Attitudes Toward a Potential SARS-CoV-2 Vaccine : A Survey of U.S. Adults

Ann Intern Med. 2020 Dec 15;173(12):964-973. doi: 10.7326/M20-3569. Epub 2020 Sep 4.


Background: Coronavirus disease 2019 (COVID-19) has rapidly instigated a global pandemic. Vaccine development is proceeding at an unprecedented pace. Once available, it will be important to maximize vaccine uptake and coverage.

Objective: To assess intent to be vaccinated against COVID-19 among a representative sample of adults in the United States and identify predictors of and reasons for vaccine hesitancy.

Design: Cross-sectional survey, fielded from 16 through 20 April 2020.

Setting: Representative sample of adults residing in the United States.

Participants: Approximately 1000 adults drawn from the AmeriSpeak probability-based research panel, covering approximately 97% of the U.S. household population.

Measurements: Intent to be vaccinated against COVID-19 was measured with the question, "When a vaccine for the coronavirus becomes available, will you get vaccinated?" Response options were "yes," "no," and "not sure." Participants who responded "no" or "not sure" were asked to provide a reason.

Results: A total of 991 AmeriSpeak panel members responded. Overall, 57.6% of participants (n = 571) intended to be vaccinated, 31.6% (n = 313) were not sure, and 10.8% (n = 107) did not intend to be vaccinated. Factors independently associated with vaccine hesitancy (a response of "no" or "not sure") included younger age, Black race, lower educational attainment, and not having received the influenza vaccine in the prior year. Reasons for vaccine hesitancy included vaccine-specific concerns, a need for more information, antivaccine attitudes or beliefs, and a lack of trust.

Limitations: Participants' intent to be vaccinated was explored before a vaccine was available and when the pandemic was affecting a narrower swath of the United States. Questions about specific information or factors that might increase vaccination acceptance were not included. The survey response rate was 16.1%.

Conclusion: This national survey, conducted during the coronavirus pandemic, revealed that approximately 3 in 10 adults were not sure they would accept vaccination and 1 in 10 did not intend to be vaccinated against COVID-19. Targeted and multipronged efforts will be needed to increase acceptance of a COVID-19 vaccine when one becomes available.

Primary funding source: Agency for Healthcare Research and Quality.

Publication types

  • Editorial
  • Multicenter Study

MeSH terms

  • Adult
  • Attitude to Health*
  • COVID-19 / epidemiology
  • COVID-19 / therapy*
  • COVID-19 Vaccines / pharmacology*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pandemics
  • Retrospective Studies
  • SARS-CoV-2 / immunology*
  • United States / epidemiology


  • COVID-19 Vaccines