The U.S. distribution of safe and efficacious vaccines to prevent COVID-19 has increased exponentially since December 2020. The average daily rates of vaccines administered in the U.S. has reached 3.3 million in April. On April 14, the U.S. reached more than 194.8 million total doses administered with 76.7 million persons (23.1% of the total U.S. population) fully vaccinated (i.e., having received either both doses of Pfizer/BioNTech or Moderna vaccine or one dose of the Johnson & Johnson/Janssen vaccine). All states have announced plans to open eligibility to all individuals 16 years of age or older no later than April 19. This progress is both remarkable and critical in preventing the further spread of and/or emergence of new variants with higher rates of transmissibility or greater disease severity. The U.S. will soon reach a point in which supply outstrips demand; ensuring more equitable access and ensuring citizen confidence has already become the next phase of the COVID vaccine effort.

The share of Americans that have reported being vaccinated or intending to do so has consistently increased, reaching 61% as of early April. Meanwhile, the proportion of persons taking a “wait and see” approach has decreased to 17% as those who will “definitely not” remains steady at 13%. There continue to be differences and changes in the rates for vaccine-related apprehension or refusal among select groups. Black adults reported the largest increase in vaccine enthusiasm; the proportion with a “wait and see” approach has decreased from 34% to 25%, with a still slightly higher percentage than among White adults. Three in ten Republicans and White Evangelicals say they will “definitely not” get the vaccine while 25% of rural individuals said the same. Adults 65 years of age and older report the highest rates of vaccine enthusiasm with 64% having already received one or more vaccine dose and another 17% who will be getting vaccinated as soon as possible.

In response, several stakeholders are poised to or have already begun to implement communications strategies to increase vaccine uptake overall and among key population groups, including:

• The Ad Council’s COVID-19 Vaccine Education campaign, including population-specific tools and resources.
• S. Department of Health and Human Services (HHS) public education campaign to encourage individuals to get vaccinated and increase vaccine confidence. The campaign will include the creation of nationwide network of trusted voices known as the COVID-19 Community Corps.
• CDC Vaccination Toolkits for key stakeholders (e.g., employers of essential workers).
• Biotechnology Innovation Organization (BIO) educational website, COVID Vaccine Facts. This website is designed for use by both health providers and the broader public to respond to the most frequently asked questions about the COVID-19 vaccines and their development.
• Local and state health departments’ tailored outreach efforts to reach critical communities (e.g., Massachusetts and Washington) as part of their vaccine equity strategies.
• Providers (e.g., doctors, nurses) in their interactions with patients.

Skepticism is not the only reason some individuals are not accessing vaccines for which they are eligible, however. As vaccine supplies had initially been scarce, many communities faced challenges in securing and reaching an appointment. Inequities in vaccine uptake have persisted across race, ethnicity, income, disability, etc. Between February and March 2021, the proportions of Americans that know when (36% to 53%) and where (55% to 67%) they will be vaccinated have increased. Yet there still remains a significant number of individuals who do not yet know when and where their turn will come. Further, three in ten individuals report that they do not know if they currently meet their state/territory eligibility criteria, with even higher rates among Hispanic adults, adults under 30 years of age, those with household incomes under $40,000, and those without college degrees. This data indicates that vaccine-related communications must also emphasize how and when individuals may get vaccinated rather than just focusing on encouraging vaccine acceptance.

Attorney general community members can support COVID-19 vaccine communications efforts by:

• Engaging with and elevating the messaging that federal, state, and local public health officials use to encourage vaccine acceptance and support vaccine access (e.g., how to find a vaccination site).
• Aiding state and local health department immunization programs in building relationships with key stakeholders with whom attorney general community members regularly engage (e.g., departments of correction, law enforcement).
• Monitoring and educating the public about vaccine and consumer protection-related issues that may create additional confusion or frustration for individuals seeking vaccine appointments (e.g., fake websites posing as vaccine sites).

Throughout 2021, NAAG will continue to provide informational updates and training opportunities to the attorney general community as COVID-19 vaccine distribution and related legal issues evolve. For more information on NAAG’s response to the COVID-19 pandemic, visit NAAG’s public health-related updates from NAAG.