Leveraging 13 million responses to the U.S. 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 pandemic called upon the joint efforts from the scientific and private sectors to work together to track vaccine acceptance and prevention behaviors.

Methods: Our study utilized individual responses to the Delphi Group at Carnegie Mellon University U.S. COVID-19 Trends and Impact Survey, in partnership with Facebook. We retrieved survey data 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 in the United States. Adjusted logistic regression models were developed to examine individual and ZIP code predictors of COVID-19 vaccine hesitancy and vaccination status. Given the COVID-19 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: In January 2021 only 9% of U.S. Facebook respondents reported receiving the COVID-19 vaccine, and 45% were vaccine hesitant. By February 2022, 80% of U.S. Facebook 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 or all the time, and identified as white and Asian had higher COVID-19 vaccination rates and lower vaccine hesitancy across Time 1 and Time 2. Essential workers and blue-collar occupations had lower COVID vaccinations and higher vaccine hesitancy. By Time 2, all adults were eligible for the COVID-19 vaccine, but blacks and multiracial individuals had lower vaccination and higher vaccine hesitancy compared to whites. Those 55 years and older and females had higher odds of wearing masks most or all the time. Protective service, construction, and installation and repair occupations had lower odds of wearing masks. ZIP Code level percentage of the population with a bachelors' which was associated with mask wearing, higher vaccination, and lower vaccine hesitancy.

Conclusion: 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.

Keywords: Big data; COVID-19 vaccine; COVID-19 vaccine hesitancy; Health surveys; Mask wearing behavior; Social media.

Fig. 1

COVID-19 vaccination and COVID-19 vaccine hesitancy by time, January 2021-Febrary 2022. COVID vaccinated were U.S. Facebook survey respondents who reported having gotten at least one dose of a COVID-19 vaccine. COVID-19 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 from January 2021 and to February 2022

Fig. 2

COVID-19 Vaccine Hesitancy Reason, Jan 2021-Feb 2022. Hesitancy reasons among vaccine hesitant individuals. Respondents could select multiple reasons

Fig. 3

Mask wearing most/all the time in public (Jan 2021-Feb 2022). Temporal trends in the prevalence of U.S. Facebook survey respondents reporting they were masks most or all of the time in public. X-axis indicates study month from January 2021 and to February 2022