A summary of presentations from the weekly Summit partner webinars


April 15, 2021

COVID-19 Vaccination Coverage Update – Kamil Barbour (CDC)

Commander Kamil Barbour, lead for CDC’s Epidemiology and Analysis Team within CDC’s Data Monitoring and Reporting Section, gave a presentation outlining the current estimates for COVID-19 vaccination coverage in the United States.

Two complementary data streams serve as the main sources of information on vaccine coverage: (1) state and local immunization information systems (IIS) and (2) a variety of surveys coordinated by CDC.  Each source differs in the variables that may be analyzed. For example, the IIS data includes basic vaccination coverage information on the number of doses used, when they were given, and demographic and location information for vaccine recipients. The survey data also looks at vaccine coverage, but it offers more insight into additional variables to aid in analyses, such as looking at reasons for vaccine hesitancy and more detailed information on individual vaccine recipients, including occupation, comorbidities, income, education, and knowledge about different vaccines.

As of April 14, almost 124 million persons in the U.S. (37.3%) have received at least one dose of COVID-19 vaccine, and 23.1% have been fully vaccinated. This coverage varies by age, with 47.6% of persons age 18 and older and just under 80% of persons age 65 or older having received at least one dose. Almost 195 million doses of COVID-19 vaccine have been administered so far, with the bulk of these (187 million) being the mRNA vaccines from Pfizer-BioNTech and Moderna, with an additional 7.5 million doses being the Janssen (Johnson & Johnson) vaccine.

Obtaining race/ethnicity data on vaccine recipients has been challenging, but concerted efforts have resulted in improvements in this reporting over the last 2 weeks. Coverage data also is assessed on four main components of the Social Vulnerability Index (SVI), i.e., socioeconomic status, household composition and disability, minority status and language, and housing type and transportation. This information was highlighted in a recently published MMWR article, County-Level COVID-19 Vaccination Coverage and Social Vulnerability — United States, December 14, 2020–March 1, 2021.  Overall, this examination indicated those with the highest levels of vulnerability were experiencing lower vaccination coverage than those with lower levels of vulnerability. Unfortunately, an examination of the data indicates this gap in vaccine coverage is widening over time.

CDC is conducting multiple analyses to provide additional information on vaccine coverage. Several of these relate to querying IIS data to look at vaccination coverage in different age groups and by urban/rural differences. Results of these will be published in future MMWRs.

Increasing COVID-19 Vaccine Confidence among the “Moveable Middle” – Brittney Baack (CDC)

Brittney Baack is the Chief Medical Officer for CDC’s Vaccinate with Confidence Team. This group is conducting continual assessment to understand who is vaccinated (or intends to be vaccinated) and examine the factors behind vaccine confidence/hesitancy. Dr. Baack’s presentation included multiple graphs and charts to illustrate the information highlighted below.

In general, vaccine confidence is the trust that patients, parents, and providers have in recommended vaccines, the providers who administer vaccines, and the processes and policies that lead to vaccine development, licensure, manufacturing, and recommendations for use. But to improve vaccine coverage, this element of trust must be built on a foundation of vaccine access and equity.

Vaccine confidence can change over time and is expressed by behaviors on a spectrum ranging from absolute refusal to a demand to be vaccinated. Motivation to be vaccinated is affected by several factors about what people think and feel and various social processes. Even when a person is motivated to be vaccinated, this can be offset by practical issues such as ease of access to vaccines at preferred sites.

CDC’s Vaccinate with Confidence program is built on 3 prongs to (1) establish trust, (2) empower healthcare providers, and (3) engage communities and individuals.

CDC is leveraging two existing probability-based omnibus panel surveys (NORC Amerispeaks and Ipsos Knowledge Panel) to assess knowledge, attitudes, beliefs and behaviors related to COVID-19 vaccines. These surveys are designed to determine an individual’s membership in priority populations for vaccination and their COVID-19 vaccination status (including intent to be vaccinated.) These biweekly surveys have been conducted since December 2020 and are scheduled to conclude in December 2021. The Ipsos panel uses address-based sampling without regard to phone or internet status, while the NORC survey uses the USPS and in-person or telephone interviews.

CDC uses the data to classify persons into one of three categories, i.e., Vaccine Refusers (definitely will not get a vaccine), Moveable Middle (range from probably won’t get vaccine to unsure or probably will get), and Vaccine Endorsers (definitely will get vaccine or already vaccinated with at least one dose). Approximately 30% of adults fall into the Moveable Middle. Detailed graphs analyzing vaccine intent among these 3 groups indicate (among other factors) vaccination intent is higher among Democrats, those with a bachelor’s degree or higher, and persons who live in metropolitan areas. The Moveable Middle includes a large number of 18–29-year-olds. Among all groups, one of the top reasons mentioned for being vaccinated was to prevent spreading the disease to family and friends, and to protect the community.

CDC also considered reasons for vaccine hesitancy. There was a high degree of concern about vaccine side effects in both the Moveable Middle and Vaccine Refuser groups. Vaccine Refusers expressed a high degree of distrust, and many of these individuals did not perceive that they were at risk for COVID-19 disease.

For all three groups, self-reported vaccine confidence or endorsement has increased since January among all age groups, though the percentage of Vaccine Refusers has remained relatively stable.

In summary, the Moveable Middle is moving and narowing; people who want to get a vaccine are getting it, and the percentage of Vaccine Refusers continue to hold steady. Trust in COVID-19 vaccines continues to be an imortant deciding factor, while the risk perception of side effects from the vaccines is stronger than the risk of getting the disease. Even so, concern about transmitting COVID-19 to friends and family is a top reason to want to get vaccinated.

Following the presentation, one Summit partner asked if CDC is seeing a higher-than-expected number of people not returning to get their second dose of vaccine. The recent MMWR article, COVID-19 Vaccine Second-Dose Completion and Interval Between First and Second Doses Among Vaccinated Persons — United States, December 14, 2020 February 14, 2021, indicates only about 3% of persons did not return for their second dose within 42 days of the first dose. However, some information suggests this percentage may have grown to as much as 8% in recent weeks.

Announcements – L.J Tan (IAC)

Dr. Tan reminded Summit partners that the webinar summaries are now called The Summit Weekly Update. These summaries and other valuable adult immunization information are posted on the Summit website as soon as possible after each week’s webinar.

Summit webinars occur each Thursday at 3 pm, unless partners are notified that a specific meeting has been cancelled.


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