Study Explores U.S. Public Attitudes Toward COVID-19 Vaccine Mandates

Ending the coronavirus disease 2019 (COVID-19) pandemic through vaccination will require sufficient uptake, possibly through mandatory vaccination. At present, certain vaccines are required for children to attend school. Although vaccine mandates for adults are legal, they have generally been applied narrowly to select groups, such as healthcare workers, rather than broadly enforced. Largent, et al. (2020) surveyed the U.S. public to assess acceptability of COVID-19 vaccine mandates.

The University of Pennsylvania institutional review board exempted this survey study because the survey was anonymous and the information was recorded in such a way that the identity of the respondents cannot be ascertained. The survey followed proprietary Gallup guidelines.

Results are based on a Gallup Panel web study completed between September 14 and 27, 2020, by 2730 consenting US adults, aged 18 years and older. Participants consented through the survey website. The survey response rate was 39% (American Association for Public Opinion Research RR1). The Gallup Panel is a well-established, probability-based panel. Respondents were asked about the acceptability of states requiring adults and children and employers requiring employees to “get the COVID-19 vaccine (unless they have a medical reason not to be vaccinated).”

Descriptive statistics were calculated using Gallup-provided survey weights to generate nationally representative estimates. Respondents’ answers were compared using χ2 tests accounting for survey weights. Statistical significance was set at α = .05 for 2-tailed tests. Analyses were conducted using R statistical software version 4.0.2 (R Project for Statistical Computing).

The sample was weighted to be demographically representative of the US population (Table). Overall, 61.4% (95% CI, 60.0%-63.0%) of respondents indicated they would likely get a COVID-19 vaccine. Republicans and Independents were, however, significantly less likely to get vaccinated than Democrats (Republicans, 44.3% [95% CI, 41.7%-46.8%]; Independents, 58.4% [95% CI, 55.5%-61.1%]; Democrats, 76.6% [95% CI, 74.7%-78.5%]), and Black respondents were significantly less likely than non-Black respondents to get vaccinated (43.6% [95% CI, 39.2%-48.2%] vs 63.7% [95% CI, 62.3%-65.2%]).

Nearly one-half (48.6%; 95% CI, 44.8%-53.0%) of respondents regarded requiring COVID-19 vaccination for children attending school as acceptable or very acceptable (hereafter, acceptable), and 38.4% (95% CI, 34.6%-42.0%) regarded it as unacceptable or very unacceptable (hereafter, unacceptable) (Figure). Although 40.9% (95% CI, 37.2%-45.0%) of respondents found state mandates for adults acceptable, 44.9% (95% CI, 41.0%-49.0%) found them unacceptable. Compared with state mandates for adults, slightly more respondents (47.7%; 95% CI, 43.8%-52.0%) found employer-enforced employee mandates acceptable, whereas 38.1% (95% CI, 34.4%-42.0%) found them unacceptable.

Individuals likely to get a COVID-19 vaccine accepted mandates at higher rates than those unlikely to do so (mandates for children, 73.6% [95% CI, 68.5%-78.1%] vs 23.7% [95% CI, 19.4%-28.7%]; mandates for adults, 65.0% [95% CI, 59.7%-69.9%] vs 17.3% [95% CI, 13.6%-21.7%]; mandates for employees, 72.5% [95% CI, 67.3%-77.1%] vs 22.9% [95% CI, 18.6%-27.8%]). Democrats were likelier than Republicans and Independents to accept state mandates for children (Republicans, 27.4% [95% CI, 21.5%-34.2%]; Independents, 44.0% (95% CI, 36.5%-51.7%); Democrats, 70.2% [95% CI, 64.3%-75.7%]) and adults (Republicans, 22.6% [95% CI, 17.1%-29.3%]; Independents, 34.0% [95% CI, 27.1%-41.5%]; Democrats, 60.8% [95% CI, 54.6%-66.6%]) and employer-enforced employee mandates (Republicans, 31.0% [95% CI, 24.8%-37.9%]; Independents, 41.0% [95% CI, 33.7%-48.8%]; Democrats, 66.0% [95% CI, 59.9%-71.7%]). Compared with non-Black respondents, fewer Black respondents accepted state mandates for adults (42.7% [95% CI, 38.7%-46.8%] vs 27.0% [95% CI, 17.5%-39.2%]), and more found them unacceptable (43.1% [95% CI, 39.1%-47.2%] vs 58.4% [95% CI, 45.7%-70.1%]). Respondents with a bachelor’s degree or higher were likelier to find mandates acceptable than those without (mandates for children, 66.0% [95% CI, 60.1%-71.4%] vs 39.7% [95% CI, 34.9%-44.6%]; mandates for adults, 56.4% [95% CI, 50.4%-62.2%] vs 32.9% [95% CI, 28.3%-37.7%]; mandates for employees, 62.4% [95% CI, 56.5%-68.0%] vs 39.9% [95% CI, 35.2%-44.9%]). No gender differences were observed.

Reference: Largent EA, et al. US Public Attitudes Toward COVID-19 Vaccine Mandates. JAMA Netw Open. 2020;3(12):e2033324. doi:10.1001/jamanetworkopen.2020.33324

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