Vaccine confidence falls as belief in health misinformation grows: Survey

Americans have less confidence in vaccines to address a variety of illnesses than they did just a year or two ago, and more people accept misinformation about vaccines and COVID-19, according to the latest health survey from the Annenberg Public Policy Center (APPC) of the University of Pennsylvania.

The survey conducted October 5-12, 2023, with a panel of over 1,500 U.S. adults, finds that the number of Americans who think vaccines approved for use in the United States are safe dropped to 71% from 77% in April 2021. The percentage of adults who don't think vaccines approved in the U.S. are safe grew to 16% from 9% over that same two-and-a-half-year period.

Despite concerted efforts by news organizations, public health officials, scientists, and fact-checkers (including APPC's project FactCheck.org) to counter viral misinformation about vaccination and COVID-19, the survey finds that some false or unproven claims about them are more widely accepted today than two to three years ago.

Although the proportion of the American public that holds these beliefs is, in some cases, still relatively small, the survey finds growth in misinformation acceptance across many questions touching on vaccination.

"There are warning signs in these data that we ignore at our peril," said Kathleen Hall Jamieson, director of the Annenberg Public Policy Center and director of the survey. "Growing numbers now distrust health-protecting, life-saving vaccines."

Highlights

• COVID-19 vaccine: Less than two-thirds of Americans (63%) think is it safer to get the COVID-19 vaccine than the COVID-19 disease, a decline from 75% in April 2021.
• Ivermectin: Over a quarter (26%) incorrectly think ivermectin is an effective treatment for COVID-19, up dramatically from 10% in September 2021.
• Autism: A small but growing number (16%) believe that "increased vaccines are why so many kids have autism these days," up from 10% in April 2021.
• Return to normal: Asked when they expected to return to their normal, pre-COVID life, two-thirds (67%) say they already have. Three-quarters (75%) say they never or rarely wear a mask or face covering.

APPC's Annenberg Science and Public Health Knowledge survey

The survey data come from the 13th wave of a nationally representative panel of 1,559 U.S. adults, first empaneled in April 2021, conducted for the Annenberg Public Policy Center by SSRS, an independent market research company. This wave of the Annenberg Science and Public Health Knowledge (ASAPH) survey was fielded October 5-12, 2023, and has a margin of sampling error (MOE) of ± 3.4 percentage points at the 95% confidence level.

All figures are rounded to the nearest whole number and may not add to 100%. Combined subcategories may not add to totals in the topline and text due to rounding.

The policy center has been tracking the American public's knowledge, beliefs, and behaviors regarding vaccination, COVID-19, flu, RSV, and other consequential health issues through this survey panel over the past two-and-a-half years. In addition to Jamieson, the APPC team on this survey includes research analyst Shawn Patterson Jr., who analyzed the data; Patrick E. Jamieson, director of the Annenberg Health and Risk Communication Institute, who developed the questions; and Ken Winneg, managing director of survey research, who supervised the fielding of the survey.

Growing acceptance of vaccine misinformation

Beliefs in vaccine misinformation are on the rise:

• Vaccinations affecting childhood autism: There's been a decline in the number of people who know it is false to say that "increased vaccinations are why so many kids have autism these days," dropping to 65% from 71% in April 2021. The number of people who believe that this is true has grown to 16% from 10% over that period. The Centers for Disease Control and Prevention (CDC) says that vaccines do not cause autism.

• Growing belief in false MMR-autism link: Asked if it is true or false that vaccines given to children for diseases like measles, mumps, and rubella (MMR) cause autism, 12% incorrectly say this is true, up from 9% in June 2021, a statistically significant rise. Most people (70%) correctly say that this allegation is false. According to the CDC, vaccine experts say "the MMR vaccine is not responsible for increases in the number of children with autism."

• Flu shot and COVID-19: There was a small but statistically significant increase in the number of people who incorrectly think that getting a flu shot increases your risk of contracting COVID-19—9% say this is true, up from 6% in January 2023. As pointed out in a story by FactCheck.org, there is no evidence a flu shot increases the risk of COVID-19.

• Growing belief that vaccines contain toxins: More than 1 in 10 people (12%) now incorrectly believe it is true that "vaccines in general are full of toxins and harmful ingredients like 'antifreeze,'" a significant increase from 8% in April 2021. Although most people (73%) know this is false, that number has declined from 77% in June 2021. FactCheck.org notes that flu ingredients are safe in this story and writes about the ingredients in COVID-19 vaccines here. A look at the ingredients in vaccines is here.

• Ivermectin to treat COVID-19: Over a quarter (26%) incorrectly say ivermectin is an effective treatment for COVID-19, up from 10% in September 2021. The percentage who know this is false also rose, to 37% from 27% in September 2021. Overall, the number of people who are unsure declined, to 38% from 63%. The Food and Drug Administration (FDA) has not authorized or approved the use of ivermectin for treating or preventing COVID-19 in humans or animals, and says current data do not show it is effective against COVID-19.

• Cancer and mRNA vaccines: 12% of those surveyed say it is true that mRNA vaccines against COVID-19 "cause cancer," up from 9% in January 2023. The number who believe this is false remained steady at 58%. There is no evidence COVID-19 vaccines cause or "accelerate" cancer, according to FactCheck.org.

In addition, many do not know that the flu vaccine cannot give you the flu: Just half of those surveyed (51%) know that the seasonal flu shot distributed in the U.S. cannot give you flu, while nearly 3 in 10 people (29%) think that is false. This finding is statistically unchanged since January. The CDC says the flu vaccine cannot cause flu.

Less confidence in vaccine safety

• Declining belief that vaccines are safe: Although most people (71%) agree that vaccines approved for use in the U.S. are safe, that is down significantly from 77% in April 2021. More people (16%) think it false to state that vaccines in the U.S. are safe than in January 2022 (11%). FactCheck.org examines what is known about vaccine safety.

• Less confidence in COVID-19 vaccine: Less than two-thirds (63%) say it is safer to get the COVID-19 vaccine than to get the disease COVID-19, a significant drop from 77% in November 2021. And the number of people who say it is false to state that the vaccine is safer than the disease is up to 21%, more than doubling from 10% in April 2021.

Safety of specific vaccines

The public has widely varying opinions about the safety of individual vaccines—but several of those we asked about are perceived as less safe today than 14 months earlier in an August 2022 wave of this survey. The MMR, COVID-19, and pneumonia vaccines are all regarded as less safe than in the earlier survey.

Beliefs in the safety of individual vaccines range from 81% for the long-established vaccines for the seasonal flu and MMR (measles, mumps, and rubella) to 50% for the vaccine approved in August by the FDA for pregnant people to protect their infants from respiratory syncytial virus, or RSV. The significant declines are marked with an*:

• MMR vaccine*: 81% say the MMR vaccine is safe (down significantly from 88% in August 2022), while 9% say it is unsafe and 10% are not sure.

• Flu vaccine: 81% say the flu vaccine is safe (no significant change from August 2022), while 11% say it is unsafe and 8% are not sure.

• Shingles vaccine: 78% say the shingles vaccine is safe (no significant change from August 2022), while 7% say it is unsafe and 15% are not sure.

• Pneumonia vaccine*: 74% say the pneumonia vaccine is safe (down significantly from 80% in August 2022), while 8% say it is unsafe and 18% are not sure.

• HPV vaccine: 65% say the vaccine for HPV, human papillomavirus, is safe (no significant change from August 2022), while 11% say it is unsafe and 24% are not sure.

• COVID-19 vaccine*: 66% say the COVID-19 vaccine is safe (down significantly from 73% in August 2022), while 24% say it is unsafe and 10% are not sure.

• RSV vaccine for older adults: 62% say the RSV vaccine for people 60 and older is safe, while 11% say it is unsafe, and 27% are not sure. This vaccine was first approved by the FDA in May 2023; this question was not asked last year.

• RSV for pregnant people: Just half (50%) say the vaccine given to pregnant people to protect their infants from RSV is safe, while 13% say it is unsafe, and over a third (38%) are not sure. This vaccine was approved by the FDA in August 2023; this question was not asked last year.

Effectiveness of different vaccines

Public perceptions of the effectiveness of some vaccines have also declined over the past 14 months. The perceived effectiveness of the vaccines for MMR, flu, pneumonia, and HPV all had statistically significant drops since August 2022 and are marked with an *. Large percentages of people are unsure of whether the new RSV vaccines are effective. When asked how effective these vaccines are at preventing symptomatic disease, survey respondents say,

• MMR vaccine*: 83% effective (down significantly from 87% in August 2022)
• Flu vaccine*: 75% effective (down significantly from 81% in August 2022)
• Shingles vaccine: 73% effective (no significant change)
• Pneumonia vaccine*: 69% effective (down significantly from 74% in August 2022)
• COVID-19 vaccine: 65% effective (no significant change)
• HPV vaccine*: 61% effective (down significantly from 66% in August 2022)
• RSV vaccine for older adults: 54% effective (37% not sure)
• RSV vaccine for pregnant persons to protect their infants from RSV: 42% effective (47% not sure)

Lives returning to normal

Return to normal: Growing numbers of Americans say they have returned to their normal, pre-COVID lives. Asked when they expect to be able to return to their normal, pre-COVID life, 67% say they already have, significantly higher than in January (52%). However, this is not true for a small but persistent group who see life as forever changed. One in 5 Americans (20%) say they will never return to their normal, pre-COVID lives, more than in June 2023 (16%).

Mask-wearing: Asked how often you wear a mask or face covering indoors when with people who are not part of your household, 75% say never or rarely (statistically unchanged from June)—with 53% of those saying they never wear one. Another 21% say they sometimes, often, or always wear a mask or face covering, and 4% say they don't go places where they might come in contact with people who are not in their household.