• Am J Prev Med · May 2023

    Characteristics of the Moveable Middle: Opportunities Among Adults Open to COVID-19 Vaccination.

    • Amel Omari, Kwanza D Boone, Tianyi Zhou, Peng-Jun Lu, Jennifer L Kriss, Mei-Chuan Hung, Rosalind J Carter, Carla Black, Debora Weiss, Nina B Masters, James Tseryuan Lee, Noel T Brewer, Peter G Szilagyi, and James A Singleton.
    • Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia. Electronic address: aomari@cdc.gov.
    • Am J Prev Med. 2023 May 1; 64 (5): 734741734-741.

    IntroductionFocusing on subpopulations that express the intention to receive a COVID-19 vaccination but are unvaccinated may improve the yield of COVID-19 vaccination efforts.MethodsA nationally representative sample of 789,658 U.S. adults aged ≥18 years participated in the National Immunization Survey Adult COVID Module from May 2021 to April 2022. The survey assessed respondents' COVID-19 vaccination status and intent by demographic characteristics (age, urbanicity, educational attainment, region, insurance, income, and race/ethnicity). This study compared composition and within-group estimates of those who responded that they definitely or probably will get vaccinated or are unsure (moveable middle) from the first and last month of data collection.ResultsBecause vaccination uptake increased over the study period, the moveable middle declined among persons aged ≥18 years. Adults aged 18-39 years and suburban residents comprised most of the moveable middle in April 2022. Groups with the largest moveable middles in April 2022 included persons with no insurance (10%), those aged 18-29 years (8%), and those with incomes below poverty (8%), followed by non-Hispanic Native Hawaiian or other Pacific Islander (7%), non-Hispanic multiple or other race (6%), non-Hispanic American Indian or Alaska Native persons (6%), non-Hispanic Black or African American persons (6%), those with below high school education (6%), those with high school education (5%), and those aged 30-39 years (5%).ConclusionsA sizable percentage of adults open to receiving COVID-19 vaccination remain in several demographic groups. Emphasizing engagement of persons who are unvaccinated in some racial/ethnic groups, aged 18-39 years, without health insurance, or with lower income may reach more persons open to vaccination.Published by Elsevier Inc.

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