CS000000-A | 12/23/22

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).

CDC’s State of 

Vaccine Confidence 

Insights Report

Updated (Bivalent) COVID-19 

Booster Dose Report

December 23, 2022

Date Range: August 30 – September 12, 2022

CDC partners can now report vaccine-related 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.
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State of Vaccine Confidence Insights Report | December 23, 2022

Summary

Major themes identified from social media, news, and other sources 

that may impact vaccine confidence:a,b

 Some consumers, news outlets, and medical professionals are 

concerned about the availability and eligibility requirements of 

the updated (also known as bivalent) COVID-19 booster dose.

 Consumers have questions and concerns about the safety of 

the updated COVID-19 booster dose, especially given reports of a lack 

of human trial data for the currently authorized formulation prior to 

being authorized.

 Consumers have questions and concerns about the effectiveness of the 

updated COVID-19 booster dose, as well as if it is even needed.

 Some health experts question whether combined messaging to 

promote uptake of both updated COVID-19 boosters and seasonal 

influenza vaccine is a helpful strategy.

Ways public health and partners can take action to improve vaccine 

confidence:

 Continue working with trusted messengers, community leaders, and 

members of the public to craft and disseminate messages that promote 

the availability, eligibility, safety, and effectiveness of the updated 

COVID-19 booster dose.

 Ensure equitable vaccine access for racial and ethnic minority groups 

that have had reduced access to COVID-19 vaccines, such as Black or 

African American and Hispanic or Latino communities (see COVID-19 

Vaccine Equity).

 Disseminate data about the effectiveness and safety in humans of the 

updated COVID-19 booster dose, when available (see December 2, 2022 

edition of CDC’s Morbidity and Mortality Weekly Report).

 Partner with healthcare workers and local community leaders to craft 

and disseminate messages about reasons eligible individuals should 

receive the updated COVID-19 booster dose. 

 Conduct and support research that evaluates the effectiveness of 

the updated COVID-19 booster doses against circulating SARS-CoV-2 

variants, as well as how this effectiveness compares to that of the 

original formulations of COVID-19 vaccines. 

 Create venues or mechanisms to hear and respond to communities’ 

questions and concerns, such as town halls, hotlines, and social media. 

 Work with trusted messengers and other community partners to 

craft and disseminate messages about the safety and effectiveness of 

receiving the updated COVID-19 booster dose and the annual influenza 

vaccine at the same time, especially as new findings emerge. 

Contents

4

Themes That Might Impact Vaccine 

Confidence

4

Some consumers, news outlets 

and medical professionals are 

concerned about the availability 

and eligibility requirements of 

the updated COVID-19 booster doses

6

Consumers have questions and 

concerns about the safety of the 

updated COVID-19 booster dose 

especially given reports of lack of 

human trial data

8

Consumers have questions and 

concerns about the effectiveness of 

a bivalent COVID-19 booster dose, 

including if a booster dose is even 

needed

11

Some health experts and evidence 

suggest that combining messaging 

promoting uptake of the updated 

COVID-19 booster dose and the 

annual influenza vaccine at the same 

time might not be effective for all 

people

12

Peer-Reviewed References

16 a Appendix: Inputs and Sources Themes for this report come from integrated and thematic analyses of data 

from sources listed in the appendix.

b

Social media citations can be found in this linked document.
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State of Vaccine Confidence Insights Report | December 23, 2022

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 help educate their constituents and build vaccine 

confidence by addressing the themes in this report: 

https://centersfordiseasecontrol.sharefile.com/d-s9e9b821333834511bca4292dc829695f

Aims and Methods

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

Confidence Insights Report emphasizes major themes currently influencing vaccine hesitancy and 

uptake. These 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: 4

State of Vaccine Confidence Insights Report | December 23, 2022

Themes That Might Impact 

Vaccine Confidencec

Some consumers, news outlets and medical 

professionals are concerned about the availability 

and eligibility requirements of the updated COVID-19 

booster doses

Despite continued SARS-CoV-2 

transmission1

 and regional spikes of 

infection,2,3

 the widespread uptake 

of the monovalent COVID-19 booster 

dose—which became widely available 

and recommended to all eligible 

individuals in Fall 2021—was lower 

than uptake of the primary series of the 

monovalent COVID-19 vaccines.1

 The 

discrepancy between coverage of the 

initial monovalent booster and primary 

series uptake1

 may be attributed to 

many factors, such as a potential 

diminished concern for infection, a potential acceptance of the risk of infection, a possible 

evaluation of preventive efforts as unnecessary or ineffective, or diminished concern relative to 

decreases in the enforcement of non-pharmaceutical preventive measures like masking.4

In an effort to increase protection against the evolving variants of SARS-CoV-2 (the virus 

that causes COVID-19) updated formulations of the Moderna and Pfizer-BioNTech COVID-19 

vaccines were authorized by the Food and Drug Administration (FDA) in August 2022.5

The newly updated bivalent booster formulations contain two messenger RNA (mRNA) 

components to protect against both the initial SARS-CoV-2 virus plus newer variants.6

 Half of 

the vaccine targets the original variant, while the other half targets the BA.4 and BA.5 Omicron 

subvariant lineages.6

 The updated COVID-19 booster dose is administered as a single dose 

at least two months after completing any monovalent primary series or previously received 

monovalent booster dose(s) (see also Clinical Guidance for COVID-19 Vaccination).7

 Individuals 

are considered up to date with their COVID-19 vaccines if they have completed a COVID-19 

primary series and received the most recent booster dose recommended for them by CDC.8

In September 2022, the White House announced an updated COVID-19 booster dose initiative 

which includes securing 170 million doses of the updated COVID-19 vaccines for distribution to 

the American public.9

c

Citations in this report are illustrative examples and are not the total number of instances of the corresponding themes.
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State of Vaccine Confidence Insights Report | December 23, 2022

Perceptions, Concerns, and Threats to Vaccine Confidence

 Slow updated booster dose uptake10 may indicate some consumers perceived updated booster 

vaccination as not an immediate necessity. Some consumers’ comments express a range of 

opinions, such as the belief that any waning protection from the primary series suggests an 

overall lack of vaccine effectivness11 and that emerging circulating variants are not targeted by 

the updated booster dose.12

 Some consumers expressed concern regarding the authorization of the updated booster 

dose, such as the lack of human studies13 during the reporting period, and vaccination 

administration errors.14,15

 Some consumers are not fazed by the notion of receiving a COVID-19 booster dose annually, as 

many have already formed a habit of receiving a seasonal influenza vaccine. 16,17,18

Commonly asked questions and queries from the publicd

 Who is eligible for the updated COVID-19 booster dose?e

 Currently, anyone aged 5 years or older who has completed at least a primary series is eligible 

for a updated booster dose, regardless of the number or type of prior booster doses received 

so long as at least two months have passed since their last COVID-19 vaccine dose.8

 Note that 

while people ages 6 years and older may receive an updated booster from either Pfizer or 

Moderna, children age 5 years old “are only currently recommended to receive the updated 

(bivalent) Pfizer-BioNTech booster, and they can get this booster whether they received the 

Pfizer-BioNTech or Moderna primary series.”8

 Where are the updated COVID-19 booster doses available?d

 To locate COVID-19 vaccines and booster doses, the CDC suggests consumers may “search 

vaccines.gov, text your ZIP code to 438829, or call 1-800-232-0233. There are several other 

ways you can look for vaccine providers near you in the United States. Ask your doctor, 

pharmacist, or community health center, or visit their website. Contact your state health 

department. Check your local pharmacy’s website to see if vaccination appointments 

are available. Some pharmacies may offer vaccines to those who walk-in without making 

an appointment ahead of time.”19 It should be noted that “CDC cannot schedule, verify, 

reschedule, or cancel a vaccination appointment.”19

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

 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 especially against more severe 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 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 it 

is challenging to 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.20

Identified misinformation themes that may impact vaccine confidence

 Some social media users believe infection-induced immunity from SARS-CoV-2 provides more 

protection than a COVID-19 vaccine and, therefore, entirely obviates the need for a vaccine.21

d

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

CDC-INFO.

e

CDC-INFO.
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State of Vaccine Confidence Insights Report | December 23, 2022

 Some social media users believe COVID-19 vaccines and booster doses are not necessary22,23

and exist to bolster pharmaceutical company profits24 or governmental control.25

 Some social media users believe additional and successive COVID-19 vaccines will inhibit 

immune response.26

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

 Continue working with trusted messengers, community leaders, and members of the public 

to craft and disseminate messages that promote the availability, eligibility, safety, and 

effectiveness of the updated COVID-19 booster dose.

 Ensure equitable vaccine access for racial and ethnic minority groups that have had reduced 

access to COVID-19 vaccines, such as Black or African American and Hispanic or Latino 

communities (for more information, see COVID-19 Vaccine Equity).

Consumers have questions and concerns about 

the safety of the updated COVID-19 booster dose 

especially given reports of lack of human trial data

As the COVID-19 updated booster dose became available in the United States, consumers 

have had questions and concerns about its safety.27,28 Some health officials have also expressed 

concerns over the FDA’s new strategy of approving new updated COVID-19 boosters based on 

studies conducted in mice instead of humans (other bivalent boosters, including a BA1 plus 

ancestral variant bivalent, were studied in humans, but a BA4/5 plus ancestral variant bivalent 

was not studied in people).5,28 Tests on human subjects continued after the updated booster 

dose release; data from both Moderna and Pfizer indicate that the safety of the updated 

COVID-19 booster doses are comparable to the original COVID-19 vaccine formulations.29,30 In 

addition, data on the clinical benefits of the updated booster have been recently published 

demonstrating benefit of the updated booster in preventing symptomatic COVID-19.31

Perceptions, Concerns, and Threats to Vaccine Confidence

 Some healthcare professionals have spoken out about the 

FDA’s new approval strategy believing that it might result in 

waning support for COVID-19 booster vaccines.28

 Some consumers are questioning whether the updated 

COVID-19 booster doses will create stronger variants of 

SARS-CoV-2 resulting in a decline in the effectiveness of the 

COVID-19 vaccines and booster doses.d

 Some social media users are concerned that the updated booster doses will not be effective 

against new and emerging variants of the SARS-CoV-2 virus.32

 Consumers have questions about the updated COVID-19 booster doses’ interaction with the 

previous COVID-19 primary series.d
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State of Vaccine Confidence Insights Report | December 23, 2022

Commonly asked questions and queries from the public

 Where can I get the updated COVID-19 booster dose?33

 To locate COVID-19 vaccines and booster doses, the CDC suggests consumers may “search 

vaccines.gov, text your ZIP code to 438829, or call 1-800-232-0233. There are several other 

ways you can look for vaccine providers near you in the United States. Ask your doctor, 

pharmacist, or community health center, or visit their website. Contact your state health 

department. Check your local pharmacy’s website to see if vaccination appointments 

are available. Some pharmacies may offer vaccines to those who walk-in without making 

an appointment ahead of time.”19 It should be noted that “CDC cannot schedule, verify, 

reschedule, or cancel a vaccination appointment.”19

 Is the updated COVID-19 booster dose safe for me to receive if I am immunocompromised?d

 Yes, not only are they safe for people who are immunocompromised, but it is highly 

recommended that people who are immunocompromised receive the updated booster 

dose.34

 Which brand, Moderna or Pfizer-BioNTech, of the updated booster dose should I receive?d

 Both the Moderna and Pfizer updated booster dose will protect against the BA.4 and 

BA.5 Omicron subvariants, as well as the original SARS-CoV-2 virus.8 Currently, PfizerBioNTech is authorized for individuals ages 5 and older, and Moderna for ages 6 and older. 

It is recommended that people receive either updated booster dose at least two months 

following primary or booster vaccination.5

 Can consumers mix monovalent and updated COVID-19 vaccine doses?d

 It is stated on the CDC website that “people ages 6 years and older can get a different 

product for their updated (bivalent) booster than they received for their primary series or 

last booster,” while children age 5 years old “are only currently recommended to receive the 

updated (bivalent) Pfizer-BioNTech booster, and they can get this booster whether they 

received the Pfizer-BioNTech or Moderna primary series.”8

 Can I receive the influenza vaccine with the updated COVID-19 booster dose?d

 Yes, you may receive the updated COVID-19 booster dose and influenza shot at the same 

time.35 CDC is currently encouraging physicians to offer both vaccines during a patient’s 

clinical visit.35 Although ideally it is recommended that patients receive the influenza vaccine 

by the end of October, influenza vaccination should continue through the flu seasons as 

long as influenza viruses are still circulating and unexpired flu vaccine is available.36

Identified misinformation themes that may impact vaccine confidence

 Some consumers believe the updated COVID-19 booster dose is not ready for release and 

those who take it are guinea pigs for pharmaceutical companies’ studies.d

 Some social media users believe COVID-19 is no longer a threat, and no further vaccines or 

protection measures are needed to curtail the disease.37

 Some social media users believe the updated booster dose was only released to extend the 

pandemic and emergency use mandates.38

 Some social media users believe the lack of safety trials in humans is evidence of a corrupt 

vaccination authorization system.39,40,41

 Some social media users believe harm from COVID-19 vaccines and booster doses is greater 

than or equal to harm incurred from SARS-CoV-2 infection.42

 Some social media users believe the updated booster dose is a scam and a new vaccine will 

come out every season so the government and pharmaceutical industry can keep making 

money from COVID-19.43
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State of Vaccine Confidence Insights Report | December 23, 2022

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

 Continue to work with researchers and community leaders to ensure any serious side effects 

or adverse events from the updated booster dose are reported. Monitor the Vaccine Adverse 

Event Reporting System (VAERS) for similar data.

 Disseminate data about the effectiveness and safety in humans of the updated COVID-19 

booster dose, when available (see December 2, 2022 edition of CDC’s Morbidity and Mortality 

Weekly Report).

 Ensure that healthcare providers have up-to-date information on the safety and effectiveness 

of the updated COVID-19 booster dose so they can discuss it with their patients.

Consumers have questions and concerns about 

the effectiveness of a bivalent booster dose, 

including if a booster dose is even needed

Similar to past COVID-19 vaccine and booster dose 

rollouts, many consumers and social media users had 

concerns about the updated booster dose. Both Pfizer and 

Moderna report data showing that their updated bivalent 

vaccines elicited a higher immune response against 

Omicron subvariants than their companies’ monovalent 

COVID-19 vaccines.44,45 Conflicting advice from public 

health professionals, misinformation, and personal 

opinions might negatively impact vaccine confidence and 

prevent individuals from seeking vaccination with the updated booster dose. 

Perceptions, Concerns, and Threats to Vaccine Confidence

 Some social media users are concerned that the updated 

booster dose will not protect against new variants.46,47,32

 Consumers expressed their confusion about why a 

Vaccines and Related Biological Products Advisory 

Committee (VRBPAC) member voted against approving 

the updated COVID-19 booster dose.48

 Some social media users and medical professionals are 

expressing their support for the updated COVID-19 booster dose.49

 Social media users are concerned that the variants targeted by the updated booster dose are 

no longer circulating in the population.50,51

 Consumers are concerned about whether the updated COVID-19 booster dose is effective,52,53

how it compares to the original COVID-19 monovalent vaccines,54,55 and whether it is 

needed.56

Commonly asked questions and queries from the public

The following questions are information voids for which there are currently no answers due to 

lack of available data:f,57

f

These were information voids identified by the Insights Unit when reviewing CDC updated COVID-19 

booster dose web content. As such, there is no source for these.
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State of Vaccine Confidence Insights Report | December 23, 2022

 Will the updated COVID-19 booster dose protect against future variants?

 How long will the updated COVID-19 booster dose provide protection against acquiring 

SARS-CoV-2 or developing severe illness from SARS-CoV-2?

The following questions are commonly asked by consumers:

 How is the updated COVID-19 booster dose different from original COVID-19 vaccines?d

 The updated COVID-19 booster dose contains two messenger RNA (mRNA) components 

of SARS-CoV-2 virus: one is a component of the original SARS-CoV-2 virus and the other 

is a component that is in both the BA.4 and BA.5 lineages of the omicron variant of SARSCoV-2.5

 Can consumers mix the brand of the updated COVID-19 booster doses with their primary 

series and first booster dose?d

 Any age-appropriate mRNA vaccine can be used if a booster dose is FDA-authorized for use 

in a specified population regardless of the brand of previous doses received.58

 How effective is the updated COVID-19 booster dose?

 Findings published in the December 2, 2022 Morbidity and Mortality Weekly Report indicate 

that bivalent boosters provided significant additional protection against symptomatic 

SARS-CoV-2 infection in persons who had previously received 2, 3, or 4 monovalent vaccine 

doses.

Identified misinformation themes that may impact vaccine confidence

 Some social media users believe one of the previous COVID-19 vaccines or booster doses 

were ineffective, so the updated vaccine will not be effective.59,60

 Some social media users believe the updated COVID-19 booster dose is so ineffective that it 

is more accurately called a placebo.61,43

 Some social media users believe COVID-19 is not a problem anymore so the FDA should not 

grant Emergency Use Authorization for the bivalent booster dose.62,63

 Some social media users believe the updated COVID-19 booster dose will cause more 

variants.64

 Some social media users believe the updated COVID-19 booster doses are unneeded 

because they do not prevent transmission,65 are not effective,66,67 or are not necessary.68,22

Ways public health and partners can take action to improve vaccine 

confidence:  

 Partner with healthcare workers and local community leaders to 

craft and disseminate messages about reasons eligible individuals 

should receive the updated COVID-19 booster dose. 

 Conduct and support research that evaluates the effectiveness of 

the updated COVID-19 booster doses against circulating SARSCoV-2 variants, as well as how this effectiveness compares to that of 

the original formulations of COVID-19 vaccines. 

 Create venues or mechanisms to hear and respond to communities’ 

questions and concerns. 
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State of Vaccine Confidence Insights Report | December 23, 2022

Some health experts question whether combined 

messaging to promote uptake of both updated 

COVID-19 boosters and seasonal influenza vaccine is a 

helpful strategy.

Many pharmacies and medical providers offer the updated COVID-19 booster dose along with the 

annual influenza vaccine in the same visit.69,70 Studies that compared coadministration of COVID-19 

vaccines and seasonal influenza vaccines with separate administration of these vaccines did not 

identify any specific safety concerns.58 Additionally, CDC guidelines confirm that individuals can 

get a COVID-19 vaccine and a influenza vaccine at the same time if eligible and timing coincides.36

Yet while some public health experts are promoting simultaneous uptake,71,72 others caution 

that taking the influenza vaccine too early in the influenza season is not optimal for longer-term 

immunity73,74 if influenza season is expected to peak around December and January.75,76 However, 

influenza activity this year is early in the U.S. and influenza vaccinations should currently be 

administered as soon as possible. 

Perceptions, Concerns, and Threats to Vaccine Confidence

 Social media users are concerned about experiencing more intense side effects from receiving 

the updated COVID-19 booster dose and annual influenza vaccine at the same time.77,78

 Some social media users are sharing their experiences with receiving the updated COVID-19 

booster dose and annual influenza vaccine simultaneously, stating the side effects are normal 

and without adverse reactions.79,80

Commonly asked questions and queries from the public

 Does combining both the seasonal influenza vaccine and any of the COVID-19 vaccines make 

either less effective?d

 Studies that compared coadministration of COVID-19 vaccines and seasonal influenza vaccines 

with separate administration of these vaccines found similar levels of immunogenicity and 

similar or slightly higher reactogenicity; effectiveness was not assessed.58

 What are side effects from coadministration of the updated COVID-19 booster dose and the 

annual influenza vaccine?d

 Studies that compared coadministration of COVID-19 vaccines and seasonal influenza vaccines 

with separate administration of these vaccines found no specific safety concerns and similar or 

slightly higher reactogenicity.58

 Can I get a COVID-19 vaccine and an influenza vaccine during the same visit?d

 Yes, you can get a COVID-19 vaccine and an influenza vaccine at the same time if you are 

eligible for both and the timing coincides.36

 What is the best timing for both the influenza shot and the updated COVID-19 vaccine?d

 Even though both vaccines can be given at the same visit, people should follow the 

recommended schedule for either vaccine: If you haven’t gotten your currently recommended 

doses of COVID-19 vaccine, get a COVID-19 vaccine as soon as you can, and ideally get an 

influenza vaccine by the end of October. Flu vaccination should continue in November, 

December and later as long as influenza viruses are still circulating.36
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State of Vaccine Confidence Insights Report | December 23, 2022

 Is it safe to get a COVID-19 vaccine and an influenza vaccine at the same time?d

 Studies conducted throughout the COVID-19 pandemic indicate that it is safe to get both a 

COVID-19 vaccine and an influenza vaccine at the same visit.36

 Will side effects from the coadministration of a seasonal influenza 

vaccine and the updated COVID-19 booster dose be more severe 

than getting each separately?d

 A recent CDC study published in JAMA (Hause et al., 2022) 

suggests people who received a seasonal influenza vaccine and an 

mRNA COVID-19 booster dose at the same time were slightly more 

likely (8% to 11%) to report systemic reactions including fatigue, 

headache, and muscle ache than people who only received a 

COVID-19 mRNA booster dose, but these reactions were mostly 

mild and resolved quickly. The findings of this study are consistent 

with safety data from clinical trials that did not identify any serious 

safety concerns with coadministration. 

 When will influenza activity begin this season 2022-2023 and when will it peak?d

 The timing of influenza is difficult to predict and can vary in different parts of the country 

and from season to season.36 You can find information about the flu season at the CDC’s 

Weekly U.S. Influenza Surveillance Report. 

Identified misinformation themes that may impact vaccine confidence

 Some social media users believe getting the seasonal influenza and COVID-19 vaccines 

simultaneously is harmful.81

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

 Conduct and support research that evaluates the effectiveness of the updated COVID-19 

booster doses against circulating SARS-CoV-2 variants, as well as how this effectiveness 

compares to that of the original formulations of COVID-19 vaccines

 Create venues or mechanisms to hear and respond to communities’ questions and concerns, 

such as town halls, hotlines, and social media. 
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State of Vaccine Confidence Insights Report | December 23, 2022

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booster shots, one month into the rollout. NBC News. https://www.nbcnews.com/health/

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Centers for Disease Control and Prevention. (2022, October 28). COVID Data Tracker. Atlanta, 

GA: US Department of Health and Human Services, CDC. https://covid.cdc.gov/covid-datatracker

Centers for Disease Control and Prevention. (2022, March 29). COVID-19 Vaccine Equity for Racial 

and Ethnic Minority Groups. US Department of Health and Human Services, CDC. https://

www.cdc.gov/coronavirus/2019-ncov/community/health-equity/vaccine-equity.html

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People Who Are Moderately or Severely Immunocompromised. US Department of Health 

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Centers for Disease Control and Prevention. (2022, October 17). Frequently Asked Influenza (Flu) 

Questions: 2022-2023 Season. US Department of Health and Human Services, CDC. https://

www.cdc.gov/flu/season/faq-flu-season-2022-2023.htm

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Vaccine or Booster? US Department of Health and Human Services, CDC. https://www.cdc.

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Vaccines. US Department of Health and Human Services, CDC. https://www.cdc.gov/

coronavirus/2019-ncov/vaccines/facts.html

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Vaccines Including Boosters. US Department of Health and Human Services, CDC. https://

www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html

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index.htm

CVS Pharmacy. (n.d.). Flu Shots. CVS Health. Retrieved October 28, 2022, from https://www.cvs.com/

immunizations/flu?cid=ps_coreflu&gclid=Cj0KCQjwnP-ZBhDiARIsAH3FSRcsKdFG3hjJJ5VdTjox

mN7AEaUfUz35jU7m-YMpGYEtaAy5mXvJHioaAloyEALw_wcB&gclsrc=aw.ds

Finucane, M., & Huddle, R. (2022, September 28). The level of coronavirus in Eastern Mass. Waste 

water just shot up. Boston Globe. https://www.bostonglobe.com/2022/09/28/nation/levelcoronavirus-e-mass-waste-water-just-swerved-upward/

Food and Drug Administration. (2022, October 12). COVID-19 Bivalent Vaccine Boosters. US 

Department of Health and Human Services, FDA. https://www.fda.gov/emergencypreparedness-and-response/coronavirus-disease-2019-covid-19/covid-19-bivalent-vaccineboosters

Food and Drug Administration. (2022, August 31). Coronavirus (COVID-19) Update: FDA Authorizes 

Moderna, Pfizer-BioNTech Bivalent COVID-19 Vaccines for Use as a Booster Dose [Press release]. 

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press-announcements/coronavirus-covid-19-update-fda-authorizes-moderna-pfizer-biontechbivalent-covid-19-vaccines-use

Fracassa, D., & Vaziri, A. (2022, September 26). COVID in California: S.F. wastewater shows virus retreat 

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COVID-in-California-live-updates-17467005.php

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& Shay, D. K. (2022). Reactogenicity of Simultaneous COVID-19 mRNA Booster and Influenza 

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Appendix: Inputs and Sources

Social Media Listening & Media Monitoring Data Sources

Input Cadence Sources Tactics for Utilization

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 (CDC 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 Report Data Sources

Input Cadence Sources Tactics for Utilization

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
Page: 17

State of Vaccine Confidence Insights Report | December 23, 2022

Research and Literature Data Sources

Input Cadence Sources Tactics for Utilization

Poll Review Weekly Harris Poll, PEW research, 

Gallup Poll, KFF, 

Annenberg Public Policy 

Center 

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 Report Data Sources

Input Cadence Sources Tactics for Utilization

Tanaq Social 

Listening +Media 

Monitoring Report

Weekly Meltwater

Sprout Social

First Draft

Native platform searches

Trending topics

Demographic and geographic 

conversation monitoring

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