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National Center for Immunization & Respiratory Diseases
An update on COVID- 19 vaccination coverage
CDR Kevin Chatham -Stephens, MD, MPH, FAAP
Readiness and Response Lead
Immunization Services DivisionNational Center for Immunizations and Respiratory Diseases (NCIRD)
COVID -19 vaccination coverage
Percent of adults and children up- to-date with 2023– 24
COVID -19 Vaccine
National Immunization Survey -Adult COVID Module (NIS -ACM) and - Child COVID Module (NIS -CCM)
0.010.020.030.040.050.0
9/30/23
10/7/23
10/14/23
10/21/23
10/28/23
11/4/23
11/11/23
11/18/23
11/25/23
12/2/23
12/9/23
12/16/23
12/23/2312/30/23
1/6/24
1/13/241/20/24
1/27/24
2/3/24Vaccinated with 2023 -24 COVID -19 vaccine (%)
Week end dateAll children 6m-17y
12-17y
5-11y
6m-4y
0.010.020.030.040.050.0
9/30/23
10/7/23
10/14/23
10/21/2310/28/23
11/4/23
11/11/23
11/18/23
11/25/23
12/2/2312/9/23
12/16/2312/23/2312/30/23
1/6/24
1/13/241/20/24
1/27/24
2/3/24Vaccinated with 2023 -24 COVID- 19 vaccine (%)
Week end dateAll adults 18+
75+
65-74
50-64
40-49
30-39
18-29COVID -19 Vaccination Coverage with 2023- 24 Vaccine
Among Adults ≥18 Years, NIS -ACMCOVID -19 Vaccination Coverage with 2023- 24 Vaccine
Among Children 6 Months -17 Years, NIS -CCM
COVID -19 vaccination status among adults ≥18 years by jurisdiction*
National Immunization Survey-Adult COVID Module (NIS -ACM)
Across jurisdictions, range of
vaccination coverage among adults 18 and older:
•Lowest jurisdiction: Puerto Rico
9.5% (95% CI: 8.0- 11.0)
•Lowest state: Mississippi 10.5%
(95% CI: 8.4- 12.5)
•Highest jurisdiction: District of
Columbia 41.9% (95% CI: 37.0-46.8)
*As of week ending 2/3/24
COVID -19 vaccination status and intent among adults ≥18 years
National Immunization Survey -Adult COVID Module (NIS -ACM)*
Probably or definitely will not get vaccinated
Probably will get vaccinated or unsureDefinitely will get vaccinatedVaccinated with 2023 -24 COVID -19 vaccine
3.0 4.0 6.1 8.2 9.5 11.9 13.2 14.5 14.8 17.1 17.9 18.2 18.6 18.9 20.6 21.0 21.4 21.7 21.928.2 27.2 24.924.2 19.718.6 18.1 15.1 14.714.6 14.2 12.0 13.1 13.314.3 12.7 11.7 11.4 11.331.7 31.9 31.0 29.329.230.1 28.8 30.1 31.230.3 27.2 29.4 28.9 28.227.6 28.2 28.2 28.1 28.537.1 36.8 38.0 38.241.6 39.4 39.9 40.3 39.3 38.0 40.7 40.4 39.5 39.6 37.5 38.1 38.7 38.8 38.3
0255075100Weighted %
*Sample size = 257,352
COVID -19 vaccination status and intent among adults ≥18 years
National Immunization Survey -Adult COVID Module (NIS -ACM)*
Probably or definitely will not get vaccinated
Probably will get vaccinated or unsureDefinitely will get vaccinatedVaccinated with 2023 -24 COVID -19 vaccine
3.0 4.0 6.1 8.2 9.5 11.9 13.2 14.5 14.8 17.1 17.9 18.2 18.6 18.9 20.6 21.0 21.4 21.7 21.928.2 27.2 24.924.2 19.718.6 18.1 15.1 14.714.6 14.2 12.0 13.1 13.314.3 12.7 11.7 11.4 11.331.7 31.9 31.0 29.329.230.1 28.8 30.1 31.230.3 27.2 29.4 28.9 28.227.6 28.2 28.2 28.1 28.537.1 36.8 38.0 38.241.6 39.4 39.9 40.3 39.3 38.0 40.7 40.4 39.5 39.6 37.5 38.1 38.7 38.8 38.3
0255075100Weighted %
*Sample size = 257,352Note: The analysis of coverage
by demographics on the
following slides is based on
survey responses from the time
period December 31, 2023-
January 27, 2024
COVID -19 vaccination status among adults ≥18 years, January 2024
National Immunization Survey -Adult COVID Module (NIS -ACM)*
24.419.216.419.413.314.111.423.218.620.9
0.0 20.0 40.0 60.0 80.0 100.0WhiteAsianBlackMulti/OtherHispanicNH/OPIAI/ANFemaleMaleOverall 18+
Weighted % (95% CI)•Among adults ≥18 years responding to the
NIS-ACM during 12/31/23 –1/27/24:
•20.9% (95% CI: 20.3- 21.6) reported that they
have received an updated 2023 -24 COVID -19
vaccine.
•By demographics:
•Vaccination coverage was significantly higher
among females (23%).
•Vaccination coverage was highest among White non-Hispanic adults (24%) and lowest among
AI/AN (11%), NH/OPI (14%), and Hispanic (13%) adults.
*Sample size = 60,840
COVID -19 vaccination status among adults ≥18 years, January 2024
National Immunization Survey -Adult COVID Module (NIS -ACM)*
21.020.618.726.119.412.76.922.716.821.321.9
0.0 20.0 40.0 60.0 80.0 100.0Disability: noneDisability: anyIncome unknownAbove poverty, >=$75KAbove poverty, <$75KBelow povertyUninsuredInsuredRuralSuburbanUrban
Weighted % (95% CI)•By urbanicity:
•COVID -19 vaccination coverage was lowest in
rural areas (17%).
•By health insurance status:
•Adults with health insurance had significantly
higher vaccination coverage (23%) than adults without insurance (7%).
•By household income:
•Vaccination coverage increased with increasing household income; highest among those with
income ≥$75k (26%).
*Sample size = 60,840
Percent of pregnant persons 18 –49 years vaccinated with 2023–24
COVID -19 Vaccine (Vaccine Safety Datalink)
•Among pregnant
persons ages 18 –49
years, 12.5% have received an
updated 2023- 24
COVID -19 vaccine
as of 1/27/24.
•Coverage varies by
race/ethnicity; ranges from 4.8%
(Black non-
Hispanic) to 21.3%
(Asian).
Attitudes and experiences regarding COVID -
19 vaccination
Most frequent COVID-19 vaccination concerns among adults ≥18
years by vaccination status/intent (Omnibus Surveys January 5 –29, 2024*)
10.1%
6.4%
6.3%
5.9%
74.1%
0 25 50 75 100Mild side
effects
Impact of side effects
on work/school
Unknown serious
side effects
Effectiveness
No concerns
Weighted % (95% confidence interval)Received/definitely will get
(N=1,296)
15.5%
12.7%
12.3%
11.8%
40.7%
0 25 50 75 100Unknown serious
side effects
Too busy or
kept forgetting
Effectiveness
Mild side
effects
No concerns
Weighted % (95% confidence interval)Probably will get/unsure
(N=1,003)
47.0%
39.0%
37.2%
33.2%
32.9%
0 25 50 75 100Unknown serious
side effects
Not enough studies
(human trials)
Do not trust
gov. or pharma
Heart- related
issues
Effectiveness
Weighted % (95% confidence interval)Probably/definitely will NOT get
(N=1,861)
*Sample size = 4,160
Most frequent COVID-19 vaccination concerns among adults ≥18
years by vaccination status/intent (Omnibus Surveys January 5 –29, 2024*)
10.1%
6.4%
6.3%
5.9%
74.1%
0 25 50 75 100Mild side
effects
Impact of side effects
on work/school
Unknown serious
side effects
Effectiveness
No concerns
Weighted % (95% confidence interval)Received/definitely will get
(N=1,296)
15.5%
12.7%
12.3%
11.8%
40.7%
0 25 50 75 100Unknown serious
side effects
Too busy or
kept forgetting
Effectiveness
Mild side
effects
No concerns
Weighted % (95% confidence interval)Probably will get/unsure
(N=1,003)
47.0%
39.0%
37.2%
33.2%
32.9%
0 25 50 75 100Unknown serious
side effects
Not enough studies
(human trials)
Do not trust
gov. or pharma
Heart- related
issues
Effectiveness
Weighted % (95% confidence interval)Probably/definitely will NOT get
(N=1,861)
*Sample size = 4,160
Most frequent COVID-19 vaccination concerns among adults ≥18
years by vaccination status/intent (Omnibus Surveys January 5 –29, 2024*)
10.1%
6.4%
6.3%
5.9%
74.1%
0 25 50 75 100Mild side
effects
Impact of side effects
on work/school
Unknown serious
side effects
Effectiveness
No concerns
Weighted % (95% confidence interval)Received/definitely will get
(N=1,296)
15.5%
12.7%
12.3%
11.8%
40.7%
0 25 50 75 100Unknown serious
side effects
Too busy or
kept forgetting
Effectiveness
Mild side
effects
No concerns
Weighted % (95% confidence interval)Probably will get/unsure
(N=1,003)
47.0%
39.0%
37.2%
33.2%
32.9%
0 25 50 75 100Unknown serious
side effects
Not enough studies
(human trials)
Do not trust
gov. or pharma
Heart- related
issues
Effectiveness
Weighted % (95% confidence interval)Probably/definitely will NOT get
(N=1,861)
*Sample size = 4,160
Most frequent COVID-19 vaccination concerns among adults ≥18
years by vaccination status/intent (Omnibus Surveys January 5 –29, 2024*)
10.1%
6.4%
6.3%
5.9%
74.1%
0 25 50 75 100Mild side
effects
Impact of side effects
on work/school
Unknown serious
side effects
Effectiveness
No concerns
Weighted % (95% confidence interval)Received/definitely will get
(N=1,296)
15.5%
12.7%
12.3%
11.8%
40.7%
0 25 50 75 100Unknown serious
side effects
Too busy or
kept forgetting
Effectiveness
Mild side
effects
No concerns
Weighted % (95% confidence interval)Probably will get/unsure
(N=1,003)
47.0%
39.0%
37.2%
33.2%
32.9%
0 25 50 75 100Unknown serious
side effects
Not enough studies
(human trials)
Do not trust
gov. or pharma
Heart- related
issues
Effectiveness
Weighted % (95% confidence interval)Probably/definitely will NOT get
(N=1,861)
*Sample size = 4,160
Most frequent COVID-19 vaccination concerns among adults ≥18
years by vaccination status/intent (Omnibus Surveys January 5 –29, 2024*)
10.1%
6.4%
6.3%
5.9%
74.1%
0 25 50 75 100Mild side
effects
Impact of side effects
on work/school
Unknown serious
side effects
Effectiveness
No concerns
Weighted % (95% confidence interval)Received/definitely will get
(N=1,296)
15.5%
12.7%
12.3%
11.8%
40.7%
0 25 50 75 100Unknown serious
side effects
Too busy or
kept forgetting
Effectiveness
Mild side
effects
No concerns
Weighted % (95% confidence interval)Probably will get/unsure
(N=1,003)
47.0%
39.0%
37.2%
33.2%
32.9%
0 25 50 75 100Unknown serious
side effects
Not enough studies
(human trials)
Do not trust
gov. or pharma
Heart- related
issues
Effectiveness
Weighted % (95% confidence interval)Probably/definitely will NOT get
(N=1,861)
*Sample size = 4,160
Specific concerns about effectiveness of updated COVID -19 Vaccines
among adults ≥18 years who reported effectiveness as a concern
Omnibus Surveys, January 5 -29, 2024*
*Sample size = 798
How people think and feel about COVID -19 vaccines has changed since 2022
National Immunization Survey -Adult COVID Module (NIS -ACM)
Disease risk perception has also changed ,
as reflected in the percentage of Americans
moderately/very concerned about getting COVID -19.
While most Americans still consider
COVID -19 vaccines to be safe and important,
vaccine confidence has declined.
Percent of Adults 18+ years of age that
think that a COVID- 19 vaccine is
very/completely safePercent of Adults 18+ years of age that
think that a COVID- 19
vaccine is somewhat/very importantPercent of Adults 18+ years of age that are
moderately/very concerned about getting
COVID -19
55.0%
32.7%
2022 January 2024 January83.9%
69.6%
2022 January 2024 January67.3%
55.6%
2022 January 2024 January
How people think and feel about COVID -19 vaccines has changed since 2022
National Immunization Survey -Adult COVID Module (NIS -ACM)
Disease risk perception has also changed ,
as reflected in the percentage of Americans
moderately/very concerned about getting COVID -19.
While most Americans still consider
COVID -19 vaccines to be safe and important,
vaccine confidence has declined.
Percent of Adults 18+ years of age that
think that a COVID- 19 vaccine is
very/completely safePercent of Adults 18+ years of age that
think that a COVID- 19
vaccine is somewhat/very importantPercent of Adults 18+ years of age that are
moderately/very concerned about getting
COVID -19
55.0%
32.7%
2022 January 2024 January83.9%
69.6%
2022 January 2024 January67.3%
55.6%
2022 January 2024 January
How people think and feel about COVID -19 vaccines has changed since 2022
National Immunization Survey -Adult COVID Module (NIS -ACM)
Disease risk perception has also changed ,
as reflected in the percentage of Americans
moderately/very concerned about getting COVID -19.
While most Americans still consider
COVID -19 vaccines to be safe and important,
vaccine confidence has declined.
Percent of Adults 18+ years of age that
think that a COVID- 19 vaccine is
very/completely safePercent of Adults 18+ years of age that
think that a COVID- 19
vaccine is somewhat/very importantPercent of Adults 18+ years of age that are
moderately/very concerned about getting
COVID -19
55.0%
32.7%
2022 January 2024 January83.9%
69.6%
2022 January 2024 January67.3%
55.6%
2022 January 2024 January
How people think and feel about COVID -19 vaccines has changed since 2022
National Immunization Survey -Adult COVID Module (NIS -ACM)
Disease risk perception has also changed ,
as reflected in the percentage of Americans
moderately/very concerned about getting COVID -19.
While most Americans still consider
COVID -19 vaccines to be safe and important,
vaccine confidence has declined.
Percent of Adults 18+ years of age that
think that a COVID- 19 vaccine is
very/completely safePercent of Adults 18+ years of age that
think that a COVID- 19
vaccine is somewhat/very importantPercent of Adults 18+ years of age that are
moderately/very concerned about getting
COVID -19
55.0%
32.7%
2022 January 2024 January83.9%
69.6%
2022 January 2024 January67.3%
55.6%
2022 January 2024 January
Healthcare provider COVID -19 vaccine recommendations
Relative to 2021, adults
reported fewer providers are
recommending COVID -19
vaccines
(National Immunization Survey -Adult
COVID Module [NIS -ACM])
Percent of adults whose healthcare
provider recommends COVID -19 vaccine
Most physicians reported always
recommending bivalent boosters
(CDC/RAND/Univ of Iowa Survey)
65.4%77.2%80.9%
Patients 18-49 years Patients 50-64 years Patients aged ≥65 yearsPercent of physicians who reported always recommending on -
site bivalent COVID- 19 vaccine to eligible patients — Feb 2023
36.1%
20.4%
2021 May
(4 mo. after vaccine
available)2024 January
(4 mo. after updated
vaccine available)
Reasons healthcare providers reported for NOT recommending COVID -19
bivalent boosters to eligible adult patients (CDC/RAND/Univ of Iowa Survey — February 2023)
Response options receiving <5% for at least one provider group not presented 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Medical reason for not getting vaccinated
Patient will refuse booster vaccination
Patients tired of hearing about COVID-19 vaccines
High level of vaccine resistance in community
Other
Won't have severe COVID-19 symptoms
Bivalent vaccine doesn't provide enough additional protection
Not enough time during visit to discuss vaccines
Vaccine unnecessary if they have had COVID-19
Not enough time during visit to give vaccine
Bivalent vaccine doesn't reduce COVID-19 severity in this age group% of respondents selecting response option (n=744)
Physicians
Nurses
Pharmacists
•Perceived low interest for COVID -19 vaccination in the patient population
•Cost of the COVID -19 vaccine and other associated vaccination costs
•Healthcare system decided to not stock the COVID- 19 vaccines
•Availability of the COVID -19 vaccines elsewhere in the community (e.g., pharmacies)Potential reasons for primary care providers to not stock
COVID -19 vaccines
Accessibility of COVID -19 vaccines
National Immunization Survey -Adult COVID Module (NIS -ACM)
Most Americans reported little to no difficulty in getting a COVID- 19
vaccine, across income ranges , in October 2023.
Fewer Americans report
difficulty getting COVID -19
vaccines in 2024.
88.9%93.4%92.8% 93.3%94.9%96.1%
95.3% 95.6%
6065707580859095100
Less than
$5,000$5,001-
$10,000$10,001-
$20,000$20,001-
$40,000$40,001-
$60,000$60,001-
$75,000$75,001-
$150,000$150,001
or morePercent of adults that reported not at all/a little difficult getting a COVID -19
vaccine, by income
80.5%95.0%
2021 May 2024 JanuaryPercent of adults that reported not at all/a little
difficult getting a COVID -19 vaccine
Acceptability of getting the Flu, COVID -19, and/or RSV vaccines
in the same visit among adults ≥18 years
Omnibus Surveys, November 30 -December 21, 2023*
*Sample size = 1,951
Acknowledgements
•Carla Black (CDC)
•Kayla Calhoun (CDC)
•Courtney Gidengil (RAND)
•Elisha Hall (CDC)
•Jennifer Kriss (CDC)
•Megan Lindley (CDC)•Sarah Meyer (CDC)
•Lakshmi Panagiotakopoulos (CDC)
•Megan Wallace (CDC)
For more information, contact CDC
1-800- CDC- INFO (232- 4636)
TTY: 1 -888- 232- 6348 www.cdc.gov
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.