More than three-quarters of American adults did not get a coronavirus vaccine last season, a figure that health experts warn could rise this year amid new U.S. government recommendations.
The Covid vaccine was initially popular. About 75% of Americans received at least one dose first versions of the vaccine by early 2022, data from the Centers for Disease Control and Prevention shows. But only about 23% of American adults received a coronavirus vaccine in the 2024-2025 viral season, well below the 47% of American adults who received a flu shot. Vaccination rate for flu, measlesand tetanus also decreases.
However, Covid remains a serious, potentially fatal health threat, listed as the leading cause of death on some 31,400 death certificates last year. For comparison: the flu killed about 6500 people and pneumonia, a common complication of influenza, died another 41,600, CDC data shows.
As millions of Americans decide whether to get a coronavirus vaccine this season, public health researchers worry that vaccination rates will decline further, especially because Hispanics, Black Americans and people under 30 have lower rates, exposing them to serious complications such as long Covid. Under the Trump administration and Health and Human Services Secretary Robert F. Kennedy Jr., the federal government has narrowed its Covid vaccine recommendations, resulting in a patchwork of pharmacy access rules, with Americans living in Republican-leaning states often facing greater barriers to getting a shot.
“There’s a lot of misinformation going around regarding Covid,” he said. Alin-RomaAssociate Professor of Health, Society and Behavior at the University of California, Irvine. “Vaccine hesitancy will increase.”
In August, the F.D.A. narrowed approval for Covid vaccines for people aged 65 and over, and for adults and children with at least one underlying health condition that puts them at high risk of serious complications from Covid.
One month later, the CDC's Advisory Committee on Immunization Practices voted for the recommendation “shared clinical decision making” on the vaccine, not recommending that all adults get vaccinated. The committee advised doctors to emphasize to adults under 65 and children that the benefit of the vaccine is greatest for people with underlying health conditions.
That guidance is contradicted by infectious disease experts, who say most adults and children should get both flu and covid vaccines, which are safe, effective and prevent serious illness. Several independent medical organizations, such as the American Academy of Family Physicians and the American Academy of Pediatrics, have reiterated their support for widespread adoption of Covid vaccines.
More than two dozen states have taken steps to ensure that most people can get a coronavirus shot at a pharmacy without a prescription, with many states tying their policies to recommendations from health organizations. And many of those states require insurers to cover vaccines at no cost, according to CFF analysis. In some other Republican-dominated states, vaccines may only be available by prescription at pharmacies.
The most commonly cited reasons for Covid vaccine hesitancy include concerns about side effects, long-term health effects and vaccine effectiveness, and mistrust of pharmaceutical corporations and government officials, according to the data. 2024 review numerous studies published in the journal Vaccines.
Covid vaccine hesitancy during the 2024-2025 virus season was higher among Hispanics, African Americans, men, uninsured people and people living in Republican-leaning states, according to the CDC.
Latino adults were significantly less likely than adults from most other racial and ethnic groups to receive a Covid vaccine last season, with a vaccination rate of about 15%.
Part of this may be due to age: A disproportionate share Latinos are young. But government policy actions may also be a factor. The first Trump administration, for example, tied Medicaid to a “public charge,” a rule that allows the federal government to deny green cards or visas to immigrants based on their dependence on taxpayer-funded programs. Some Latinos may be afraid to sign up for social services even after the Biden administration reversed Trump's first-term policies.
Haro-Ramos co-author study published in 2024, which found that many Latinos are hesitant to get vaccinated due to concerns about their immigration status, and that health discrimination, such as denial of health care or delays, increases their vaccine hesitancy.
“Do you trust the health care system as a whole? Are you willing to provide your information—your name, your address?” Haro-Ramos said. “Trust is critical.”
Haro-Ramos said the problem has likely gotten worse since her study was published. Trump administration revealed this summer that it would share Medicaid enrollees' personal information with Immigration and Customs Enforcement. Many Latinos canceling doctor visits to prevent a possible confrontation with immigration officials.
“People are avoiding leaving their homes at all costs,” Haro-Ramos said.
Janani Rajbhandari-TapaAssociate Professor, College of Public Health, University of Georgia, recently co-authored the study coronavirus vaccinations among nearly 1,500 African Americans living in south Georgia. The study found that participants were more likely to listen to their health care providers rather than religious leaders or colleagues when seeking advice about vaccination.
More than 90% of those surveyed had received at least one dose of the vaccine, but those who had not been vaccinated were more likely to agree with false claims linking vaccines to miscarriages, prolonged retention of components in the body, or even a conspiracy about implanting a computer chip in the body.
“It is doctors who may accept that messages about vaccination are myths,” Rajbhandari-Thapa said.
Although hospitalization and death rates from Covid have dropped sharply since the worst days of the pandemic, fatal Covid-related complications remain most common among older people. About 89% Covid deaths in the US last year were among people aged 65 and older, compared with about 81% deaths from influenza and pneumonia.
As the pandemic recedes into the background, young people have developed a sense of invincibility. Just 11% of Americans ages 18 to 29 have received a vaccine during the 2024-2025 virus season, the lowest vaccination rate among adult age groups. It's much lower 70% of young people who have received at least one dose of the first coronavirus vaccine by November 2023.
While many people get Covid after receiving a Covid vaccine, because the vaccine's ability to prevent infection wanes quite quickly, some misunderstand the purpose of the shot, he says. Otto Jahninfectious disease specialist at UCLA Health.
“They think, 'Well, the vaccine didn't stop me from getting coronavirus, so the vaccine didn't work,'” Yang said. “And what they don’t see is that the vaccine prevented them from getting seriously ill, which is ultimately what matters most.”
And the vaccine could help prevent long Covid, which is a problem for all ages, Yang said. Recent Research from Northwestern University discovered that Young people suffer more severe symptoms of long covid than older people.
Ultimately, Yang said, it's not a consistent choice to get the flu shot and not get the Covid vaccine, since both vaccines are safe, effective and prevent serious illness. Obviously, he added, people with weakened immune systems and those at higher risk should get the Covid vaccine. For others, the decision is “a little less clear,” but “probably most adults should get the vaccine, just as is recommended for the flu vaccine, and most children as well.”
Philip Reese is a data scientist and assistant professor of journalism at California State University, Sacramento.
