What We Can Learn From America’s Most Recent COVID-19 Vaccine Converts
One in four American adults is unvaccinated or only partially vaccinated, and that number isn’t budging much these days. Fewer than 80,000 adults are getting their first shot every day—a 96% drop from the more than 2 million a day in April 2021. It’s easy to believe that anyone who hasn’t gotten a shot by now is unlikely to get one in the future—but there is still a group of people, however small, just finally coming around to the vaccine. What are the names of these individuals? What is the reason they waited so long for the shot to be delivered?
TIME analyzed the Centers for Disease Control and Prevention (CDC), vaccination survey data for adults in the United States to discover this. This survey began in April 2021 and shows how eager people are to get the shot. It also shows how different demographics’ vaccination rates have changed.
Certain segments of the population were slow out of the gate, but managed to catch up to—or even surpass—the national average by January 2022, according to TIME’s analysis. Mostly, these are America’s marginalized communities: Black and hispanic people, LGBTQ people, those living in under-resourced counties, and the uninsured. Vaccine uptake among these groups didn’t happen in a sudden rush in early 2021 but rather at a slower, steadier pace over much of the last year. Community health organizations say that’s because certain demographics have required more personal outreach, information, and support than the initial federal vaccine rollout offered.
It is more difficult to determine who remains on the fence. Only 5% of Americans are willing or able to get vaccinated, according to CDC data. TIME arrived at this number by adding up the respondents who said they are “definitely” or “probably” going to get vaccinated, and those who said they were still “unsure.” In contrast, 10% of the survey takers are unwilling: they reported to the CDC that they “probably” or “definitely” will not get vaccinated. The following charts are examples of the definitions.
But the overall numbers don’t tell the whole story. TIME’s deeper analysis reveals that some subgroups of the unvaccinated population have more potential to come off the fence than others.
If the country’s vaccination rate ticks higher, it will likely be because people who are still feeling unsure today finally took the plunge. They are searching for them through grassroots organizations. But they’re not always easy to spot. The CDC data show that willingness isn’t necessarily tied to a person’s race, gender, or any other topline demographics. More nuanced factors such as work mandates, friends’ and family opinions, and political influences are all part of the equation.
TIME interviewed several people who were vaccinated in the period December through March to better understand this complexity. All spoke candidly—and sometimes emotionally—about their decisions. And though their vaccine experiences are as diverse as their backgrounds, just about everyone agreed that the choice wasn’t easy. The stories of these individuals, although personal, provide context for those from wider populations that are included in the data..
A gentle nudge from someone you know
Chris Fisher (36), a Stone Lake resident, Wisc. was staunchly against the vaccine up until December. “I’m just [not the type] of, well, ‘everybody else is doing it, so let’s go do it.’ I wanted to make sure that’s not gonna affect everybody else,” he says. “My initial thought was they came up with this way too quick. They take years and years to learn how to do any other vaccine. And I mean, within less than a year, they had this one popping out.”
Fisher didn’t feel that he was at risk of getting COVID-19 given that he worked outdoors at a cranberry marsh and steered clear of intimate gatherings. Fisher settled down to a long wait-and-see period. As more people in his circle got vaccinated, he became more comfortable with it. “Once I started chatting with other people that have gotten it and it hasn’t really affected them or interfered with anything then I figured it was all right to go get it,” he says.
Patricia, his wife who was vaccinated, persuaded him to give the shot, in the end.
One of the greatest predictors of a person’s vaccination status is whether those they love and trust are vaccinated. Over 90% of those who claim to have many vaccinated relatives and friends also report that they are vaccinated. But among people who only have a few vaccinated family and friends, the rate drops to 55%, according to TIME’s analysis.
s the holidays approached, Fisher’s desire to see his grandparents—who are in their 80s and in poor health—and Patricia’s insistence that in order to do so, he needed to get vaccinated, won him over. Fisher got his first shot right before the new year and plans to visit his grandparents once he has had the second one.
He met a former colleague days after his first dose and was soon diagnosed with the disease. Fisher was soon diagnosed with the virus and took a second dose. The second shot was postponed by Fisher, which further delayed his plans for travel. He has no regrets. “It was just one of them weird situations,” he says. “You got to take the punches where they come.”
Resolving cultural differences
Spanish-speaking Americans are among the most open to getting vaccinated according to TIME’s data analysis. 86% of those surveyed have had at least one dose. Only 3% of the remaining respondents expressed no or little interest in being vaccinated.
The reason for vaccine hesitation in Latino immigrants is frequently tied to their immigration status, according Helena Olea. Those who are awaiting court permission to stay in the country often worry that use of free public benefits—like a government-funded vaccination—could adversely impact their legal case. Undocumented immigrants worry that they could be deported or subject to other legal actions if they share personal information. With the COVID-19 vaccines, says Olea, “there was a concern that even when they requested the appointment, too much information was being asked.”
Immigrants had many difficulties getting vaccines at the beginning of the rollout. Many of the resources materials weren’t available in Spanish. There weren’t many vaccination sites, and some of them were difficult to get to, and often didn’t have a Spanish speaker to translate or answer questions.
Through the years, many grassroots groups have attempted to resolve these issues by organizing vaccination drives and information campaigns at convenient times and places. Olea believes that vaccine mandates would be a great approach to this population. She says that Latin American immigrants often comply with state policies, which outline the exact requirements. “It’s absolutely cultural,” Olea says. “It’s like, ‘Tell me what to do. Tell me what’s safe, and I will follow.’”
J. Rodriguez is an undocumented worker, who arrived in America at the age of 15. He spends his winters in Florida at a plant nursery, while summers in Minnesota at a midwest golf course. When the COVID-19 shots became available, he didn’t rush to get vaccinated. “I wasn’t sure if I needed the vaccine,” he says in Spanish. “I didn’t want it and they weren’t demanding it at work. So I didn’t do it.” Logistics were also difficult. “I work nine or 10 hours a day, so that also played a part in me not getting vaccinated.”
Rodriguez (whose name has been changed to protect his identity) also had some initial reservations about the vaccine’s safety after hearing from a friend that someone had died after taking it. Rodriguez believes the cause of his death may have been related to other medical conditions. Rodriguez was comfortable with getting vaccinated when he found out that the course required him to get it. In mid-February, Rodriguez got his first dose at a vaccination drive run by one of Alianza Americas’ health campaigns.
“I’m not worried any more,” Rodriguez says. “I’m more worried about catching COVID in crowded places.”
Grappling under race-driven mistrust
Monique Burroughs (48), Ellicott City. Md. didn’t believe there was enough information about the vaccines when they first became available. As she felt greater pressure to have it, her hesitation only grew.
“Between the government getting involved and the way they were really pushing it, it made me nervous because I felt like there was an ulterior motive,” she says. “I didn’t like the way they were portraying it. Like, you get vaccinated and you will be cleared, or…you don’t have to worry about catching it. And I didn’t feel that was truthful.”
Burroughs believes her African American experience has influenced her decision-making. She’s been leery of the ever-changing COVID-19 guidance since the early days of the virus, when she found out that Black communities in her area were being hit hardest. While Maryland has allowed for the use of masks, most Americans have not. She has continued to wear a mask. Burroughs harbors a general distrust of government health policies, and she was particularly turned off by pressure from her employer, a state agency, to get vaccinated—even though she works from home. “It makes you sort of feel like you’re just being forced. And they’re not trying to give you any information, they’re just like, you need to go do this.”
Burroughs’ viewpoint isn’t uncommon. According to Michael Rhein, President and CEO at InstitutePHI, Washington, D.C., which is a non-profit health organization serving communities of color, mistrust has played a major role in vaccine hesitancy among Black communities. The mistrust results from generations of racism in American health care systems and historical inequalities. Rhein believes, however, that this group of people could “change their minds when they have the right messenger and they don’t feel like it’s the government or white-controlled institutions that are telling them to get vaccinated.”
TIME’s analysis of CDC data found that Black people—particularly those between ages 18 and 49—are the only segment of the U.S. population that has both a below-average vaccination rate (74% compared with 85% for all adults) and, among the remaining unvaccinated population, a majority with some degree of willingness to get the shot.
In November, Burroughs’s husband got so sick with COVID-19 that he needed to be hospitalized. Burroughs also contracted the virus and fell ill. However, he was able to recover at home. Both decided to take shots after that. They felt more confident about the vaccination and thought that additional protection might be beneficial if they contracted the virus again. Burroughs received her full vaccination in January. She’s still deciding whether or not to get a booster.
Studying science and blocking partisan rhetoric
LJessica Greenhow, 44 years old, from Eau Claire, Wisc. took the job of outreach coordinator at Indianhead Community Action Agency. She was responsible for educating the public about COVID-19 and helping people get to vaccination sites if they were interested. The only problem was that Greenhow wasn’t herself vaccinated, and she wasn’t comfortable broaching the subject with community members.
“I didn’t have a problem with people getting the vaccine,” she says. But, she didn’t want to start a debate about the merits of her own choice. “There was a lot of judgmental people and I didn’t want to get into it. It’s like avoiding a politics conversation or a religious conversation—you didn’t want to get in a heated conversation about it.”
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Since shots were given, Republican-leaning states have experienced lower vaccination rates that Democrat-leaning. Those that are more evenly split have closely followed the national averages—both in terms of vaccination rate and willingness among the unvaccinated.
Greenhow lives in a relatively politically diverse area—Joe Biden took 54% of the Eau Claire county’s votes in the 2020 election, while Donald Trump took 44%—and she doesn’t consider herself either a Democrat or a Republican and often sees the middle ground on hot button issues. Greenhow was made to understand the process of vaccine development and she did so after accepting the job. She came to understand that the vaccines had been years in the making by teams of scientists around the world, and that human trials weren’t shortened, but rather done simultaneously so that the process could be both rigorous and efficient. She also studied how the vaccine worked in the body and realized that, despite misinformation she knew was floating around, the vaccine had no way to alter a person’s DNA.
According to her, the learning process was difficult. “When I was starting to do the research on it, [so] many times I was popping up another window, because I had to type in a word to get the definition because I was not understanding anything I was reading,” she recalls.
Greenhow received her first shot in February, and her second earlier this month from a pharmacist. She is encouraging her teenager children to be vaccinated. She wants to be respectful of their decisions, but she’s hopeful that providing them with resources and answering their questions will reassure them that it’s safe. Sometimes, she asks for their input on her distribution materials, knowing that they’re learning from them. “It’s like sneaking vegetables in the supper,” she says.
Familial feuds, employer mandates
Jessica Howard, 40 years old, is a Salyersville, Ky. certified nursing assistant. She has several health conditions, including borderline diabetes, chronic obstructive and pulmonary disease (COPD), high blood pressure, and borderline diabetic. After quitting smoking for a time, she recommenced when COVID-19 helped to soothe her nerves. Howard, a nurse home worker, was under great stress, as is the case with many other health care workers. She recalls that many of her residents became ill during the outbreak of the pandemic. Their health was a concern. She worried about her family’s health. Her own well-being was also a concern.
Howard, who was high-risk and obsessed with wearing protective gear such as a mask, became obsessive. But when the vaccines came out, she wasn’t ready to commit. The vaccine was not approved for her full use. She also worried about its effects. Howard misinformed her about the dangers of the shot and encouraged her doctor to give the shot.
“It’s common to hear things, and you can see what I mean. Everybody’s like, if you have any bad health issues, it can bring them out and people can die from it. With my luck, I’d take it and probably fall over,” she says.
Month after month, Howard didn’t get sick, even as she cared for infected people. This gave Howard some comfort that her preventative measures had been sufficient to protect her. Then, in August, the same month that the FDA fully approved the Pfizer-BioNTech vaccine, Howard’s husband tested positive, and she soon followed. The illness, she says, made her so sick that it was “like an out of body experience.” Howard recovered slowly at home, and then underwent surgery for an unrelated issue. Her employer issued her a mandate to get vaccinated before she could return to work at year’s end.
About a third of Americans say their work or school requires vaccination—and nearly all of them report being vaccinated. The vaccination rate for those who do not have to be vaccinated is 78%.
Howard sought help from her friends and family as she struggled to balance her fear of her job with her concerns. Her daughter, who had stopped attending school due to her college’s vaccine requirement, was adamantly against it. She was also encouraged to get vaccinated by her mother who has many health issues and is now a nurse. Her doctor encouraged her to continue to receive it.
“I was debating on it,” Howard recalls. “I wanted to go back to work, but then I was like, nah, I ain’t taking that shot. I prayed about it and stuff and I said, Lord, I hope this ain’t what will take me out. I was scared of it.”
Howard received her first shot in December, and her second in January. She says that the only side effect was temporary fatigue. Since then, she’s encouraged others to get vaccinated, but the issue has polarized the family, some of whom believe that getting vaccinated runs counter to their religious beliefs. “They won’t even hardly talk to me now because I took the shot,” says Howard. Was her daughter okay? “She’s still saying I was crazy for taking it.”
—With reporting by Ciara Nugent