Published: April 28, 2021 | The Senior List Research Team
More than eight in 10 U.S. deaths from COVID-19 since the pandemic began have been among those 65 and older, which is the main reason why initial vaccine rollouts largely targeted older adults.
But with an estimated 37 million older adults now fully vaccinated, according to CDC data through April 24, and another eight million having gotten their first of two doses, fewer than one in five Americans 65 and older remain completely unvaccinated.
We wanted to check in with older adults, both vaccinated and unvaccinated, about how their behavior and feelings of isolation have changed over the course of the COVID-19 crisis. We’ve conducted a total of five surveys of adults 65 and older since mid-March, getting more than 2,500 responses that helped us understand the emotional toll the COVID-19 pandemic has had on older Americans.
Here are some key findings of our April 2021 survey:
- Higher-income seniors are much more likely than those with incomes less than $50,000 to be fully vaccinated. Twenty-two percent of those making less than $50,000 per year aren’t vaccinated compared to just 11 percent of those with six-figure household incomes.
- Feelings of isolation and loneliness have not yet dropped to pre-pandemic levels. 4 in 10 older adults say they feel more lonely today than before the pandemic, which also represents a seven-point drop from December.
- Those who are between their first and second vaccine doses are generally more active when it comes to in-person gatherings than other groups: About 33 percent of this group say they’re going to indoor gatherings of more than 10 people, compared to 17 percent of all respondents.
Take a closer look at our previous survey installments:
- March 2020 – How Seniors are Adapting to COVID
- April 2020 – A Month Into Social Distancing
- July 2020 – Seniors and Loneliness Over the Summer
- December 2020 – Senior Isolation Peaking as Holiday Season Begins
Men, High-Income Seniors More Likely to be Vaccinated
According to the most up-to-date CDC data available, about 81 percent of people 65 and older have received at least one dose of a two-dose vaccine or the single-shot option, which largely tracks with our survey group, 84 percent of whom said they were at least partially vaccinated.
Men in our survey were more likely than women to report being both fully and partially vaccinated, while about 17 percent of women in our survey haven’t had a vaccine dose of any kind.
| Self-reported COVID-19 vaccine status by gender | ||
|---|---|---|
| Vaccine status | Women | Men |
| Full | 77% | 81% |
| Partial | 6% | 7% |
| None | 17% | 12% |
People in households with six-figure incomes were more likely to be vaccinated. In fact, compared to those with household incomes below $50,000, older adults from households with incomes of at least $100,000 were 21 percentage points more likely to be fully vaccinated and half as likely to be totally unvaccinated.
| Self-reported COVID-19 vaccine status by household income | |||
|---|---|---|---|
| Vaccine status | <$50,000 | $50,000-$99,999 | $100,000+ |
| Full | 66% | 84% | 87% |
| Partial | 11% | 6% | 1% |
| None | 22% | 10% | 11% |
Whether this is an issue of access or lack of desire to be vaccinated (or both) is unclear, but this trend generally holds when looking at results of other surveys. For example, a Morning Consult survey published April 22, just a few days after our survey concluded, found that only 58 percent of Americans earning under $50,000 per year were already vaccinated or planned to get the shot; nearly one in four people in that income bracket said they would not be getting vaccinated. However, that survey found that only nine percent of older adults don’t plan on getting vaccinated.
We know that older adults are by far the most likely to have a serious illness if they become infected with COVID-19, and outbreaks in nursing homes and other congregate settings that are popular among older adults remain of great concern nationally. A recent outbreak in a Kentucky nursing home was traced to an unvaccinated worker, and in Colorado, a rise in cases is being attributed in part to unvaccinated residents of long-term care facilities.
Senior Loneliness Rate Falls After Widespread Vaccine Rollout
For many people of all ages, in addition to fears of long-term health effects, the pandemic has increased social isolation and loneliness. In fact, a Harvard study in October found that more than one-third of Americans reported feeling serious loneliness, measured by feeling lonely “frequently,” “almost all of the time,” or “all of the time.”
While our surveys have shown varied results for older Americans, before the Christmas holiday, loneliness had been generally trending downward. But our December 2020 installment saw feelings of loneliness in older adults at their highest levels, with just under half saying they were lonelier than before the pandemic.
As vaccines have rolled out not just to seniors but to all adults no later than May 1, our April 2021 survey shows that the loneliness tide may be turning.
In our first installment (March 2020), only 10 percent of seniors said they were lonelier than before the COVID-19 crisis, but that survey was conducted before most major lockdowns and activity restrictions began.
The percentage of seniors who say the pandemic has increased their feelings of isolation reached its lowest level (39 percent) in April 2021 and July 2020. Still, throughout most of the pandemic crisis, the majority of older adults say it hasn’t made them feel lonelier than they were before it began.
| Older adults’ assessment of how pandemic has impacted their feelings of loneliness by survey month | |||
|---|---|---|---|
| Month | More lonely | Less lonely | No different |
| March ‘20 | 10% | 4% | 86% |
| April ‘20 | 40% | 3% | 57% |
| July ‘20 | 39% | 4% | 57% |
| December ‘20 | 46% | 5% | 50% |
| April ‘21 | 39% | 4% | 57% |
Women have consistently been more likely than men to say they feel lonelier than before the pandemic. However, while both men and women were less likely in April 2021 than in December 2020 to say the pandemic has them feeling lonelier, women saw a better bounceback than men.
| Percentage of older adults who say pandemic made them feel more lonely by gender and survey month | ||
|---|---|---|
| Month | Women | Men |
| March ‘20 | 12% | 7% |
| April ‘20 | 47% | 29% |
| July ‘20 | 46% | 30% |
| December ‘20 | 52% | 38% |
| April ‘21 | 42% | 36% |
Living situation has a big impact on feelings of loneliness, which is not surprising, and those in senior living settings have generally been the most likely to report feeling lonelier during the pandemic than before.
| Percentage of older adults who say pandemic made them feel more lonely by survey month, living alone vs. senior living vs. all respondents | |||
|---|---|---|---|
| Month | Alone | Senior living | All |
| March ‘20 | 13% | 20% | 10% |
| April ‘20 | 46% | 38% | 40% |
| July ‘20 | 42% | 47% | 39% |
| December ‘20 | 51% | 61% | 46% |
| April ‘21 | 40% | 48% | 39% |
In March 2020, before most activity restrictions began, about one in five senior living residents said they felt lonelier since the pandemic crisis compared to 10 percent of seniors overall. Today, while 39 percent of all respondents say they’re lonelier, that number is closer to half (48 percent) for those living in senior care or similar facilities.
Bars, Restaurants Most Popular In-Person Activity
While the CDC recommends vaccinated people still avoid certain activities, such as large gatherings, and mask-wearing is still advised in public, frequent interaction with people outside their household has gone up considerably for older adults.
About 39 percent of respondents, regardless of vaccine status, said they were interacting with folks from outside their household a few times per week in April 2021, up from 30 percent in December and 25 percent this time last year.
Interestingly, while unvaccinated respondents were more likely than others to say they have weekly contact with people outside their household, vaccinated people are much more likely to interact with others on a daily basis.
| In-person interaction frequency with non-household members | |||
|---|---|---|---|
| Vaccine status | Daily | Weekly | Monthly |
| Vaccinated | 32% | 50% | 18% |
| Unvaccinated | 22% | 57% | 21% |
| Note: “Vaccinated” includes full and partial | |||
Visiting restaurants and bars was the most common in-person social activity seniors said they were participating in, both for those who are vaccinated or unvaccinated. Outdoor social events and in-person religious services were the second and third most popular overall, respectively, after the percentage who said they weren’t doing any of these activities (34 percent).
| Percentage of older adults reporting engaging in activity | |
|---|---|
| Visiting restaurants and bars | 43% |
| None | 34% |
| Outdoor social events with more than 10 people | 23% |
| Attending in-person religious services | 19% |
| Indoor social events with more than 10 people | 17% |
| Attending in-person fitness classes or hobby groups | 10% |
| Visiting large venues like museums, amusement parks, zoos, etc. | 10% |
| Going to movie theaters | 4% |
Unvaccinated people are more likely than those who have had at least one dose to say they’re visiting bars or restaurants. It’s possible that many of those who haven’t yet been vaccinated never stopped going to restaurants or bars, but when considering both partially and fully vaccinated people and how they differ from unvaccinated people, there were a few distinctions.
The biggest was visiting large venues like museums or amusement parks, with about 13 percent of unvaccinated seniors saying they’re doing that compared to only nine percent of vaccinated seniors. Unvaccinated seniors were also twice as likely as vaccinated seniors to say they’re going to the movies (six percent vs. three percent).
But worryingly, in many cases, partially vaccinated people, meaning those who have received only one of a two-dose vaccine, were the most active of the three groups. And in all but one case, they were more likely than fully vaccinated people to report doing any of these activities. It’s important to note that this represents a small group in our survey.
There are any number of reasons why rushing out to your formerly favorite in-person activities while you’re in between vaccine doses is a bad idea. The most obvious, of course, is that the vaccine reaches its full protection level between 10 and 14 days after the second dose, or 14 days after the Johnson & Johnson single-shot vaccine.
Other big problems include the fact that all three vaccines approved in the U.S. have varying efficacy rates, some are less effective for older people, and their effectiveness against variants isn’t well-understood yet.
The biggest risk is in a so-called “breakthrough infection,” or a diagnosed COVID-19 infection in a fully vaccinated person. These cases represent less than one-thousandth of a percentage point of all people who have been fully vaccinated, but those 60 and older accounted for nearly half, while women made up about two-thirds.
Conclusion
The past year has been one unlike any other, and the cabin fever most of us are experiencing is real and challenging. But while there’s certainly good news to celebrate, you don’t win a race by slowing down when the finish line is in sight, and given that they remain the most at-risk group, older adults should continue to stay the course until the virus is behind us.
Methodology
Since mid-March 2020, we have surveyed more than 2,500 Americans 65 or older about how the pandemic has affected their lives and whether it’s caused them to feel more lonely than before the crisis began. The most recent installment was completed online April 19-20, 2021, and the other installments were conducted online over the course of 2020 (March, April, July, and December).
