Estimates of
vaccine hesitancy
for COVID-19


Due to the change in the survey instrument regarding intention to vaccinate, our estimates for “hesitant or unsure” or “hesitant” derived from April 14-26, 2021, are not directly comparable with prior Household Pulse Survey data and should not be used to examine trends in hesitancy.
The above map shows estimates of COVID-19 vaccine hesitancy rates using data from the U.S. Census Bureau’s Household Pulse Survey (HPS). We estimate hesitancy rates in two steps. First, we estimate hesitancy rates at the state level using the HPS for the collection period April 14, 2021 – April 26, 2021, which is referred to as Week 28. Then, we utilize the estimated values to predict hesitancy rates in more granular areas using the Census Bureau’s 2019 American Community Survey (ACS) 1-year Public Use Microdata Sample (PUMS). To create county-level estimates, we used a PUMA-to-county crosswalk from the Missouri Census Data Center. PUMAs spanning multiple counties had their estimates apportioned across those counties based on overall 2010 Census populations.

How did we get this DATA?

  • We use the HPS survey question, “Once a vaccine to prevent COVID-19 is available to you, would you…get a vaccine?”, which provides the following options: 1) “definitely get a vaccine”; 2) “probably get a vaccine”; 3) “unsure”; 4) “probably not get a vaccine”; 5) “definitely not get a vaccine.” We note that for the survey collection period April 14-26, 2021, the survey question was changed to include the response option of “unsure” for the first time. We use three definitions to capture the strength of hesitancy to receive a vaccine.
    • Strongly hesitant: includes only survey responses indicating that they would “definitely not” receive a COVID-19 vaccine when available.
    • Hesitant: includes survey responses indicating that they would “probably not” or “definitely not” receive a COVID-19 vaccine when available.
    • Hesitant or unsure: includes survey responses indicating that they would “probably not” or “unsure” or “definitely not” receive a COVID-19 vaccine when available.
  • Full methodology for estimates of COVID-19 vaccine hesitancy is available here.
  • Demographic data were obtained from the 2019 American Community Survey (ACS) 5-year estimates.
The percent of adults (18+) in the population who are fully vaccinated was obtained from the CDC COVID-19 Data Tracker, Integrated County View as of May 9, 2021. Vaccination rate data may not be available for all states. Systematic missing data in some states may result in vaccination coverage by county appearing artificially low.
Social Vulnerability Index
Overall social vulnerability index was obtained from the 2018 CDC Social Vulnerability Index.  The CDC's Social Vulnerability Index (SVI) summarizes the extent to which a community is socially vulnerable to disaster. The factors considered in developing the SVI include economic data as well as data regarding education, family characteristics, housing language ability, ethnicity, and vehicle access. SVI values range from 0 (least vulnerable) to 1 (most vulnerable). The SVI can also be categorized as follows: Very Low (0.0-0.19), Low (0.20-0.39); Moderate (0.40-0.59); High (0.60-0.79); Very High (0.80-1.0).
COVID-19 Vaccine Coverage Index
The Surgo Covid-19 Vaccine Coverage Index (CVAC) captures supply- and demand-related challenges that may hinder rapid, widespread COVID-19 vaccine coverage in U.S. counties, through five specific themes: historic undervaccination, sociodemographic barriers, resource-constrained healthcare system, healthcare accessibility barriers, and irregular care-seeking behaviors. The CVAC measures the level of concern for a difficult rollout on a range from 0 (lowest concern) to 1 (highest concern). The CVAC Index can also be categorized as follows: Very Low (0.0-0.19), Low (0.20-0.39), Moderate (0.40-0.59), High (0.60-0.79), or Very High (0.80-1.0) Concern.