CS000000-A | 2/2/22

COVID-19 State of Vaccine 

Confidence Insights Report

Report 22 | February 2, 2022 | Date Range: December 21, 2021 – January 10, 2022 

Summary

Findings. The first major theme of this report is that consumers continue to express confusion and frustration regarding the 

updated guidance on the shortened duration for isolation and quarantine and when to receive the booster dose. The second 

major theme is that consumers continue to express frustrations over long wait times and difficulty getting tested amid the 

recent spike in COVID-19 cases. A third theme is that consumers have questions about the effectiveness and safety of COVID-19 

vaccines for children. The final finding during this report is regarding consumers’ concern about the vaccine’s impact on 

menstrual cycles and fertility.

Ways to 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 mis/disinformation with evidence-based messaging. These efforts aim 

to increase confidence in COVID-19 vaccines and expand vaccine uptake more broadly. Efforts should be made to engage and 

collaborate with vaccine advocates and other trusted messengers to disseminate messages that explain the reasons for the 

updated guidance and how changing guidance is a normal process as more data is collected. Create and amplify messages that 

educate people on when they should get tested for COVID-19, the differences in the types of tests, and where they can access 

tests.

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

our partners can you to address the issues raised in this report: https://centersfordiseasecontrol.sharefile.com/d-sb2a4c1fd4bdb

4b5d8d08c2bc04c93c04  

Contents

2 Aims and Methods

3 Major Themes

3 Consumer expressed confusion and frustration 

regarding updated official guidance related to 

quarantining and receiving booster doses.

3 Consumers express frustrations over long wait times 

and difficulty getting tested

4 Continuing and Emerging Themes

3 Consumers continued to have concerns about the 

effectiveness and safety of COVID-19 vaccines for 

children.

3 Consumers expressed concern about the vaccines’ 

impact on menstrual cycles and fertility

4 Appendix: Inputs and Sources

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).
Page: 2

COVID-19 State of Vaccine Confidence Insights Report | Report 22 | February 2, 2022

Aims and Methods

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

Insights Report emphasizes major themes influencing COVID-19 vaccine hesitancy and uptake. Themes are characterized by the 

level and type of threat to vaccine confidence, degree of spread, and directionality. 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: 3

COVID-19 State of Vaccine Confidence Insights Report | Report 22 | February 2, 2022

Major Themesa

Consumer expressed confusion and outrage regarding updated official guidance 

related to quarantining and receiving booster doses.

On December 23, the CDC announced that asymptomatic healthcare workers infected with the virus that causes COVID-19 

could return to work after seven days with a negative test.1 Additionally, healthcare workers who are up to date on their 

COVID-19 vaccines (i.e., have received all recommended COVID-19 vaccine doses, including a booster dose) do not need to 

quarantine following high-risk exposures. On December 27, the CDC shortened 

the recommended time for isolation from 10 days to 5 days for those infected 

with SARS-CoV-2 if asymptomatic, but required mask usage when around others 

and to avoid travel.2 On January 4, CDC updated guidance on the recommended 

COVID-19 isolation period for individuals who are sick or test positive, telling 

people that if they have access to a COVID-19 test and want to take it, the best 

approach is to use a rapid test on the fifth day after they initially developed 

symptoms or tested positive. If they tested negative, then they could shorten 

their isolation period to 5 full days, if they wear a mask in public and avoid travel 

and people who are high-risk for 10 days.3

 Recommendations for quarantine 

after close contact to someone with COVID-19 differ based on a person’s 

vaccination status and prior SARS-CoV-2 infection in the past 90 days.4

Many news outlets declared the new guidance as confusing5,6,7

 while others 

questioned why the guidance did not include a requirement to test negative 

for COVID-19 on day five.8,9 The number of consumers seeking clarification on 

guidance greatly increased during this period.b,c,d The heightened frustrations 

around COVID-19 guidance may further undermine public trust in CDC and 

government leadership. This can potentially threaten vaccine confidence by 

increasing skepticism in response to public health messaging.10,11,12,13 If sources 

for guidance are no longer viewed as trusted entities, the public may be less 

likely to follow recommendations for vaccines and booster doses.14

Perceptions, Concerns, and Threats to Vaccine Confidence

 Some consumers stated that guidance changes were made for economic benefit and as a response to staffing shortages 

rather than based on science.d,15,16,17,18

 Consumers expressed confusion about the guidelines and uncertainty about how they should react to acquiring, exposures 

to, and symptoms of COVID-19b,d,19,20

 Some social media users stated their belief that changing the quarantine guidelines was to appease corporations, specifically 

the airline industry.21,22,23,24

 Consumers expressed concern that not including recommendations for a negative test in the updated guidance could lead to 

an increase of COVID-19 cases.25,26,27,28

 Many felt the new guidelines were unsafe for patients and healthcare workers.29,30,31 Some people discussed the discrepancy 

between federal guidance and statements from other trusted organizations, such as nurses’ associations32,33 and the World 

Health Organization.34,35

 Skeptics interpreted changes in booster dose guidance as evidence that booster doses are ineffective36,37 or an intentional 

manipulation designed to increase pharmaceutical profit.38,39,40,41

a

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

b

Google Trends

c

SEMrush

d

CDC-INFO
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COVID-19 State of Vaccine Confidence Insights Report | Report 22 | February 2, 2022

Content Gaps and Information Voids

 Are healthcare workers putting themselves and their patients at risk by reducing the length of quarantine?

 CDC’s recommendations follows the latest evidence to enhance healthcare worker and patient protection while also 

addressing adverse impacts of the surge in Omicron cases on healthcare systems.42

 What do you do if you test positive or have close contact with someone who tested positive for COVID-19?

 CDC’s quarantine guidance is located on the CDC’s Quarantine and Isolation webpage. 

 If cases are rising, why is the quarantine guidance for a reduced amount of time? 

 CDC’s quarantine guidance is based on the latest evidence to enhance healthcare worker and patient protection while also 

addressing adverse impacts of the surge in Omicron cases on healthcare systems.43,44

 Why is CDC not recommending a negative test to end the isolation period? 

 Tests for the virus that causes COVID-19 are best used early in the course of illness to diagnose COVID-19 and are not 

authorized by the U.S. Food and Drug Administration (FDA) to evaluate the duration of infectiousness.45

 If CDC is recommending a shorter period (from 6 months to 5 months after a primary series of mRNA COVID-19 vaccines, and 

from 2 months to 1 month after a primary dose of Janssen COVID-19 vaccine) between booster doses, does that mean the 

vaccine is not working? 

 COVID-19 vaccines work well to prevent severe illness, hospitalization, and death. However, public health experts noted a 

reduction in protection over time and particularly against newly emerging SARS-CoV-2 virus variants.46

Misinformation Themes

 CDC is making guidance decisions based on economic and political gain47,48,49,50 and, as a result, is no longer a credible source 

of information.51,52,53,54

 Increased COVID-19 cases prove that quarantining, isolating, and booster doses are ineffective mitigation strategies.55,56,57

 CDC booster dose guidance directly contradicts the WHO’s assertion that booster doses are ineffective.58,59,60,61

Ways to Take Action

 Create and disseminate messages that educate the public on the changes in the guidance for healthcare workers and fully 

vaccinated asymptomatic people.

 Engage and collaborate with vaccine advocates and other trusted messengers to disseminate messages that explain the 

reasons for the updated guidance and how changing guidance is a normal process as more data is collected. 

 Continue to disseminate and amplify messages about the benefits and limitations of COVID-19 testing.

 Continue to disseminate information about the demonstrated benefits of booster doses in preventing severe illness and 

hospitalization from Delta and Omicron variants.
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COVID-19 State of Vaccine Confidence Insights Report | Report 22 | February 2, 2022

Consumers express frustrations over long wait times and difficulty getting tested 

There were reports of a national shortage of COVID-19 tests possibly driven by a combination of a surge in cases of the Omicron 

variant and increased demand for COVID-19 testing, including for holiday season travel.62,63,64 The existing surge in demand 

for testing and delays in results could undermine trust in the government and public health institutions that authorize and 

distribute vaccines.65,66 In addition, frustrations over test shortages,67,68 the public’s outrage at price gouging,69,70,71 and conflicting 

updated guidelines72 may weaken vaccine confidence as this could create the perception to some that the government and 

public health agencies are ineffective in addressing the COVID-19 pandemic.73,74 

Perceptions, Concerns, and Threats to Vaccine Confidence 

 Online consumers expressed a lack of confidence in the government’s ability to control the COVID-19 pandemic75,76,77,78 and 

questioned the accuracy of reported COVID-19 cases.79 

 Several online users questioned the reliability of rapid tests for the Omicron variant amid growing evidence that tests may 

provide false negative results.80,81,82,83 

 There were concerns that the COVID-19 testing shortage negatively impacted people’s ability to take sick leave after testing 

positive84,85,86 or be prescribed alternative therapeutics.87

 Some social media users expressed fear that the long lines for COVID-19 testing 

increased exposure to the virus.88,89

Content Gaps and Information Voids: 

 Who should get tested for COVID-19? 

 Anyone with COVID-19 symptoms or who has been in close contact with 

someone with COVID-19 should be tested regardless of vaccination status.90,91

 How are rapid home COVID-19 tests different from PCR tests? 

 An in-depth explanation of the differences in tests for COVID-19 infection can 

be found on CDC’s COVID-19 Testing: What You Need to Know.

 Which COVID-19 test is better, viral or antibody tests? 

 Viral tests and antibody tests provide different types of information.

 Viral tests tell you if you have a SARS-CoV-2 infection at the time of the test and use samples that come from the nose or 

mouth. 

 Antibody tests use blood samples and tell if someone had a prior infection.

 Antibody testing is not currently recommended to determine:92

 If you have a current infection.

 If you have immunity to the virus following COVID-19 vaccination.

 Whether you need to get vaccinated if you are not fully vaccinated.

 Whether you need to quarantine after a known or suspected exposure to COVID-19.

 Where can I get an at-home COVID-19 test? 

 Call or visit a local pharmacy, healthcare provider, or public health department to see if they have available COVID-19 testing 

kits.93 You can order four free at-home tests online at COVIDTests.gov.

Misinformation Themes 

 The COVID-19 antigen tests were made to produce false-positive results to drive up case counts.94,95,96

Ways to Take Action 

 Partner with public health departments and non-profits to distribute free or affordable COVID-19 tests to the general public. 

 Create and amplify messages that educate people on when they should get tested for COVID-19, the differences in the types 

of tests, and where they can access tests.
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COVID-19 State of Vaccine Confidence Insights Report | Report 22 | February 2, 2022

Continuing and Emerging Themes 

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 previous Insights Reports.

Consumers continued to have concerns about the effectiveness and safety of 

COVID-19 vaccines for children.

Parents and caregivers continue to have questions about the COVID-19 vaccine for children, including safety, long-term 

side effects, and effectiveness. Web searches for “COVID vaccine side effects in children” rose by 150% during this reporting 

period. Although debunked, a viral video falsely claiming mRNA vaccines cause permanent damage to vital organs in children 

continues to be circulated online by vaccine opponents. Consumers spreading misinformation that children are not at risk for 

severe COVID-19 illness, despite increasing hospitalization rates,97 is likely to adversely impact vaccine confidence. However, 

safety monitoring has identified an elevated risk for myocarditis after mRNA COVID-19 vaccination, particularly in males ages 

12–29 years after the 2nd dose.98 A more in-depth review of this theme is in a previous State of Vaccine Confidence Insights’ Rapid 

Report – Announcement of Pediatric COVID-19 Vaccines for Children ages 5–11 years old.

Perceptions, Concerns, and Threats to Vaccine Confidence

 Social media users continue to cite concern for serious side effects and unknown long-term outcomes, like fertility and heart 

problems.99,100,101,102

 Many consumers suggest authorization for vaccines in children should wait until long-term studies have been completed.103,104

 Consumers continue to express the belief that children do not need to be vaccinated due to mild symptoms and lower risk of 

severe infections.105,106,107,108

 Studies show a rural-urban vaccination gap, with pediatricians in rural areas less likely than urban pediatricians to recommend 

COVID-19 vaccinations for children.109  

Content Gaps and Information Voids

 When will vaccines for children under 5 years be authorized or approved?  

 The U.S. currently does not have an FDA-authorized or approved COVID-19 vaccine available for populations younger than 

5 years old. Some sources indicate a COVID-19 vaccine for use in children younger than 5 years old may be available within 

the next few months.110 

 Is Omicron causing more severe illness in children compared to other strains? 

 Evidence from a recent MMWR indicates that for children 17 years and younger, “hospital severity indicators, including 

length of stay and ICU admission, were similar to and lower, respectively, during the Omicron period compared with those 

during previous high-transmission periods.”111However, more data are needed to know if Omicron infections cause more 

severe illness or death than infection with other variants.112

 How do parents and caregivers distinguish between typical vaccine site injection reactions and serious side effects or adverse 

reactions? 

 CDC has an online resource that details common side effects and provides information as to when a parent should seek 

medical care for adverse reactions after vaccination.113

 What should a healthcare professional do if the wrong dose of the COVID-19 vaccine was administered to a child? 

 Providers, patients, and parents should report vaccine administration errors to the Vaccine Adverse Events Reporting 

System. To know what to do regarding the need for revaccination, providers should refer to the COVID-19 Vaccine 

Administration Errors Revaccination Guidance. 

Misinformation Themes

 COVID-19 vaccines are killing, permanently damaging, or disabling children.

 COVID-19 vaccines are still experimental, and pharmaceutical companies will not release the final safety data for several 

decades. 

 The risk of adverse events from COVID-19 vaccination are more severe than the potential impact of COVID-19 illness. 
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COVID-19 State of Vaccine Confidence Insights Report | Report 22 | February 2, 2022

Ways to Take Action

 Utilize and promote motivators to vaccinate children, such as protection of family members not yet eligible for vaccines and 

the ability to continue in-person school learning and activities.

 Develop and disseminate messages about the potential risk of severe COVID-19 illness in children and how vaccination 

can help reduce that risk.

 Develop plain language messages using findings from these two recent MMWR reports to educate people on the safety of the 

vaccine for children and the risk of severe COVID-19 illness in children: 

 Trends in COVID-19 Cases, Emergency Department Visits, and Hospital Admissions Among Children and Adolescents Aged 

0–17 Years — United States, August 2020–August 2021

 COVID-19 Vaccine Safety in Adolescents Aged 12–17 Years — United States, December 14, 2020–July 16, 2021
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COVID-19 State of Vaccine Confidence Insights Report | Report 22 | February 2, 2022

Consumers expressed concern about the vaccines’ impact on menstrual cycles and 

fertility

The release of a study analyzing the association between menstrual cycle length and COVID-19 vaccination114 renewed 

discussions about the impact of COVID-19 vaccination on reproductive systems and fertility. Similarly, online conversations 

surrounding the association between COVID-19 vaccination and menstruation increased by more than 300% during the current 

reporting time frame.e Inconsistent and confusing messaging surrounding the impact of COVID-19 vaccines on functions of 

reproductive systems may adversely affect vaccine confidence. 

Perceptions, Concerns, and Threats to Vaccine Confidence

 News outlets115,116 and online consumers discussed117,118 the findings of a recent study that indicated there were very limited, 

short term changes in menstrual cycle length or timing (less than one day) associated with COVID-19 vaccination.119

 Consumers expressed apprehension about the safety of the COVID-19 vaccines for women of all reproductive age and 

pregnant people including, but not limited to, irregular menstrual cycles,120 spontaneous abortion,121 and unknown long-term 

side effects.122

 Some consumers believe vaccines also impact other reproductive system functions besides the menstrual cycle.123

Content Gaps and Information Voids

 Are COVID-19 vaccines safe for those already pregnant or thinking about becoming pregnant?

 COVID-19 vaccination is recommended for people who are pregnant, breastfeeding, trying to get pregnant now, or might 

become pregnant in the future, as well as their partners.124,125

 Is there safety monitoring for children exposed to the COVID-19 vaccine in utero? 

 CDC and FDA continue to monitor COVID-19 vaccines and other vaccines for safety when given during pregnancy.126,127

 Early data from three safety monitoring systems did not find any safety concerns for people who received an mRNA 

COVID-19 vaccine late in pregnancy or for their babies.128,129

 Scientists have not found an increased risk for miscarriage among people who received an mRNA COVID-19 vaccine just 

before and during early pregnancy (before 20 weeks of pregnancy).130,131,132

 The monitoring of COVID-19 vaccination during pregnancy is ongoing. CDC will continue to follow people vaccinated 

during all trimesters of pregnancy to better understand effects on pregnancy and babies.133

Misinformation Themes

 Consumers are reporting severe adverse events into VAERs s (e.g., spontaneous abortion,134 changes in the quality and 

quantity of menstrual bleeding),135 however, the CDC is ignoring these adverse events.136

 If COVID-19 vaccines impact menstrual cycles, then vaccines also negatively impact other aspects of reproductive systems, 

including the health of fetuses.137

Ways to Take Action

 Given the high rate of unintended pregnancies and circulating misinformation related to fertility, tailor messages to the 

broader population of women of reproductive age, and partner with health care providers (e.g., midwives, OBGYNs) and 

pregnancy or pregnant influencers to disseminate these messages. 

 Partner with websites and organizations that host fertility- or pregnancy-related support groups or discussion boards to 

identify and address information gaps.

 Disseminate messages through trusted messengers related to the following topics: 138

 That no safety concerns have been identified for people who received an mRNA COVID-19 vaccine late in pregnancy or for 

their babies.

 There is not an increased risk of miscarriages.

 CDC continues to monitor the safety of COVID-19 vaccinations in pregnancy. 

 Continue to disseminate messages about the risks of COVID-19 in pregnancy for both the pregnant person and the fetus/

infant that the vaccines are effective and protect the mom and baby against harm.

e

Meltwater
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COVID-19 State of Vaccine Confidence Insights Report | Report 22 | February 2, 2022

Appendix 1: 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

First Draft News Vaccine 

Misinformation Insights 

Report

Monthly  Proprietary methods  Media trends analysis

 Emerging threats and data deficits

Online vaccine narratives

Project VCTR Weekly  Proprietary methods National and regional trends in negative 

attitudes toward vaccination

Conversations around Legislation

Virality Project Weekly  Proprietary methods  Mis- and disinformation trends related to 

COVID-19 vaccine