By Jennifer L. Gaskin | Updated January 26, 2021
Though hundreds of thousands of people have been vaccinated against COVID-19 as of mid-January, thanks to a patchwork of protocols for targeting specific groups, there remains much uncertainty about who will be able to get the vaccine and when.
The federal Centers for Disease Control and Prevention (CDC) has recommended that healthcare personnel and individuals who live in long-term care facilities should be first in line, followed by people over the age of 75, and then people over the age of 65. But states have varied their approaches, with some moving to later phases much more quickly than other states.
We wanted to understand how enthusiastic older Americans are about rolling up their sleeves and getting the vaccine, so we surveyed more than 700 people 65 and older on their vaccine plans, living situation, and what factors may hold them back from getting the shot.
Read on for more details of our findings, and check out the topline results below, which we broke into two groups 65-74 and 75+:
- Combining both age groups, about 76 percent of people said they definitely would get the vaccine once it’s available, while only about six percent said they wouldn’t get it.
- Among the reasons most commonly cited for not planning to get the shot were fears of side effects (67 percent), the accelerated process of developing the vaccines (43 percent), and distrust of the pharmaceutical industry (26 percent).
- One in four respondents who have already been vaccinated work in the healthcare industry.
Vaccine Plans
More than three in four survey respondents said they were definitely planning to get the COVID-19 vaccine once it becomes available to them. Just six percent of respondents said they definitely wouldn’t get it, and 16 percent weren’t sure.
| COVID-19 vaccination plans | |
|---|---|
| Yes | 76% |
| No | 6% |
| Not sure | 16% |
| Already received vaccine | 2% |
Respondents of both age groups — 65-74 and 75+ — planned to get vaccinated at a rate of at least 75 percent, with the groups separated by only about a percentage point. Those between 65 and 74 were slightly more likely to say they definitely would not get the shot, while the oldest respondents were considerably more likely than their younger counterparts to be unsure (20 percent vs. 15 percent).
People working in the healthcare field were the most likely to say they planned to get vaccinated — or already had. Only about 16 percent of respondents overall remain in the workforce, but about one in four respondents who are healthcare workers have already been vaccinated. And another 61 percent said they’re planning to, a combined 87 percent.
| Affirmative COVID-19 vaccination plans by area of employment* | |
|---|---|
| Healthcare | 87% |
| Other essential work | 84% |
| Another field | 70% |
* Respondents who said they already had been vaccinated plus those who plan to get vaccinated
Barriers to Vaccine Uptake
What areas are most likely to lead seniors to say they’re not interested or remain unconvinced about getting the vaccine? For all respondents, the most commonly cited concern was fears of side effects, followed by the rushed nature of the vaccine development process.
But there were some interesting differences along age lines. Generally, those between 65 and 74 were more likely across the board to cite any of the concerns included in our survey as their reason for hesitation with a few notable exceptions. While a tiny percentage of those not planning to get vaccination or who remain unsure cited a fear of needles, those 75 and older were about twice as likely to list that as a concern, while they were seven times more likely to report already having COVID-19.
| Reasons for not getting vaccine, by age and overall* | |||
|---|---|---|---|
| Reason | 65+ | 75+ | All |
| Allergy to one or more ingredients | 9% | 8% | 8% |
| Concern about rapid development process | 49% | 33% | 43% |
| Concern about side effects | 73% | 54% | 67% |
| Concern over “microchips” | 14% | 10% | 13% |
| Distrust in Big Pharma companies | 31% | 13% | 25% |
| Distrust in medical system | 20% | 13% | 18% |
| Distrust in medical system due to history of systemic racism (e.g. Tuskegee Syphilis Study) | 10% | 6% | 8% |
| Don’t believe COVID-19 is real | 3% | 2% | 3% |
| Don’t believe I need it | 10% | 13% | 11% |
| Don’t like the ingredients | 4% | 6% | 4% |
| Doubts about effectiveness | 30% | 13% | 24% |
| Fear of needles | 2% | 4% | 3% |
| Have medical condition that prohibits getting vaccine | 6% | 0% | 4% |
| Only use natural/homeopathic medicine | 9% | 6% | 8% |
| Prior bad reaction to another vaccine | 11% | 4% | 9% |
| Tested positive for COVID-19 antibodies | 1% | 8% | 3% |
* Respondents who said they would not get vaccine or weren’t sure
Vaccine FAQs
We also asked survey respondents to share with us what questions they still have about the vaccine and other coronavirus-related areas. Here’s what we gathered from experts.
What are the most common side effects?
Chances are good that you’ll experience at least one side effect after one or both doses of the vaccine, regardless of which one you get. That said, it’s not common to have serious side effects or ones that last more than a few days.
The most common side effects, other than pain and swelling at the site of the injection, are chills, fever, fatigue, and headache. There’s a common misconception that vaccines, including those against COVID-19, can give a person the very disease for which they’re being vaccinated, and the main side effects of this vaccine have perhaps further helped to spur that misbelief.
But the actual cause for this phenomenon is that the body is going through the process of building its immunity to whatever condition you’re being vaccinated against. So in this case, the COVID-19-like symptoms that many people have experienced after getting vaccinated are a result of the body’s natural defenses springing into action, which is exactly what the vaccines are meant to do.
The CDC reports that during the study periods before both the Pfizer and Moderna vaccines were released for widespread public use, local reactions like swelling and pain were the most common (about 80 percent for both vaccines). Systemic reactions like fever, fatigue, headache, and chills were less common, though the majority experienced at least one. However, the Pfizer vaccine study resulted in higher rates of these side effects.
In both cases, few study participants had serious side effects, but both vaccines also had higher reported rates of most side effects after the second dose than the first. For example, in the Moderna study, about 48 percent of participants over 65 reported any systemic side effects after the first dose, but by the time they’d gotten their second dose, that rose to about 72 percent.
All that said, only about 13 percent of seniors in Pfizer’s trial and about two percent in Moderna’s trial reported moderate systemic side effects.
Can people with compromised immune systems get the COVID-19 vaccine?
Yes; in fact, the vaccine rollout in some states already includes these people, regardless of their age. It’s important to consult with your doctor if you do have a compromised immune system, as specific medications you may be taking to suppress your immune system could create an unforeseen reaction to the vaccine.
However, the science behind both the Pfizer and Moderna shots is a big reason why those particular vaccines are less of a concern for those with weakened immune systems than other vaccines might be. For example, people with compromised immune systems are often unable to receive live-attenuated vaccines, which use a depleted but living version of a virus, such as vaccines against chickenpox or shingles.
Both vaccines that have been approved for use in the U.S. use a technology called mRNA, or messenger RNA. They use the genetic code of the coronavirus to train the body’s immune system in how to fight the virus. No version of the virus itself is injected. If you’ve ever had an mRNA vaccine in the past and had a severe allergic reaction, you should not get either of these vaccines.
While the use of this technology in a vaccine program of this scale is new, mRNA vaccines have been studied for influenza, rabies, and Zika virus, and researchers also have used mRNA-based science to target cancer cells.
What is the difference between the two approved vaccines?
The Pfizer and Moderna vaccines are essentially the same in most important aspects; both use mRNA technology and they have similar effectiveness rates (94 percent for Moderna and 95 percent for Pfizer). For this reason, most health experts advise people to get whichever vaccine is available where they live.
As we’ve mentioned, side effects were slightly more common for the Pfizer vaccine during trials, but there are some other aspects to consider. Because of the temperature at which it needs to be stored, the Moderna vaccine may be easier to distribute than the Pfizer shot, which must be kept extremely cold until it’s ready to be injected. Depending on how rural or remote your community is, it may be more likely that the Moderna vaccine is what’s available to you because it is easier to transport and store.
Both require two doses to reach maximum effectiveness, and the Pfizer second-shot window is shorter — 21 days vs. 28 days for Moderna’s shot.
How soon after getting fully vaccinated can you return to normal life?
Importantly, both vaccines were studied for how well they prevent serious illness and not necessarily if or how well they prevent infection. Because of that, it’s not yet known how effective either vaccine is at keeping people from contracting COVID-19; efficacy rates for both vaccines are a measure of how effective they are at preventing symptomatic COVID-19 infections.
What that means in practical terms for people who get the vaccine is that their risk of developing any COVID-19 symptoms is much lower than if they were unvaccinated but that they may still be a risk for contracting or spreading the virus. The vaccines simply have not been around long enough for us to know with any degree of certainty the extent to which vaccinated people can contribute to viral spread, and the initial study periods focused on keeping people from getting gravely ill.
Plus, a 95 percent effectiveness rate is not 100 percent, and it does not take into account your prior risk of getting very sick from coronavirus.
For these reasons, you should plan to continue common-sense safety practices like social distancing, handwashing, and mask-wearing until more people are vaccinated and more is known about how effective the vaccines are at preventing coronavirus infection and not just serious COVID-19 illness.
Once a sufficient number of people have been vaccinated, it’s presumed that the positivity rate, hospitalizations, and deaths will all drop. These may be signs that the U.S. is approaching herd immunity and making strides to completely eradicate COVID-19. If those conditions could be achieved, life would begin to return to something close to normal.
However, researchers don’t yet know the specific percentage of vaccinated people necessary to achieve herd immunity. This rate varies depending on the virus; for example, measles requires about 95 percent of people to be vaccinated, but for polio, the rate is about 80 percent, according to the World Health Organization.
Another complicating factor is that it’s not yet known how long immunity lasts, whether from the vaccine or from natural exposure. Again, the virus and vaccines are too new for scientists to have certainty in these matters.
Conclusion
Those 65 and older account for at least 80 percent of COVID-19 deaths in the U.S., so it’s undeniably good news that most of them seem eager to get the vaccine when their state reaches their phase in the vaccine rollout. However, that also underscores the need to ensure vaccine doses reach those who want (and need) it most.
Methodology
We surveyed 706 older U.S. adults on their plans for receiving the COVID-19 vaccine and what issues might make them not take the vaccine. Our survey was conducted online during the first and second weeks of January 2020.
