CS000000-A | 8/10/22

COVID-19 State of Vaccine 

Confidence Insights Report

Report 27 | August 10, 2022 | Date Range: April 5 – May 2, 2022

SPECIAL UPDATE: CDC partners can now report COVID-19 rumors directly to CDC. To report a rumor, go to: 

www.cdc.gov/report-rumors and start the subject line with: “Rumors:” and in the question box, give as much information about 

the rumor as you can, including a description of the rumor, where you heard it, and how many times you have heard it.

Summary

Major themes identified from social media, news, and other sources that may impact 

vaccine confidence:a

 Consumers continue to have questions and concerns about additional COVID-19 booster doses.

 Consumers continue to express their support or opposition to COVID-19 mitigation measures.

Continuing and evolving themes that may impact vaccine confidence: 

 Consumers continue to have questions and express frustration with proof of vaccination requirements because of the belief

that the vaccines are not safe or effective.

 While some consumers eagerly awaited emergency use authorization of COVID-19 vaccines in children less than 6 years of

age, others are opposed to approving vaccines in this age range.b

 Consumers continue to have questions about the effectiveness of the COVID-19 vaccines against SARS-CoV-2 variants.

 Consumers continue to express their lack of trust in CDC.

Ways public health and partners can take action. 

Federal, state, and local partners should continue to work together to explain the rationale for updated guidance, respond 

to gaps in information, and confront misinformation with evidence-based messaging. The goal of these efforts is to increase 

confidence in vaccines and increase vaccination with primary series and booster doses. Other ways to take action on the 

themes in this report include:

 Engage communities in a sustainable, equitable, and inclusive way using two-way communication to listen, build trust, and

increase collaboration.

 Work with partners to create, disseminate and amplify messages explaining why vaccines are still important in the COVID-19

prevention response.

 Work with partners to create, disseminate and amplify messages about community-level risk and corresponding COVID-19

mitigation measures.

 Work with public health officials, healthcare workers, and community leaders to create, disseminate and amplify messages

that stress the safety of COVID-19 booster doses over infection-induced immunity. Create visuals and plain-language

documents showing the efficacy of COVID-19 vaccines.

 Work with trusted messengers to create, disseminate and amplify communication products that communicate scientific

findings about adverse events to people who are unvaccinated with a focus on uncommon dissemination channels and

innovative messaging.

For findings and ways to act from our other reports, see previous Insights Reports.

Resources: The following link contains social media resources such as graphics, language, and social media calendars 

that our partners can use to address the issues raised in this report: https://centersfordiseasecontrol.sharefile.

com/d-s76fa27bf854a4e59b1dea93e1e3f1bf7

a

Themes for this report come from an integrated and thematic analysis of the data from the sources listed in the appendix.

b

As of June 18, 2022, everyone 6 months and older is recommended to get a Moderna or Pfizer-BioNTech COVID-19 vaccine.

Centers for Disease Control & Prevention, COVID-19 Response, Vaccine Task Force

Vaccine Confidence & Demand Team, Insights Unit

The findings and conclusions in this report are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention (CDC).
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COVID-19 State of Vaccine Confidence Insights Report | Report 27 | August 10, 2022

Contents

3 Aims and Methods

4 Major themes identified from social media, 

news, and other sources that may impact 

vaccine confidence 

4 Consumers continue to have questions 

and concerns about 2nd COVID-19 booster 

doses. 

6 Consumers continue to express their 

support or opposition to performing and 

following COVID-19 mitigation measures.

8 Continuing and evolving themes that may 

impact vaccine confidence

8 Parents continue to have questions and 

express frustration towards COVID-19 

vaccination in children.

10 Consumers continue to have questions 

about the effectiveness of the COVID-19 

vaccines against SARS-CoV-2 variants.

11 Consumers continue to question the 

benefits of getting a booster dose 

following vaccine breakthrough infections 

in high-profile people.

12 Consumers continue to express their lack 

of trust in CDC.

14 Appendix 1: Inputs and Sources
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COVID-19 State of Vaccine Confidence Insights Report | Report 27 | August 10, 2022

Aims and Methods

By rapidly reviewing and analyzing numerous sources and inputs (see Appendix), the biweekly COVID-19 State of Vaccine 

Confidence Insights Report emphasizes major themes influencing COVID-19 vaccine hesitancy and uptake. These are 

characterized by the level and type of threat to vaccine confidence, the degree the respective theme appears in the data 

sources, and directionality (i.e., increasing, decreasing or stable). In addition, by examining how consumers think and feel, social 

processes, and the practical issues around vaccination, the Insights Report seeks to identify emerging issues of misinformation, 

disinformation, and places where intervention efforts can improve vaccine confidence across the United States.

The information in this report is only a snapshot, and certain populations may be underrepresented. Images and quotes are 

illustrative examples and are not meant to comprehensively cover all content related to the highlighted themes. 

How do you classify this theme/information? 

High risk Moderate risk Low risk Positive sentiment

 May lead to vaccine 

refusals and decreased 

uptake 

 Wide reach, pervasive  

 Potential to trigger 

hesitancy to vaccination

 Moderate reach, modest 

dissemination 

 Concerning, but low risk 

to vaccine confidence 

 Limited reach, limited 

dissemination 

 Could increase vaccine 

confidence, intent, or 

motivation

 Variable reach and 

dissemination

How has this theme/idea changed over time (since last report or over the course of multiple reports)? 

Increasing

Information spreading rapidly 

Stable

Information remaining 

constant at prior level 

Decreasing

Information is not gaining further 

traction and there has been no 

indication of additional activity 
Page: 4

COVID-19 State of Vaccine Confidence Insights Report | Report 27 | August 10, 2022

Major themes identified from social media, news, and other 

sources that may impact vaccine confidencea

Consumers continue to have questions and concerns about 2nd COVID-19 booster 

doses.

As of June 18, 2022, everyone 6 months and older are recommended to 

get a COVID-19 vaccine. Currently, individuals 5 years and older can get a 

COVID-19 booster dose. Adults fifty years and older, people 12 years and 

older who are immunocompromised, and people who received two doses 

of Johnson & Johnson’s Janssen vaccine are eligible for a 2nd booster dose.1

In this reporting period, searches for “how long does second booster last” 

increased by 1,050 percent.b Many individuals are stressing the importance 

of individuals getting a COVID-19 booster dose as soon as they are eligible.2,3

However, consumers are also resistant to an additional COVID-19 dose. 

Some believe a good vaccine wouldn’t require additional doses, infectioninduced immunity provides equal, if not more, protection,4,5 and additional COVID-19 booster doses solely exist as a means for 

pharmaceutical companies to make money.6,7 Going forward, public health experts hope to devise a long-term plan addressing 

the need for additional COVID-19 booster doses.8,9,10

Mis-Perceptions, Concerns, and Threats to Vaccine Confidence

 Infection-induced immunity from SARS-CoV-2 provides more protection than a COVID-19 vaccine and, therefore, entirely 

negates the need for a vaccine.11,12

 The COVID-19 vaccines do not work because 2nd booster doses are needed to protect individuals from COVID-19.13,14

 2nd booster doses are not necessary and exist solely for pharmaceutical companies to make money.15,16

 The need for continual booster doses is not an effective nor practical way to end the pandemic. Therefore, an action plan is 

needed to address a return to normalcy.17,18

Information voids and commonly asked questions from the publicc

 Who is eligible for COVID-19 booster doses?d

 Everyone ages 5 years and older can get one booster dose 

5 months after completing their Pfizer-BioNTech COVID-19 

vaccine primary series. A booster is recommended 5 months 

after a Moderna primary series for persons 18 years and older. A 

booster is recommended 2 months after receiving Johnson & Johnson’s Janssen COVID-19 vaccine. You are eligible for a 2nd 

COVID-19 booster dose if you are 

 50 years of age or older, 

 12 years of age or older and are moderately or severely immunocompromised, or 18 years of age or older and got two 

doses of J&J/Janssen vaccine.19

 Which vaccine brand should individuals receive for their booster dose?b

 Three COVID-19 vaccines are authorized or approved for use in the United States to prevent COVID-19. Pfizer-BioNTech or 

Moderna (COVID-19 mRNA vaccines) are preferred for the 1st booster. Only the mRNA vaccines are recommended for a 2nd 

booster.20

 Can immunocompromised individuals receive COVID-19 booster doses?b

 Children ages 6 months and older who are moderately or severely immunocompromised should receive a primary series 

of 3 doses of Pfizer-BioNTech or Moderna COVID-19 vaccine. A Pfizer-BioNTech booster dose is now recommended for 

children5 - 17 years who received the Pfizer-BioNTech primary series-including those who are immunocompromised

Children 6 months – 17 years who are immunocompromised and received a 3-dose primary series with Moderna mRNA are 

not currently recommended to get a COVID-19 booster.21

a

Citations in this report are illustrative examples and are not the total number of instances of the corresponding themes.

b

Google Trends

c

These questions come from online data sources such as social media, news stories, Google Trends, and CDC-INFO

d

CDC-INFO
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COVID-19 State of Vaccine Confidence Insights Report | Report 27 | August 10, 2022

 People ages 12-17 years who are moderately or severely immunocompromised and received Pfizer-BioNTech vaccine 

3-dose primary series should receive a 4th dose (booster #1) at least 3 months after the primary series and a 5th dose (2nd 

booster) at least 4 months after the 1st booster. Immunocompromised children 12-17 years who had a 3-dose primary 

series with Moderna COVID-19 vaccine are not recommended to receive a booster at this time.22

 People ages 18 years and older who are moderately or severely immunocompromised and received a 3-dose series with 

either Moderna or Pfizer-BioNTech vaccine should receive 2 booster doses of an mRNA vaccine. 

 People 18 years and older who had one dose of Johnson & Johnson’s Janssen COVID-19 vaccine should get a dose of either 

mRNA COVID-19 vaccine (Pfizer-BioNTech or Moderna) at least 4 weeks after Janssen vaccination, then a second booster at 

least 2 months later. A 3rd booster (4th dose) with an mRNA vaccine is recommended at least 4 months later.23

 For more information about the recommended COVID-19 vaccinations, refer to CDC’s At-A-Glance COVID-19 Vaccination 

Schedules.

 Does infection-induced immunity provide more protection than a COVID-19 vaccine dose?b

 COVID-19 vaccination causes a more predictable immune response than infection with the virus that causes COVID-19. 

Getting a COVID-19 vaccine gives most people a high level of protection against COVID-19 and can provide added 

protection for people who already had COVID-19. Getting a COVID-19 vaccination is a safer way to build protection than 

getting sick with COVID-19. COVID-19 vaccination helps protect you by creating an antibody response without you having 

to experience sickness. Getting vaccinated yourself may also protect people around you, particularly people at increased 

risk for severe illness from COVID-19. Getting sick with COVID-19 can cause severe illness or death, and we can’t reliably 

predict who will have a mild or severe illness. If you get sick, you can spread COVID-19 to others. You can also continue to 

have long-term health issues after COVID-19 infection.24

Identified misinformation themes that may impact vaccine confidence

 Booster doses will cause a large number of serious adverse events or give people COVID-19.25,26,27

 COVID-19 vaccines weaken the body’s immune system.28,29

 Booster doses cause vaccine-induced AIDS.30,31

Ways public health and partners can take action to improve vaccine confidence 

 Engage communities in sustainable, equitable, and inclusive ways using two-way communication to listen, build trust, and 

increase collaboration.

 Work with leaders and trusted messengers in communities to develop strategies and messages about the efficacy and safety 

of COVID-19 vaccines that incorporate community values and priorities

 Work with public health officials, healthcare workers, and community leaders to stress the safety of COVID-19 booster doses 

over infection-induced immunity.

 Create visuals and plain-language documents that communicate the efficacy of the COVID-19 vaccines. 

 Create and disseminate messages clearly describing who is eligible for 1st and 2nd COVID-19 vaccine booster doses.

 Develop a sound social media strategy to disseminate messages addressing themes that includes community partners.
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COVID-19 State of Vaccine Confidence Insights Report | Report 27 | August 10, 2022

Consumers continue to express their support or opposition to performing and 

following COVID-19 mitigation measures.

The US public continues to demonstrate pandemic fatigue and a desire 

to end the use of all mitigation measures. This coincides with some 

states relaxing their masking and vaccination requirements.e,

32,33,34

A recent Axios-Ipsos poll found a similar lack of urgency, with only 

9% of respondents describing COVID-19 as a crisis.35 These concerns 

appeared to be amplified by two significant events during this 

reporting period. On April 18, 2022, a Florida federal judge struck down 

the national mask requirement for airplanes, airports and other public 

transportation, which the Department of Justice said they would 

appeal.36,37 On Google Trends, searches related to the judge’s ruling 

accounted for 6 of the top 10 most frequently searched queries related to masks. On April 26, 2022, Dr. Fauci gave an interview 

where he stated that “we are certainly right now in this country out of the pandemic phase.”

f

38 After the interview, Dr. Fauci 

clarified his statement by saying that the US was out of the “full-blown explosive pandemic phase.” However, some social media 

users shared the original quote as evidence that COVID-19 was now endemic in the US and, because COVID-19 is endemic, it is 

no longer a threat.39,40,41

Public’s Perceptions, Concerns, and Threats to Vaccine Confidence 

 Many social media users continue to state that because the 

pandemic is over, the public can progress past pandemic 

mitigation measures.42,43,44,45

 A recent Reuters-Ipsos poll found that 44% of respondents said that 

Americans need to get back to normal and get on with their lives. 

This is an increase from 36% in February.46

 According to the same Reuters-Ipsos poll, 64% of respondents said 

cities and states should impose mask requirements for indoor public places if there is a resurgence of COVID-19 in their area.47

 An AP-NORC poll found that 56% of Americans support mask requirements for people traveling on planes and public 

transportation, compared to 24% who oppose masks on public transportation.48

 A KFF poll found that 59% of adults think people should continue to wear masks in public places to minimize the spread of 

COVID-19.49

 A recent Axios-Ipsos poll found that 50% of respondents still support schools requiring students, teachers, and staff to wear 

masks, although this is down from 70% at the start of the school year.50

 Patients and healthcare organizations express their frustration and confusion regarding masking guidance in healthcare settings.51

Information voids and commonly asked questions from the public

 Is COVID-19 endemic in the U.S.?

 While the virus that causes COVID-19 is now endemic, the continued evolution of the virus and continued health impact 

remains, although with much lower deaths and hospitalizations than earlier in the pandemic. As of the writing of this 

report, since President Trump declared a nationwide emergency on March 15, 2020, the emergency declaration remains in 

effect.

 Why is it still recommended by CDC to wear masks on public transportation?

 As a result of a court order, effective April 18, 2022, CDC’s January 29, 2021 order requiring masks on public transportation 

conveyances and at transportation hubs was no longer in effect. However, CDC continues to recommend that people wear 

masks in indoor public transportation settings at this time.52

 When people properly wear a well-fitting mask or respirator, they protect themselves and those around them, and help 

keep travel and public transportation safer for everyone. Wearing a well-fitting mask or respirator is most beneficial in 

crowded or poorly ventilated locations, such as airport jetways. This public health recommendation is based on the 

currently available data, including an understanding of domestic and global epidemiology, circulating variants and their

impact on disease severity and vaccine effectiveness, current trends in COVID-19 Community Levels within the United 

States, and projections of COVID-19 trends in the coming months.53

e

CDC-INFO

f

Google Trends
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COVID-19 State of Vaccine Confidence Insights Report | Report 27 | August 10, 2022

 Should a used N95 mask be replaced with a cloth mask in healthcare settings?

 Replace the N95 when the straps are stretched out and it no longer fits snugly against your face or when it becomes wet, 

dirty, or damaged.54 Masks and respirators (i.e., specialized filtering masks such as “N95s”) can provide different levels 

of protection depending on the type of mask and how they are used. Loosely woven cloth products provide the least 

protection, layered finely woven products offer more protection, well-fitting disposable surgical masks and KN95s offer even 

more protection, and well-fitting NIOSH-approved respirators (including N95s) offer the highest level of protection.54

Identified misinformation themes that may impact vaccine confidence

 CDC declared the pandemic over.g

Ways public health and partners can take action to improve vaccine confidence  

 Develop and amplify messages explaining why vaccines are still important in the COVID-19 prevention response.

 Disseminate messages about community-level risk and corresponding COVID-19 mitigation measures.

 Support employers that have existing proof of vaccination requirements by providing or helping them craft messages about 

the importance of vaccination for their employees or offer onsite vaccinations.

 Support employers that do not have existing proof of vaccination by helping them implement COVID-19 preparedness, 

response, and control plans.

 Continue to encourage vaccinations and staying up to date with vaccine boosters by suggesting employers offer time off to 

get vaccines, or recover from side effects.

g

CDC-INFO
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COVID-19 State of Vaccine Confidence Insights Report | Report 27 | August 10, 2022

Continuing and evolving themes that may impact vaccine confidence

The themes below have been noted in previous reports and continue to undermine vaccine confidence. The information 

highlighted below focuses on what is new or different from previous reports. For additional context and previous 

recommendations on these themes, see previousInsights Reports.

Parents continue to have questions and express frustration towards COVID-19 

vaccination in children.

As of June 18, 2022, everyone 6 months and older are recommended to get a Moderna or Pfizer-BioNTech COVID-19 vaccine. On 

April 28, 2022, Moderna formally submitted data to the FDA to approve their COVID-19 vaccine in children aged younger than 6 

years of age.55 Likely in response to this announcement, searches for “moderna vaccine for kids under 5” rose by 250% compared 

to the previous reporting period.h

 Many parents were calling on the FDA to immediately schedule a meeting to review 

Moderna’s childhood vaccination data.56,57 Additionally, Pfizer submitted data to the FDA to approve a booster dose for children 

5-11 years of age.58 Some parents were relieved and hopeful at the notion of being one step closer to childhood vaccination.59,60

However, others were still frustrated with the process and that emergency use authorization had not been granted earlier for 

this age range.61,62,63 Some individuals were pushing for off-label use of the COVID-19 vaccine to get kids under 5 years of age 

vaccinated.64,65

Other consumers continue to raise concern over side effects,66,67 believe vaccination is unnecessary in younger children,70,71

and cite a lack of data to support childhood vaccination.68,69 On June 18, 2022, CDC Director Rochelle Walensky endorsed the 

Advisory Committee on Immunization Practices’ (ACIP) recommendation that all children 6 months through 5 years of age 

should receive a COVID-19 vaccine. This expands eligibility for vaccination to nearly 20 million additional children and means 

that all Americans ages 6 months and older are now eligible for vaccination.72

Perceptions, Concerns, and Threats to Vaccine Confidence

 Many parents are hesitant to vaccinate their children due to 

a fear of serious side effects and adverse events.73,74

 Some people question the need for the COVID-19 vaccine if 

a person recovered from COVID-19.75,76

 Consumers believe the FDA was not moving as fast as it 

should to approve COVID-19 vaccines in children.77,78

 While some parents are against childhood immunization, others remain advocates for COVID-19 vaccines in children.79,80

 Low vaccine confidence and uptake have already led to low vaccination levels in children.81,82

Information voids and commonly asked questions from the public

 When will COVID-19 vaccines for children under the age of 5 be available? 

 As of June 18, 2022, everyone 6 months and older is recommended to get a Moderna or Pfizer-BioNTech COVID-19 vaccine.83

 What are the vaccines approved for use in children? 

 CDC recommends the Moderna and Pfizer-BioNTech COVID-19 vaccines for everyone 6 months and older. Use CDC’s 

COVID-19 booster tool to learn if and when your child or teen can get boosters to stay up to date with their COVID-19 

vaccines.84

 What are common COVID-19 vaccine side effects in children? 

 Review of vaccine safety data for children find that side effects most commonly reported after getting vaccinated with 

the Pfizer-BioNTech COVID-19 vaccine were mild and brief. These side effects were more common after the 2nd dose and 

included headache, pain in the arm where the shot was given, and tiredness.85 Younger children may experience fewer side 

effects after COVID-19 vaccination than teens or young adults. For children and teens ages 12 through 17 years, the most 

commonly reported side effects after getting the 1st two doses of the Pfizer-BioNTech COVID-19 vaccine are tiredness, fever, 

headache, and pain in the arm where the shot was given.86



h

Google Trends
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COVID-19 State of Vaccine Confidence Insights Report | Report 27 | August 10, 2022

For children 4 years and older, side effects are more common after the second dose and can include:87

» Pain, swelling, and redness in the arm where the shot was given

» Fever

» Tiredness

» Headache

» Chills

» Muscle or joint pain

» Swollen lymph nodes

For children 3 years and younger, common side effects can include:

» Pain where the shot was given

» Swollen lymph nodes

» Irritability or crying

» Sleepiness

» Loss of appetite

Identified misinformation themes that may impact vaccine confidence: 

 Children have a high risk of death from receiving the COVID-19 vaccines.88,89

 COVID-19 poses no risk to children.90,91

 Children are getting hepatitis from the COVID-19 vaccines.92

Ways public health and partners can take action to improve vaccine confidence

 Collaborate with pediatricians and community leaders to create and 

disseminate information about the safety and need for COVID-19 vaccination in 

children 6 months and older. 

 Share recommendations for the use of COVID-19 vaccines in children 6 months and older.

 Create and disseminate messages with trusted messengers that reassure parents that the safety of COVID-19 vaccination in 

children will continue to be monitored and encourage enrollment of children in v-safe.  

 Create and disseminate messages with trusted messengers that accurately describe the side effects and risk of side effects 

COVID-19 vaccination in children. 
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COVID-19 State of Vaccine Confidence Insights Report | Report 27 | August 10, 2022

Consumers continue to have questions about the effectiveness of the COVID-19 

vaccines against SARS-CoV-2 variants.

As COVID-19 cases rise nationally,93,94,95 drug companies are thinking of 

different methods to combat symptomatic infection.96 Scientists believe 

nasal spray vaccines could help combat future variants by providing a higher 

level of protection.97 Additionally, during this reporting period, Moderna 

announced the company is developing a bivalent vaccine,98 one that contains 

spike proteins of both the ancestral and more recent strains of SARS-CoV-2 

virus.99 The bivalent vaccine produced a better immune response in trials 

against several SARS-CoV-2 variants, including Omicron and Delta.100 On 

June 22, 2022, Moderna announced their bivalent MRNA booster dose was 

effective at neutralizing antibody response against omicron subvariants BA.4 

and BA.5.101 Many news reports are also highlighting the presence of several 

variants and addressing questions about COVID-19 cases caused by Omicron variants, such as BA.4 and BA.5.102,103 And, despite 

the BA.2 variant’s earlier pervasiveness, few unvaccinated or unboosted adults who were aware of the BA.2 variant during its 

peak reported that it would influence their decision to get vaccinated or boosted.104

Perceptions, Concerns, and Threats to Vaccine Confidence

 Consumers believe an updated vaccine is necessary to properly protect against SARS-CoV-2 variants.105

 Public health officials are still pushing for COVID-19 vaccination even though the vaccines were developed for protection 

against the ancestral strain of the virus.106

 Updated vaccines are necessary to protect against new variants.107

Information voids and commonly asked questions from the public  

 How does CDC identify and track SARS-CoV-2 variants? 

 To identify and track SARS-CoV-2 variants, CDC uses genomic surveillance. CDC’s national genomic surveillance system 

collects SARS-CoV-2 specimens for sequencing through the National SARS-CoV-2 Strain Surveillance (NS3) program, as well 

as SARS-CoV-2 sequences generated by commercial or academic laboratories contracted by CDC and state or local public 

health laboratories. Virus genetic sequences are analyzed and classified as a particular variant. The proportion of variants in 

a population are calculated nationally, by HHS region, and by jurisdiction. The thousands of sequences analyzed every week 

through CDC’s national genomic sequencing and bioinformatics efforts fuel the comprehensive and population-based US 

surveillance system established to identify and monitor the spread of variants.108

 Will booster doses be effective against SARS-CoV-2 variants? 

 Breakthrough infections in people who are vaccinated are expected, but being up to date on recommended vaccines is 

effective at preventing severe illness, hospitalizations, and death. The emergence of the variants further emphasizes the 

importance of being up to date on COVID-19 vaccination.109

 Can all adults receive a 2nd booster dose to protect against SARS-CoV-2 variants? 

 No. Right now, adults 50 years of age or older are eligible for a 2nd COVID-19 booster dose if they received a 1st booster 

dose at least 4 months ago. Others 12 years of age or older are eligible for a 2nd booster dose if they are moderately or 

severely immunocompromised and received a 1st booster dose at least 4 months ago.110

Identified misinformation themes that may impact vaccine confidence 

 The COVID-19 vaccine is useless because it does not protect against SARS-CoV-2 variants.111

 The new variants are a political tactic to incite fear and raise support for certain candidates.112,113,114

Ways public health and partners can take action to improve vaccine confidence

 Work with trusted messengers to communicate scientific findings of side effects and adverse events to people who are 

unvaccinated with a focus on using uncommon dissemination channels and innovative messaging. 

 Continue to monitor the spread of SARS-CoV-2 variants and make such data publicly available. 

 Monitor and update the public on the COVID-19 vaccine’s effectiveness against variants and communicate any concerns in 

real-time. 

 Create messages that encourage people who are vaccinated to support their friends and family to get the COVID-19 vaccines. 
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COVID-19 State of Vaccine Confidence Insights Report | Report 27 | August 10, 2022

Consumers continue to question the benefits of getting a booster dose following 

vaccine breakthrough infections in high-profile people.

Notable breakthrough infections,115,116 for example, the April 26th announcement of VP Kamala Harris’ positive COVID-19 test 

result after having received a 2nd booster dose,117,118,119 have sustained consumer discussion about the benefit of additional 

booster doses. Recent studies demonstrate that the COVID-19 vaccines continue to provide protection against severe illness, 

hospitalization, and death.120 However, some consumers 

express doubt about the benefit of vaccinations and 

booster doses given the presence of breakthrough 

infections.121,122,123 Increased doubt in vaccine effectiveness 

can decrease vaccine confidence and uptake, including 

decreased booster dose uptake.

Perceptions, Concerns, and Threats to Vaccine Confidence 

 Some consumers worry that the CDC is not disseminating data related to breakthrough infections.124,125,126

 Vaccinated individuals who experienced breakthrough infections may be less likely to receive future COVID-19 booster 

doses.127

Information voids and commonly asked questions from the public

 Does being up to date on COVID-19 vaccines reduce your likelihood of SARS-CoV-2 infection?

 Recent data suggests that unvaccinated people aged 12 and older had a 2-3x higher risk of testing positive for SARS-Cov-2 

infection compared to people vaccinated with a primary series and a booster dose.128

 Why should you get a COVID-19 vaccine if you can still get a SARS-CoV-2 infection and spread it to others?

 Fully vaccinated people with a vaccine breakthrough infection are less likely to develop serious illness than those who are 

unvaccinated and get COVID-19. Even when fully vaccinated people develop symptoms, they tend to be less severe than in 

unvaccinated people.129

Identified misinformation themes that may impact vaccine confidence 

 COVID-19 vaccines are ineffective and should not be classified as vaccines.130,131,132,133

Ways public health and partners can take action to improve vaccine 

confidence

 Continue to disseminate and amplify messages that

demonstrate why vaccines are still an important 

tool to protect against severe COVID-19 infection, 

hospitalization, or death.

 Work with community members and trusted 

messengers to create and disseminate messages that educate the public about breakthrough cases and how they are 

expected due to the high transmissibility of the circulating variants.
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COVID-19 State of Vaccine Confidence Insights Report | Report 27 | August 10, 2022

Consumers continue to express their lack of trust in CDC.

As reported in SoVC 25, news outlets reported consumers’ lack of trust in 

public health, science, and CDC,134,135 following a news story about CDC 

withholding COVID-19 data.136 Social media users continue to express a 

lack of trust in CDC, including misgivings about CDC’s data and related 

dissemination.137,138,139 Consumers express frustration regarding CDC’s 

Community Levels data, arguing that the February 25 change in metric 

from Transmission Levels to Community Levels was poorly communicated 

and misleading.i,140,141 Some social media users also pushed back on CDC’s 

vaccine outreach to Tribal populations as a targeted effort to mislead 

American Indians and Alaskan Natives.142,143,144

Additionally, consumers question the accuracy of CDC data across a wide range of domains, including COVID-19 deaths,h 

vaccination rates,145 and vaccine-induced adverse events.146 Consumers continue to discuss inventories of reported adverse 

events such as the Vaccine Adverse Event Reporting System (VAERS) and Pfizer’s Cumulative Analysis of Post-Authorization 

Adverse Event Reports of Pf-07302048 (Bnt162b2) Received Through 28-Feb-2021 document as evidence of CDC ignoring or 

suppressing adverse event information.147,148,149

Lack of trust in the CDC’s data and messaging regarding COVID-19 may contribute to decreased vaccine confidence and uptake, 

while wider mistrust in CDC and public health agencies may hamper public health efforts unrelated to COVID-19. 

Perceptions, Concerns, and Threats to Vaccine 

Confidence 

 Some consumers worry that the COVID-19 

community levels map is misleading and 

will lead to reduced use of mitigation 

measures.150,151

 Some consumers worry that the CDC introduced the COVID-19 community levels map to prioritize the economy over public 

health.152

 Some consumers believe the CDC is suppressing or ignoring VAERS data.153

 Some consumers believe the CDC attempted to suppress a recently released Pfizer document, or is ignoring the data it 

contains.154,155

Information voids and commonly asked questions from the public

 Why did the CDC introduce the COVID-19 community levels? Where did the community transmission information go?

 The CDC provides COVID-19 community levels data as a tool to provide current, local information for decision-making 

around community prevention strategies and individual behaviors. It can be used to prevent COVID-19 from placing strain 

on communities and healthcare systems.156

 You can find more information and your county’s COVID-19 community level by going to CDC’s COVID-19 Community 

Levels website.

 Community transmission information is still actively updated and is provided for healthcare facility use at CDC’s Integrated 

County View website. 

 Are the adverse events reported in VAERS or the recently released Pfizer document proof that COVID-19 vaccines are not safe?

 No. Multiple analyses from CDC and others have found all approved or authorized COVID-19 vaccines to be safe, with rare 

serious adverse events identified and publicly reported. You may find more information by going to: Ensuring COVID-19 

Vaccine Safety in the US | CDC

 VAERS is an early warning system that accepts and analyzes reports of possible health problems—also called “adverse 

events”—after vaccination. Anybody can submit a report to VAERS; VAERS data is publicly available. VAERS data contains 

all submitted reports of health problems individuals experience following vaccination, and this data alone cannot be used 

to determine if the vaccine caused the adverse event(s) reported. Additional information can be found at CDC’s Vaccine 

Adverse Event Reporting System (VAERS) website. 

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 The Pfizer document is a comprehensive listing of all reported adverse events or health issues described following 

vaccination, regardless of whether the vaccine caused them. Tracking such events is a requirement for pharmaceutical 

companies, FDA, and CDC to identify possible safety signals, particularly rare events that may not have been possible to 

detect during clinical trials. An adverse event is simply an event that has occurred after vaccination — it does not mean the 

vaccine caused the problem. And many of these events are likely to be purely coincidental. Adverse events related to the 

Pfizer-BioNTech vaccine are similar to many routine vaccines. These adverse events are mild and short lasting. Importantly, 

for severe adverse events, there is a detailed process to determine whether these are related to vaccination or not. FDA and 

CDC use several different sources of data to monitor vaccine safety closely and identify events that occur more often after 

vaccination compared to how often they typically occur in the general population.157 The Pfizer report did not include any 

comparison of adverse events in unvaccinated people.

Identified misinformation themes that may impact vaccine confidence

 The CDC is lying and spreading misinformation.158,159,160

 The CDC cannot be trusted due to undue influence of pharmaceutical 

companies and/or political entities.161,162,163,164

 The CDC is hiding information about a link between COVID-19 

vaccination and a cluster of children identified with hepatitis and 

adenovirus infection. j,165,166

 CDC and the federal government conspired to put snake venom in the 

water supply, remdesivir, or the mRNA COVID-19 vaccines to create or 

exacerbate the COVID-19 pandemic.167,168

Ways public health and partners can take action to improve vaccine confidence  

 Engage communities in a sustainable, equitable, and inclusive way using two-way communication to listen, build trust, and 

increase collaboration.

 Coordinate with federal, state, local agencies and partners to share clear, complete, and accurate messages about COVID-19 

vaccines and take visible actions to build trust in the vaccine, the vaccinator, and the system. 

 Communicate transparently about the process for authorizing, approving, making recommendations for, monitoring the 

safety of, distributing, allocating, and administering COVID-19 vaccines, including data collection, analysis, and reporting.

 Provide regular updates on the benefits, safety, side effects, and effectiveness of COVID-19 vaccines and clearly communicate 

what is known, what isn’t known, and what is being done to find out what isn’t known.

 Proactively address and help stop the spread and harm of misinformation via social media platforms, partners, and trusted 

messengers.

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Appendix: Inputs and Sources

Type Input Cadence Sources Tactics for Utilization

Social Media 

Listening 

& Media 

Monitoring

Communication 

Surveillance Report

Daily on 

weekdays

Google news

 Meltwater

CrowdTangle

Native platform searches

 Share of voice topic analysis to identify 

themes

 Emerging topics 

Meltwater Daily  Facebook, Twitter, Instagram

 Blogs

News media

Online forums

 Share of voice topic analysis

 Emerging theme topics

Identify high reach/velocity topics

OADC (Office of the 

Associate Director of 

Communication) Channel 

COVID-19 Post metrics

Weekly  Sprout Social

Native OADC account analytics

Analyze # of posts, topics 

 Success of messages, # of impressions, 

reach, # engagements

OADC Channel Comment 

Analysis

Daily on 

weekdays

Native platform searches  Sentiment analysis

Identify message gaps/voids

Direct 

Reports

CDC-INFO Metrics Weekly CDC-INFO inquiry line list

 Prepared response (PR) usage report

Cross-compare PR usage with inquiry 

theme analysis

 Sentiment analysis

Identify information gaps/voids

VTF Media Requests Weekly  Media request line list  Leading indicator for news coverage

Identify information gaps/voids

Web Metrics Weekly  Top pages

Google search queries

 Top FAQs

 Referring domains

Identify information gaps/voids,

Identify keywords/search terms, changes in 

web traffic

Research

Poll Review Weekly Harris Poll, PEW research, Gallup Poll, 

KFF 

New data related to vaccine 

hesitancy

Identify socio-behavior indicators related 

to motivation and intention to vaccinate 

Literature Review Weekly  PubMed, LitCovid, ProQuest Central, 

Altmetric 

New data related to vaccine 

hesitancy

Identify current vaccination intention

Identify barriers to vaccination

Third Party 

Reports

Tanaq Social Listening 

+Media Monitoring Report

Weekly  Meltwater

 Sprout Social

 First Draft

Native platform searches

 Trending topics

Demographic and geographic 

conversation monitoring

CrowdTangle content 

insights report

Biweekly  Facebook  Top pages (voices), groups

General trends/sentiment analysis

News analysis through posts

Washington St. Louis 

iHeard

Weekly  Proprietary methods  Survey results

 Emerging threats and data deficits

Vaccine narratives

Project VCTR Weekly  Proprietary methods National and regional trends in negative 

attitudes toward vaccination

Conversations around Legislation