Given that fewer than half of US adults typically receive an annual influenza (flu) vaccine (despite the recommendation that everyone age 6 months and older gets vaccinated each year), the National Foundation for Infectious Diseases (NFID) commissioned a new survey to better understand beliefs about flu and pneumococcal disease, as well as attitudes and practices around vaccination including the impact of the COVID-19 pandemic. The survey, conducted August 12-16, 2021, included 1,126 complete responses—1,064 via the web and 62 via telephone—from US adults age 18 years and older representing the 50 states and the District of Columbia.
Survey findings highlight the importance of raising awareness and addressing misconceptions about flu, pneumococcal disease, and COVID-19, and the importance of healthcare professionals strongly recommending safe and effective vaccines to their patients to prevent serious complications, including hospitalization and death.
Summary of Key Results
Attitudes and Practices around Flu Vaccination
Overall, most US adults believe vaccination is the best protection against flu, but many do not plan to get vaccinated against flu during the 2021-2022 flu season
- 61 percent agree that flu vaccination is the best preventive measure against flu-related deaths and hospitalizations
- 44 percent of US adults are either unsure or do not plan to get vaccinated against flu during the 2021-2022 flu season
- Among those who do not plan to get a flu vaccine, top reasons cited include:1
- 39 percent do not think flu vaccines work very well
- 36 percent said that they never get the flu
- 25 percent are concerned about potential side effects from the vaccine
- 20 percent do not think flu is a serious illness
- 19 percent are concerned about getting flu from the vaccine
- Of concern, nearly 1 in 4 (23 percent) who are at higher risk2 for flu-related complications said they were not planning to get vaccinated this season
- 71 percent of adults age 65 years and older plan to get a flu vaccine; only 42 percent of adults age 18-64 years plan to get a flu vaccine
- A majority (68 percent) of US adults say the mild flu season last year does not impact their likelihood of getting a flu vaccine during the 2021-2022 season
- Nearly half (48 percent) report that they plan to get a flu vaccine
Flu Prevention Behaviors during the COVID-19 Pandemic
The COVID-19 pandemic is driving changes in flu prevention behaviors
- 28 percent say the COVID-19 pandemic makes them more likely to get vaccinated against flu during the 2021-2022 flu season
- 45 percent of US adults say the pandemic will make them more likely to stay home from work or school if they are sick
- A majority of US adults (54 percent) report they will wear a mask at least sometimes during flu season, of these:
- 43 percent will wear a mask around crowds and large groups of people
- 37 percent will wear a mask indoors
- 21 percent will wear a mask outdoors
- 22 percent of US adults will wear a mask only if required and 16 percent will not wear a mask
- Black adults (73 percent) and Hispanic adults (62 percent) are more likely than White adults (46 percent) to say they will wear a mask during flu season
- Women (60 percent) are more likely than men (48 percent) to report that they will wear a mask during flu season
Concerns about Flu and COVID-19 Infection
US adults are more likely to worry about getting COVID-19 than flu
- 37 percent are very or extremely worried about COVID-19 infection (for themselves or someone in their family), but only 19 percent are similarly concerned about being infected with flu
- Another 36 percent are worried about being infected with COVID-19 and flu at the same time
- Hispanic adults (52 percent) and Black adults (45 percent) are more likely to be worried about contracting both infections at the same time compared to White adults (27 percent)
Sources of Information about Flu Vaccination
Healthcare professionals are the primary and most trusted source of information about flu and flu vaccination
- Most US adults get information about flu vaccines from a healthcare professional, with 56 percent indicating healthcare professionals as their primary source of information
- 74 percent of US adults trust healthcare professionals a great deal or a lot for flu vaccine information, far more than other sources3
Antiviral Medication to Mitigate Flu Symptoms
An overwhelming majority of US adults would take antiviral medication to mitigate severe flu symptoms if prescribed by a healthcare professional
- 77 percent of US adults would be willing to take antiviral medication if prescribed by a healthcare professional to help reduce severe flu symptoms
- White adults (81 percent) and Hispanic adults (79 percent) are more likely than Black adults (58 percent) to say they are willing to take antiviral medication if prescribed
- 21 percent of US adults would not be willing to take an antiviral medication if prescribed by a healthcare professional to help reduce severe flu symptoms
- Younger adults4 (25 percent) are more likely to say they will not take antiviral medication if prescribed than adults age 65 years and older (7 percent)
Attitudes and Practices around COVID-19 Vaccination
Despite the availability of COVID-19 vaccines in the US, many adults say they will not get vaccinated
- Among US adults who have not received at least one dose of a COVID-19 vaccine, 63 percent will not get a COVID-19 vaccine and 28 percent are not sure
- Among those who will not get a COVID-19 vaccine or will not receive all recommended doses, top reasons cited include:
- 63 percent are concerned about possible side effects of COVID-19 vaccines
- 56 percent don’t trust COVID-19 vaccines
- 38 percent don’t think COVID-19 vaccines work
- 35 percent plan to wait and see if it is safe and may get it later
- 32 percent are concerned about having an allergic reaction to a COVID-19 vaccine
Knowledge and Attitudes around Pneumococcal Disease
Among adults age 65 years and older, or those with an underlying health condition5 who are at higher risk for pneumococcal disease, there are gaps in awareness and understanding about pneumococcal disease and vaccination
- 51 percent are not familiar with pneumococcal disease
- About a third (32 percent) of those at higher risk have been advised to receive a pneumococcal vaccine
- Among those who have been advised to get vaccinated, the majority (84 percent) have received a pneumococcal vaccine
- Among those who are unsure or do not plan to get a pneumococcal vaccine, the top reason (56 percent) cited was that their doctor has not recommended it1
Survey findings highlight the importance of raising awareness and addressing misconceptions about flu, pneumococcal disease, and COVID-19 vaccines, and the importance of healthcare professionals strongly recommending vaccines for their patients
- Safe, effective vaccines are available in the US to help prevent flu, pneumococcal disease, and COVID-19
- Even in cases when flu vaccination does not prevent infection completely, it can help reduce the severity and duration of illness and prevent serious complications, including hospitalization and death6
- Even in cases when COVID-19 vaccination does not prevent infection completely, it can reduce hospitalizations and death
- Both flu and pneumococcal disease vaccination should be part of the routine management of patients with chronic health conditions
- During the ongoing COVID-19 pandemic, flu vaccination is critical not only to protect yourself, your loved ones, and your community (especially those who are most vulnerable including children, adults age 65+, and individuals with certain chronic health conditions), but also to reduce potential strain on the US healthcare system
- For more than 50 years, hundreds of millions of individuals in the US have safely received seasonal flu vaccines7
- Getting vaccinated, wearing a mask, handwashing, social distancing, and staying home when you are sick can help stop the spread of flu and COVID-19
The survey findings also underscore the need to address health disparities and educate populations at increased risk, including older adults and individuals with chronic health conditions such as lung disease, heart disease, and diabetes, who are at higher risk for complications from flu, pneumococcal disease, and COVID-19.
About the National Foundation for Infectious Diseases
Founded in 1973, the National Foundation for Infectious Diseases (NFID) is a non-profit 501(c)(3) organization dedicated to educating the public and healthcare professionals about the burden, causes, prevention, diagnosis, and treatment of infectious diseases across the lifespan.
For more information, visit www.nfid.org.
About the Survey
This NFID-sponsored survey was conducted by NORC at the University of Chicago. Data were collected using the AmeriSpeak Omnibus®, a monthly multi-client survey using the NORC probability-based panel designed to be representative of the US household population.
Interviews for this survey were conducted between August 12 and 16, 2021, with adults age 18 years and older representing the 50 states and the District of Columbia. Panel members were randomly drawn from AmeriSpeak, and 1,126 completed the survey—1,064 via the web and 62 via telephone. Interviews were conducted in English. The final stage completion rate is 19.1 percent, the weighted household panel response rate is 22.0 percent, and the weighted household panel retention rate is 75.0 percent, for a cumulative response rate of 3.2 percent. The overall margin of sampling error is +/- 3.8 percentage points at the 95 percent confidence level, including the design effect. The margin of sampling error may be higher for subgroups.
Once the sample has been selected and fielded, and all the study data have been collected and made final, a poststratification process is used to adjust for any survey nonresponse as well as any noncoverage or under and oversampling resulting from the study specific sample design. Poststratification variables included age, gender, census division, race/ethnicity, and education. Weighting variables were obtained from the 2021 Current Population Survey. The weighted data reflect the US population of adults age 18 years and older.
1Top responses reflect survey respondent answers when asked to select “all that apply.”
2People at higher risk for complications from flu or pneumococcal disease as defined in the survey include those age 65 years and older, smokers, and those with diabetes, asthma, heart disease, and/or kidney disease.
3Responses reflect survey respondents ranking selections on a scale of “trust a great deal/a lot,” “trust somewhat,” and “trust a little/not at all.” Healthcare professionals include doctors, nurses, pharmacists, and other health professionals.
4Younger adults are defined as individuals age 18-64 years.
5Underlying conditions are defined in the survey as smoking, diabetes, asthma, heart disease, and/or kidney disease.
6Misconceptions about Seasonal Flu and Flu Vaccines | CDC. Centers for Disease Control and Prevention. www.cdc.gov/flu/prevent/misconceptions.htm. Accessed September 2021.
7Centers for Disease Control and Prevention. Flu Vaccine Safety Information: Q&A. www.cdc.gov/flu/prevent/general.htm. Accessed September 2021.
Animated video in Spanish on flu symptoms, prevention, and treatment, reminding viewers to get vaccinated each year and stay home when sick to help protect themselves and those around them from flu