Study population
From 24 March 2020 to 1 February 2021, we enrolled a total of 4,797,306 individuals (n = 370,282 U.S. participants and n = 4,427,024 U.K participants), of whom 1,605,019 individuals were active and logged at least one entry in December 2020 (i.e., 2 weeks prior to the initial vaccine questionnaire). After excluding participants who did not provide information on their racial or ethnic identity and restricting to those who responded to at least one vaccine questionnaire, a final analytic cohort of 1,341,682 individuals remained; Suppl. Fig. 1).
In the U.S., white participants tended to be older and reside in communities with higher income and educational attainment compared to Black or Hispanic participants (Suppl. Methods and Suppl. Table 1). Black and Hispanic participants more frequently reported being a frontline HCW and having previously been infected with SARS-CoV-2. Similar trends were observed among U.K. participants.
Vaccine hesitancy among racial and ethnic minorities
Among 1,228,638 individuals who answered the question on vaccine willingness, 91% of U.S. participants and 95% of U.K. study participants were willing to accept a COVID-19 vaccine if offered (Suppl. Table 2). In the U.S., participants who were hesitant (unwilling or unsure, respectively) tended to be younger, female, less likely to have had heart disease or cancer, and more likely to live in communities with lower average educational attainment and median incomes. Among frontline HCWs, 7% were unwilling to pursue vaccination and 13% were unsure, compared to 2 and 7%, respectively, across the entire U.S. study population. Similar (younger) age distributions, burden of chronic disease, proportion of frontline HCWs, and rates of prior SARS-CoV-2 infection were observed among U.K. participants.
In both the U.S. and U.K., racial and ethnic minority participants were more likely to report being unsure or unwilling to undergo vaccination. In the U.S., compared to white…