We document a number of key facts related to trends in COVID-19 vaccination intentions of unvaccinated adults in the United States from April 2021 to January 2022 using the Household Pulse Survey. First, among unvaccinated adults both those who were willing to vaccinate and those who were previously unwilling to vaccinate eventually vaccinated in large numbers. We estimate that from April 2021 to January 2022, the number of unvaccinated but willing adults dropped from 74 million to 12 million, a decrease of 84 percent; and the number of unvaccinated and unwilling adults dropped from 45 million to 23 million, a decrease of 49 percent. Second, as more adults vaccinated, the remaining pool of unvaccinated adults became increasingly unwilling to vaccinate, which is consistent with those who were willing to vaccinate being more likely to vaccinate than those who were unwilling. The one exception to this pattern is that during COVID-19 surges willingness to vaccinate instead increased, suggesting that COVID-19 surges may induce vaccine willingness. Third, younger, lower-income, and less-educated populations have consistently been the most willing to vaccinate among unvaccinated adults. Fourth, Black, Hispanic and Asian unvaccinated adult populations have consistently been more willing to vaccinate than the White unvaccinated adult population. Fifth, survey responses indicate that over the time period of our study vaccine cost and accessibility have not been major impediments to vaccine uptake. Instead, as reasons for not vaccinating, unvaccinated adults who were willing to vaccinate most frequently highlighted concerns over COVID-19 vaccine side effects and a desire to wait and see whether COVID-19 vaccines are safe. While unvaccinated adults who were unwilling to vaccinate also emphasized worries over vaccine safety, they additionally commonly stated they have not vaccinated due to distrust in COVID-19 vaccines and the government. This suggests that as the unvaccinated population has become less willing to vaccinate over time, outreach efforts may need to adapt to the difference in concerns between those who are willing and unwilling to vaccinate.
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