The Annenberg Public Policy Centre (APPC) shared a report in August 2024, revealing that the number of Americans believing COVID-19 vaccination misinformation has risen and their “willingness” to take or recommend vaccination against COVID-19 is “lower than in the past”. The Annenberg Science and Public Health (ASAPH) Knowledge Monitor tracks national levels of health knowledge and misinformation to generate “indices of knowledge” about health topics. The latest report is based on 20 waves of a nationally representative panel survey of US adults, the most recent of which was conducted in July 2024.
Confidence levels
The survey asks respondents to report their level of confidence in people who provide public health information. Respondents had the most confidence in primary care providers regarding “matters of public health” in 2023 and 2024. However, they had less confidence in public health institutions like the FDA and CDC. Respondents expressed least confidence in Dr Fauci, who stepped down as NIAID Director at the end of 2022.
In February 2024, Americans reported trusting scientists and police officers to act in their best interests “more than other groups”, including business leaders and journalists. Medical scientists were trusted “significantly more than any other group”. Confidence in the trustworthiness of the FDA exceeded specific measures of confidence concerning the FDA’s vaccine approval process. The four items assessing the FDA protecting the vaccine process from outside influence were the most highly correlated with each other and general confidence in the FDA.
COVID-19 misinformation and vaccines
The report emphasises that vaccines are “one of the great success stories of public health”. However, recent years have seen “declines in Americans’ perceptions that a variety of vaccines are safe and effective”. Although “most respondents” report vaccines as safe (65%-81%) and effective (61%-83%), respondents showed “significant declines” in perceptions of safety for MMR and COVID-19 vaccines, and in perceptions of efficacy for MMR, seasonal flu, and pneumonia vaccines.
Respondents considered MMR and seasonal flu vaccines safer and more effective (75%-83%) than the COVID-19 (65%-66%), even though CDC evidence indicates that the COVID-19 vaccines are “actually more effective” than flu vaccines. The authors also identify an increase in perceptions that the COVID-19 vaccines are “very or somewhat unsafe” (18%-24%).
The surveys tracked the amount of endorsement of five COVID-19 vaccine misinformation beliefs for nearly three years. Although most respondents still endorse the “science-consistent response” (55%-65%), endorsing the “science-inconsistent response” has increased over time. The “misinformed belief” that COVID-19 vaccinations have been responsible for thousands of deaths in the US increased from 22% in June 2021 to 28% in July 2024. Another trend was an increase in the “false belief” that it is safer to get a COVID-19 infection than a COVID-19 vaccine.
Vaccination in pregnancy
From June 2023 to April 2024, respondents increased their understanding of the vaccinations recommended during pregnancy by the CDC. In the most recent assessment, many respondents knew that seasonal flu (50%), COVID-19 (43%), and the Tdap (35%) vaccines are recommended in pregnancy. However, the recent survey also found that “large numbers of people” are “uncertain or do not know” the benefits of COVID-19 vaccination during pregnancy. Opinions were divided on whether to recommend the RSV vaccine to a pregnant friend or family member.
Measles
Despite the availability of an MMR vaccine that provides “long-lasting protection” against measles for people who have received both recommended doses, only 93% of kindergarten students in the US in 2022-2023 had received both doses. Exemption requests in the 2022-2023 school year, while still low, increased to 3.0% from 2.6% in the previous year.
“These increases in exemptions could be attributable to actual increases in vaccine hesitancy or persistent barriers to vaccination for families whose access to routine childhood vaccination series was reduced by the COVID-19 pandemic.”
The American public “remains relatively confident” in the vaccine for measles, mumps, and rubella. In October 2023, respondents perceived the MMR vaccine as “safer and more effective than any other surveyed vaccine”; 81% reported that the MMR is either “somewhat or very safe” and 83% reported it as “somewhat or very effective”. However, these perceptions represent a “significant decline” from August 2022, when 88% of respondents reported that the MMR vaccine was “somewhat or very safe” and 87% perceived it as “somewhat or very effective”.
In April 2024, a “large proportion of the public” knew that medical professionals recommend taking the MMR vaccine. However, less than half of respondents (49%) know that it is not more harmful than helpful to give children more than a single vaccine on the same day, and many were “not sure” (23%). Indeed, combining vaccines reduces the overall number of visits to the doctor, reducing barriers to “full, on-time vaccination”. Only 63% of respondents believe that healthy children should meet school vaccination requirements for attendance in public schools.
Most respondents (56%) were unsure about the effect of measles on potential pregnancy complications. About 4 in 10 people correctly identified two complications associated with contracting measles while pregnant: delivering a low-birth-weight baby and early delivery. Some people incorrectly indicated that diabetes (7%), blurred vision (11%), and death (12%) are more likely to occur if measles is contracted during pregnancy; this is not the case. Of particular concern is that a quarter of US adults still do not know that there is “no causal evidence” linking the measles vaccine to autism.
Mpox
As the “salience” of mpox receded in the US after the 2022 global outbreak, so has the public’s knowledge concerning the issue. The public is “significantly less worried about contracting mpox”; only 5% of respondents reported being “somewhat or very worried” about contracting mpox in the next 3 months. In July 2024, only 9% were worried about personally contracting mpox or someone in their family contracting mpox. 76% of respondents reported in October 2022 that they were “very likely or somewhat likely” to receive an mpox vaccine if they were exposed.
“In the immediate aftermath of the 2022 global mpox outbreak, many in the public learned important public health knowledge to help prevent and treat the disease. With new outbreaks recently declared in Kenya and the Central Africa Republic, now is the time for public health officials to remind the public of the risks, symptoms, and means of treatment.”
STIs
Sexually transmitted infections (STIs) are “on the rise” in the US. Thus, it is “not surprising” that 47% of respondents reported either having personally been diagnosed or knowing someone who had been diagnosed with an STI. However, just over half of respondents (54%) know that a case of syphilis can be permanently cured and most either believe (mistakenly) that there is a vaccine to prevent it (16%) or are unsure (45%). The public is “not sure” whether some STIs can be permanently cured or whether a vaccine exists to prevent them.
When asked about vaccines to prevent these infections, 67% of the public are aware that these a vaccine for HPV. 44% know that there is a vaccine for mpox. For infections without a vaccine, most of the public is either unsure or incorrect about whether that is the case:
- 61% of people do not know there is no vaccine for syphilis
- 52% of people do not know there is no vaccine for HIV
- 57% of people do not know there is no vaccine for gonorrhoea
- 55% of people do not know there is no vaccine for genital herpes
- 59% of people do not know there is no vaccine for chlamydia
To read the full report click here. Get your tickets to join us at the Congress in Barcelona for discussions about vaccine confidence, public health communication, and vaccine uptake, and don’t forget to subscribe to our weekly newsletters here.
