Unraveling Attributes of COVID-19 Vaccine Hesitancy in the U.S.: A Large Nationwide Study

SARS-CoV-2 vaccines are powerful tools to combat the COVID-19 pandemic, but vaccine hesitancy threatens these vaccines effectiveness. To address COVID-19 vaccine hesitancy and ensure equitable distribution, understanding the extent of and factors associated with vaccine hesitancy is critical. We report the results of a large nationwide study conducted December 2020-January 2021 of 34,470 users from COVID-19-focused smartphone-based app How We Feel on their willingness to receive a COVID-19 vaccine. Nineteen percent of respondents expressed vaccine hesitancy, the majority being undecided. Vaccine hesitancy was significant among females, younger people, minority and low-income communities, healthcare and essential workers, rural residents, geographical regions with higher COVID-19 burden, those who did not use protective measures, and those who did not receive COVID-19 tests. Our findings support the need for targeted efforts to develop education and outreach programs to overcome vaccine hesitancy and improve equitable access, diversity, and inclusion in the national response to COVID-19.