Prior COVID-19 infection: an underappreciated factor in vaccine hesitancy in the USA

Despite tremendous efforts to quickly identify the 'vaccine hesitant' in the USA, what has emerged instead is a complex picture of a highly heterogeneous unvaccinated population. Although numerous factors have been implicated in influencing US COVID-19 vaccine decision-making, the role that prior coronavirus disease 2019 (COVID-19) infection may play in vaccine receipt has been largely uninvestigated. Using data from two separate US national surveys, the US COVID-19 Trends and Impact Survey and the Household Pulse Survey, we find that roughly one-quarter of unvaccinated survey respondents has had a prior COVID-19 infection. Prior COVID-19 infection halves the odds of receiving the vaccine. This information is consequential for ongoing vaccine outreach efforts.

Automated summary

In the United States, efforts to identify the vaccine hesitant have revealed a diverse and heterogeneous unvaccinated population. However, the role of prior COVID-19 infection in vaccine receipt has not been extensively investigated. Data from national surveys show that approximately one-quarter of unvaccinated individuals in the US have had a prior COVID-19 infection, and this reduces the likelihood of vaccine uptake. This information has significant implications for vaccine outreach efforts.