Medicine 2003; Sparks et al. 2020).18 Such disparities have continued during the COVID19 pandemic, during which Black people and other people of color have suffered disproportionate exposure and harm (Azar et al. 2020; Dubay et al. 2020; Escobar et al. 2020). 19 Republicans were more likely to mention not needing the vaccine, including perceiving being at low risk of severe illness from COVID-19. Though some adults described vaccines as part of a hoax or conspiracy, these responses were uncommon. This does not necessarily imply misinformation is an unimportant determinant of vaccine hesitancy, but the survey results suggest most adults were weighing a trade-off between their perceived risks from the vaccines and perceived risks from the virus—a cost-benefit decision explicitly mentioned by several respondents. These findings underscore the importance of providing clear and accurate information comparing the risks of long-term illness and death from COVID-19 with the much lower risks of an adverse reaction to the vaccines, particularly for younger and healthier adults, and the benefits of getting vaccinated to protect oneself and other people in households and communities (Blackburn et al. 2021; Carfi, Bernabei, and Landi 2020; del Rio, Collins, and Malani 2020; Gee et al. 2021; Shimabukuro 2021; Tenforde et al. 2020). Transparency in reporting adverse reactions and greater visibility of information gathered from long-term monitoring for the vaccines’ safety and effectiveness, including for diverse populations and people with different types of health conditions, can help adults make informed decisions. Health officials and their community partners can also assuage concerns about new vaccine technologies and the vaccines’ fast development by educating the public about how the vaccines work, the years of research that allowed them to be developed quickly, and the rigorous testing protocols used to assess their safety. 1 Engaging Health Care Providers as Trusted Messengers for Vaccine Outreach Messaging about the vaccines’ risks and benefits will be most effective if delivered through trusted sources, whether in the media, government, communities, or social networks. Trusted sources will not be uniform across or within communities, and people may trust multiple sources for different types of information. For instance, some entities may be trusted for their scientific expertise, and others may help amplify messages from health officials, connect residents to information and resources, or facilitate vaccine access. Though research on evidence-based strategies to address vaccine hesitancy is limited, a systematic review predating the pandemic found interventions that employed multiple strategies and applied dialogue-based approaches effectively increased vaccine uptake and underscored the need for tailored approaches for different populations and concerns (Jarrett et al. 2015). Within communities, doctors and other health care providers are among the most trusted sources of information on COVID-19 vaccines across racial and ethnic groups and political affiliations. However, different groups of vaccine-hesitant adults interact with the health care system differently. Our findings suggest Medicaid programs and managed-care plans can play an important role in vaccination by working with providers to reach a significant share of vaccine-hesitant adults, including Black adults, who are disproportionately insured with public coverage (NORC at the University of Chicago 2020). Early experiences with COVID-19 vaccine distribution also highlight the key role of providers closely connected to the community in enhancing trust and access.20 Additionally, though most vaccine-hesitant adults had a usual source of care and health insurance, nearly one-quarter of Hispanic/Latinx adults were uninsured. This suggests it will be important to support outreach conducted by safety net providers and other community- and immigrant-serving organizations. In response to reports of inequitable distribution of the vaccines for more vulnerable people, the Biden administration has begun shipping vaccine doses to federally qualified health centers.21 In addition to expanding access and complementing distribution through long-term care facilities, large hospitals and health care systems, pharmacies, mass and mobile vaccination sites, and other locations, engaging more primary care providers in distribution may also help overcome vaccine hesitancy. 22 However, data on health care providers’ engagement in vaccine outreach efforts and the availability of funding to support provider-led outreach are limited, and strategies for reaching vulnerable populations vary in their levels of detail across state vaccination plans (Michaud et al. 2020). Reimbursement for vaccine administration may affect the time and resources providers can devote to outreach and patient counseling. 23 For instance, Medicare payment rates for COVID-19 vaccine administration “recognize the costs involved in administering the vaccine, including the additional resources involved with required public health reporting, conducting important outreach and patient education, and spending additional time with patients answering any questions they may have about the vaccine.” 24 But for providers vaccinating nonelderly patients, most of whom are not