Leveraging 13 million responses to the Facebook COVID-19 Trends and Impact Survey to examine vaccine hesitancy, vaccination, and mask wearing, January 2021-February 2022

Abstract

Background: The urgency of the COVID-19 global pandemic called upon the joint efforts from the scientific and private sectors to work together to track vaccine acceptance, prevention behaviors, and symptoms. Methods: Our study utilized individual responses to the Facebook’s COVID-19 Trends and Impact Survey from January 2021 to February 2022 (n=13,426,245) to examine contextual and individual-level predictors of COVID-19 vaccine hesitancy, vaccination, and mask wearing. Adjusted logistic regression models were developed to examine individual and zip code predictors of COVID-19 vaccine hesitancy and vaccination status. Given the COVID vaccine was rolled out in phases in the U.S. we conducted analyses stratified by time, January 2021-May 2021 (Time 1) and June 2021-February 2022 (Time 2). Results: On January 2021 only 9% of Facebook respondents reported receiving the COVID-19 vaccine, and 45% were vaccine hesitant. By February 2022, 80% of respondents were vaccinated and only 18% were vaccine hesitant. Individuals who were older, held higher educational degrees, worked in white collar jobs, wore a mask most of the time or some of the time, and identified as white and Asian had higher COVID-19 vaccination rates and lower vaccine hesitancy across Time 1 and Time 2. COVID vaccinations were lower among essential workers and blue-collar occupations (OR=0.31-0.40) including those in food preparation and serving, construction, installation and repair, transportation, and production in Time 1. In Time 2, these disparities attenuated but were still present (OR-0.36-0.64). For these same occupation groups, vaccine hesitancy was higher (OR=1.88-2.30 in Time 1) and (OR=2.05-2.80 in Time 2). By Time 2, all adults were eligible for the COVID-19 vaccine, but blacks (OR=0.71; 95% CI: 0.70-0.72) and multiracial (OR=0.47; 95% CI: 0.47-0.48) individuals had lower vaccination and higher vaccine hesitancy compared to whites. Conclusions: Associations found in earlier phases of the pandemic were generally found to also be present later in the pandemic, indicating stability in inequities. Additionally, inequities in these important outcomes suggests more work is needed to bridge gaps to ensure that the burden of COVID-19 risk does not disproportionately fall upon subgroups of the population.

Figure 1.. COVID vaccination and COVID vaccine hesitancy by time, January 2021-Febrary 2022.

COVID vaccinated were Facebook survey respondents who reported having gotten at least one dose of a COVID-19 vaccine. COVID vaccine hesitant were individuals who indicated that they would “No, probably not” and “No, definitely not” get the COVID vaccine if it was offered to them today. X-axis indicates study month; Month 1 is January 2021 and Month 14 is February 2022.

Figure 2.. COVID-19 Vaccine Hesitancy Reason, Jan 2021-Feb 2022.

Hesitancy reasons among vaccine hesitant individuals. Respondents could select multiple reasons.

Figure 3.. Mask wearing most/all the time in public (Jan 2021-Feb 2022).

Temporal trends in the prevalence of Facebook survey respondents reporting they were masks most or all of the time in public. X-axis indicates study month; Month 1 is January 2021 and Month 14 is February 2022.