This secondary analysis of the CEAL Common Survey 2 (November 2020–November 2022) examined demographic factors associated with COVID-19 vaccine hesitancy, trust in physicians and institutions (e.g., CDC, FDA), and reasons for vaccine refusal among 13,802 U.S. residents across 21 sites.
Over 12% of respondents were unvaccinated; Non-Hispanic Black participants had the lowest vaccination rate (81.78%) vs. Non-Hispanic White (91.80%). Educational gradient was steep: 20.78% of those with a high school education were unvaccinated vs. 6.18% with a graduate degree. Adults 55+ were less likely to be unvaccinated than younger participants. While <5% distrusted their doctors, >40% distrusted the FDA to ensure a safe pediatric vaccine. Racial and educational differences existed in specific reasons for non-vaccination (e.g., needle aversion, community disapproval).
Secondary analysis limits causal inference. Survey respondents may not be nationally representative despite multi-site recruitment. Full text was inaccessible, so granular methodological details (e.g., sampling strategy, response rates) could not be verified.
Tailored vaccine outreach is needed by subgroup: address community-level norms and needle aversion in lower-education and minority communities, and prioritize rebuilding FDA trust for pediatric vaccine uptake. A single-message campaign is unlikely to reach all hesitant groups equally.
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