or health care provider even if they did not report a usual source of health care. Estimates are not shown for non-Hispanic/Latinx adults who are not Black or white or are more than one race and for adults who are independent, affiliated with a third party, or unaffiliated. We define vaccine-hesitant adults as those who would definitely not or probably not get a vaccine. Estimate differs significantly from the reference group (^) at the 0.10/0.05/0.01 level, using two-tailed tests. Estimate for Hispanic/Latinx adults differs from estimate for white adults at the 0.10/0.05/0.01 level, using twotailed tests. Compared with their trust in health care providers, vaccine-hesitant adults were less likely to trust state and local health officials and other community leaders. Vaccine-hesitant Black adults were more likely than white and Hispanic/Latinx adults to trust state or local public health officials (40 percent versus 29 percent and 32 percent), and Democrats trusted this source more than Republicans (41 percent versus 27 percent). Trust in elected community officials was greater among Black adults and Hispanic/Latinx adults than among white adults and higher among Democrats than Republicans. Republicans were more likely than Democrats to trust religious leaders in their communities (25 percent versus 19 percent). Given their relatively high trust in health care providers, understanding how vaccine-hesitant adults interact with the health care system can inform vaccine outreach efforts. More than threequarters of vaccine-hesitant adults (76 percent) reported having a usual source of health care,16 and 85 percent had some form of health insurance, but these rates varied by race, ethnicity, and political affiliation (table 3). 1 0 *++ Political party affiliation Republican^ Source: Well-Being and Basic Needs Survey, December 2020. Notes: Estimates are not shown for non-Hispanic/Latinx adults who are not Black or white or are more than one race and for adults who are independent, affiliated with a third party, or unaffiliated. We define vaccine-hesitant adults as those who would definitely not or probably not get a vaccine. Estimate differs significantly from the reference group (^) at the 0.10/0.05/0.01 level, using two-tailed testsEstimate for Hispanic/Latinx adults differs from estimate for white adults at the 0.10/0.05/0.01 levels, using twotailed tests. Vaccine-hesitant white adults were more likely than such Black adults and Hispanic/Latinx adults to have a usual source of care (79 percent versus 73 percent and 71 percent) and to be covered by employer-sponsored health insurance (59 percent versus 51 percent and 43 percent). More than one in four vaccine-hesitant Black adults (28 percent) reported having coverage through Medicaid or other public insurance, compared with 16 percent of white adults. Nearly one in four vaccine-hesitant Hispanic/Latinx adults was uninsured (24 percent), compared with 14 percent and 13 percent of vaccine-hesitant Black and white adults. Relative to Democrats, Republicans were more likely to have a usual source of care and employer-sponsored coverage and less likely to have public coverage or to be uninsured. Discussion As of December 2020, more than one-third of adults reported not wanting to get a COVID-19 vaccine, including 19 percent who said they would probably not get vaccinated and 16 percent who said they would definitely not get vaccinated. Consistent with other surveys and polls,17 we find vaccine hesitancy is relatively high among Black adults, but many have not made up their minds. Despite these relatively high vaccine hesitancy rates among Black adults, white adults are a much larger subgroup of the nonelderly adult population and, therefore, constitute 59 percent of the vaccine-hesitant group. Republicans were nearly twice as likely as Democrats to report they would not get vaccinated, and these partisan differences were most pronounced among white adults, followed by Hispanic/Latinx adults. 1 Perceptions of Risks and Benefits from Vaccines Nearly all vaccine-hesitant adults said concerns about the safety and effectiveness of the vaccines were important reasons they would not get vaccinated. More than half believed they did not need the vaccine. After a year of conflicting and highly politicized messaging about the virus’s risks from elected officials and media across the political spectrum, Republicans were more likely than Democrats to believe they did not need a vaccine. Written responses reflected deep concerns about safety and whether vaccines were sufficiently tested. Many respondents believed vaccine development (dubbed Operation Warp Speed) was rushed and wanted to see how the vaccines affected other recipients. Among adults who provided written responses, Black adults were more likely than others to raise concerns about the vaccines being adequately tested and mention lack of trust in the vaccines and the people or entities that developed them. These concerns are grounded in a history of medical abuses, including the Tuskegee syphilis study and other unethical medical experimentation, the use of Henrietta Lacks’ cells in medical research without consent, and involuntary sterilizations, as well as persistent racial disparities in treatment by the health care system and government (AHRQ 2020; Institute of