level, using two-tailed tests. When asked if they had other reasons for not getting a COVID-19 vaccine, 40 percent of vaccinehesitant adults—more than 1,100 overall—provided a written response.11 More than one-third of those who provided a written response elaborated on concerns about vaccine safety or side effects.12 The most common responses in this category were fearing the vaccines would cause long-term illness or death, followed by being worried about having an allergic reaction, not knowing the vaccines’ ingredients, and thinking the vaccines would change one’s DNA or affect one’s fertility. Others reported being unsure about how they would react to the vaccines because of preexisting health conditions or pregnancy; some of these adults pointed to the limited research on the vaccines’ effects for their conditions or were waiting for guidance from their health care providers. 13 One-third of the vaccine-hesitant adults who wrote in responses, including 4 in 10 Black adults, expressed concerns about how the vaccines were developed, which could be related to vaccine safety or effectiveness. This included 17 percent of adults who raised concerns the vaccines were not tested enough and 11 percent who mentioned the vaccines’ development or manufacturing was rushed. Smaller shares wanted to see how other vaccine recipients are affected before getting the vaccine, reported general concerns the vaccines are too new, believed political pressure affected the vaccines’ development, or questioned how scientists developed vaccines for COVID-19 so quickly but have not found cures for other diseases like cancer and HIV. Several adults were unsure how frequently they would need a vaccine as the virus mutates, which may be a growing concern given that new variants have spread since December. 8 C O N FR O NT I NG C About one in seven adults (14 percent) who wrote in responses reported not needing a vaccine because they have already been infected with the virus, are in a low-risk group, believe people of a similar age or health status have high rates of survival or recovery from COVID-19 (typically defined by respondents as being above 98 or 99 percent), prefer to have their body fight the infection naturally rather than with a vaccine, and think the risks from COVID-19 are no worse than those from the flu. Responses related to not needing a vaccine were nearly twice as common among Republicans as among Democrats and more common among white adults than Black adults. Fourteen percent of adults who wrote in a response reported lacking trust in the vaccines; the government or specific politicians, officials, or agencies; pharmaceutical companies; or other sources. Black adults reported this lack of trust more frequently than white adults (18 percent versus 12 percent). Several Black adults mentioned the unethical US Public Health Service syphilis study at the Tuskegee Institute or the government being dishonest or indifferent about their well-being.14 Five percent of vaccine-hesitant adults who wrote in a response stated COVID-19 was a hoax or the government or pharmaceutical companies had sinister or conspiratorial motives (e.g., that the vaccines would be used to implant a microchip to track people’s movements or be used for population control). A similar share opposed vaccines or medication in general. White adults and Republicans were most likely to refer to the pandemic or vaccines as part of a hoax or conspiracy, but these beliefs accounted for only 6 percent of these groups’ responses. Republicans were also more likely than Democrats to mention religious objections or freedom of choice. Only a few adults mentioned cost, fear of needles, or that other people should be prioritized. Trusted Community Sources and Connections to the Health Care System About half of vaccine-hesitant adults trusted their health care providers for information about the vaccine. However, variation in how adults interact with the health care system across race, ethnicity, and political affiliation suggests the need for targeted outreach strategies and tailored efforts by health care providers and other trusted community groups to better inform the public about the vaccines. Among all vaccine-hesitant adults, 51 percent reported they would strongly or somewhat trust their usual doctor or health care provider for information about the vaccines, compared with 89 percent of adults who were not hesitant about the vaccines (table 2). 15 About 50 percent of vaccine-hesitant adults of each racial and ethnic group and political party affiliation trusted their usual providers. However, this rate was lower for Hispanic/Latinx adults than white adults. Vaccine-Hesitant Adults Ages 18 to 64 Trusted Health Care Providers More than Other Community Sources for Information about a COVID-19 Vaccine in December 2020 Share Who Trust the Following Sources (%) Usual doctor or health care provider State or local public health officials Religious leaders in community Elected officials in community Vaccine-hesitant adults^ 51 32 22 13 Adults who are not vaccine- 16++ Political party affiliation Republican^ Source: Well-Being and Basic Needs Survey, December 2020. Notes: Data represent shares of respondents who strongly or somewhat trust each source. Adults were asked about trust in their usual doctor