiness for a vaccine program allowed it to join the first group of countries who received vaccines through COVAX. The first vaccine in Colombia was given to a nurse on 17 February 2021.

COVID-19 vaccination in New Zealand Ongoing COVID-19 vaccine programme in New Zealand

COVID-19 vaccination in New Zealand began on 20 February 2021, and will continue throughout the year with the goal of vaccinating all willing New Zealanders aged 12+. As of 1 September, anyone in New Zealand is eligible to be vaccinated.

COVID-19 vaccination in Brazil

The COVID-19 vaccination campaign in Brazil is an ongoing mass immunization campaign for the COVID-19 pandemic in Brazil. It started in January 17, 2021, when the country had 210 thousand deaths.

COVID-19 vaccination in Ukraine

The COVID-19 vaccination campaign in Ukraine is an ongoing mass immunization campaign for the COVID-19 pandemic in Ukraine.

COVID-19 vaccine misinformation and hesitancy Misinformation regarding the SARS-CoV-2 vaccine and the resulting hesitancy towards it

Anti-vaccination activists and other people in multiple countries have spread a variety of unfounded conspiracy theories about COVID-19 vaccines based on misunderstood science, religion, and other factors. Theories including overblown claims about side effects, a story about COVID-19 being spread by childhood vaccines, misrepresentations about how the immune system works, and when and how COVID-19 vaccines are made have proliferated, contributing to widespread vaccine hesitancy among the public. This has led to governments around the world introducing measures to encourage vaccination, which has in turn led to further misinformation about the legality and effect of these measures themselves.

COVID-19 vaccination mandates in the United States Mandates for people to receive the COVID-19 vaccine in the U.S.

COVID-19 vaccine mandates have been enacted by numerous states and municipalities in the United States, and also by private entities. In September 2021, President Joe Biden announced that the federal government would take steps to mandate COVID-19 vaccination for certain entities under the authority of the federal government or federal agencies.

Vaccine passports during the COVID-19 pandemic Use of immunity passports for COVID-19 vaccination

A vaccine passport or proof of vaccination are immunity passports which have been employed as a credential in a number of countries and jurisdictions as part of efforts to control the COVID-19 pandemic via vaccination. They are typically issued by a government or health authority, and have consisted of a scannable barcode, QR code or are accessible in paper form or as part of a mobile app. They may or may not use a COVID-19 vaccine card as a basis of authentication. As of 5 October 2021, more than 46 percent of the world population has been vaccinated with a COVID-19 vaccine.


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