Population Attributable Fraction of Non-Vaccination and Under-Vaccination of COVID-19 Due to Vaccine Hesitancy, 2022.

Non-vaccination and under-vaccination with the COVID-19 vaccine may be attributed to multifaceted barriers including hesitancy and access issues. Using data from the CDC's Research and Development Survey, a nationally representative survey fielded from November 3, 2022 - December 12, 2022 (n=6,821), we examined the adjusted population attribution fraction (PAF) of COVID-19 non-vaccination and under-vaccination attributed to vaccine hesitancy by sociodemographic characteristics. Overall, the adjusted PAF of non-vaccination attributed to vaccine hesitancy was 84.8%, and the adjusted PAF of under-vaccination attributed to vaccine hesitancy decreased with increasing COVID-19 vaccine doses (76.0%, 41.0%, and 16.9% for ≥2, ≥3, and ≥4 doses, respectively). The proportion of adults who considered the social benefit of the vaccine, risk of contracting COVID-19, and information received from a medical provider increased with greater number of COVID-19 vaccine doses received. In contrast, the proportion of adults who were concerned about long-term impacts, speed of vaccine development and personal risk of getting vaccinated decreased with greater number of COVID-19 vaccine doses received. Understanding the PAF estimates from the acute phase of the pandemic serves as an important comparison for post-pandemic vaccination estimates, and is needed for messaging as COVID-19 cases, hospitalizations, and deaths resurge in the fall of 2024.