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To fight the Delta variant, better understanding of unvaccinated Americans is critical


The highly transmissible and more potent Delta variant of COVID-19 is poised to become the dominant strain in the United States over the next few weeks. We need to stop it in its tracks, and we can, but to do that we need millions more Americans to get vaccinated, and fast.

But how? The U.S. vaccination rollout has been strong, but even so millions of Americans remain unvaccinated. Our organizations, the African American Research Collaborative and the Commonwealth Fund, with additional support from the Robert Wood Johnson and W.K. Kellogg Foundations, polled over 12,000 people to find out all we can about what is standing between our fellow unvaccinated Americans and a shot. Our survey had the largest sample of African Americans, Latinos, Asian Americans, Pacific Islanders and Native Americans of any study of COVID-19 vaccine uptake to date.

This is what they told us.

First, for vaccination, place matters. Fifty-three percent of unvaccinated people prefer to get vaccinated in their personal doctor’s office. But that’s not where most vaccines are being administered. And for those most hesitant to be vaccinated, the current locations are much less popular, with only 13 percent preferring a retail pharmacy, 6 percent a large community-based vaccination site, and 9 percent a clinic set up by their town. This preference for a personal doctor’s office held true for unvaccinated people across all races, genders and ages, and across rural, suburban and urban areas, and regardless of political affiliation.  In fact, rural Americans, Republicans and white Americans without a college degree had some of the highest preferences for getting vaccinated in their doctor’s office.

We believe this preference for getting the vaccine at a doctor’s office reflects people’s desire to go somewhere they trust, that is accessible, and where they can talk to their doctor about their decision – the same as they do with other medical choices. 

Second, discrimination in the medical profession impacts people of color in their vaccination decisions. Over 40 percent of African Americans, Latinos, and Native Americans reported that they or a household member were denied appropriate medical care because of their race, ethnicity or language. This had the biggest impact on unvaccinated African Americans, with 27 percent saying discrimination from medical professionals against Black people made it hard to trust COVID-19 vaccine safety and made them less likely to get vaccinated. 

Another major concern among the unvaccinated is a sense that the Biden administration is pushing the vaccine out too fast — 31 percent of unvaccinated white people and Native Americans reported this. On the other hand, Biden’s election appears to have encouraged many people of color to get vaccinated.  Among the already vaccinated, 28 percent of African Americans, 31 percent of Latinos and 21 percent of Asian Americans and Pacific Islanders reported that Biden winning the election increased their desire to get vaccinated.  

We have work to do now to prepare people for the future. We asked whether Americans would be willing to take an annual COVID vaccination, if boosters were needed. Less than half of all adults (vaccinated and unvaccinated) responded that they would definitely get an annual COVID booster. One in four said they would not.  Native Americans were most opposed, with 30 percent unwilling to get a booster.

Finally, what can we say to unvaccinated Americans to help them change their minds and get the shot?  There is no silver bullet, but one message about love stands out. “Getting a COVID-19 vaccine can protect the lives of my family, friends, and those I love,” scored highest of all tested messages and led 44 percent of the unvaccinated to say they would be more likely to get their shot in the arm. Other strong messages described vaccines as helping reopen local businesses, stop children from losing a parent, return to family occasions and protect elders and culture.

The progress we have made on vaccinations so far is impressive. The U.S. can beat back the Delta variant, stop others from emerging and finish what we started, but our research indicates that to do so, we need to shift our thinking and our policies. We must make it easy for people to get vaccinated in their doctor’s office. We need to speak candidly about discrimination in the medical profession.  And we need to talk more to the unvaccinated about protecting the ones we love, our neighbors and local businesses.

We are so close. If we can remove these remaining barriers of mistrust and concern, we can get there once and for all.

David Blumenthal is president of the Commonwealth Fund and Henry Fernandez is CEO of the African American Research Collaborativea polling, quantitative and qualitative research firm.

Tags covid-19 delta COVID-19 vaccine the commonwealth fund Vaccination vaccine efficacy Vaccine hesitancy

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