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. 2021 Dec 17;70(50):1723–1730. doi: 10.15585/mmwr.mm7050a1

TABLE 1. Characteristics of adults who reported a health care provider recommendation for COVID-19 vaccination, by selected sociodemographic characteristics and associated factors — National Immunization Survey-Adult COVID Module, United States, April 22–September 25, 2021.

Characteristic Overall
Provider recommendation
Prevalence
Prevalence ratio
No. % (95% CI) % (95% CI) Unadjusted
(95% CI)
Adjusted*
(95% CI)
All adults
340,543
100.0
37.4 (37.1–37.7)


Period of data collection
Apr 22–May 29
77,162
20.0 (19.7–20.3)
34.6 (33.9–35.3)
Ref
Ref
May 30–Jun 26
56,749
20.0 (19.7–20.3)
35.8 (35.0–36.6)
1.03 (1.00–1.07)
1.03 (1.00–1.06)
Jun 27–Jul 31
73,512
20.0 (19.7–20.3)
37.6 (36.9–38.3)
1.09 (1.06–1.12)
1.08 (1.05–1.11)
Aug 1–Aug 28
63,193
20.0 (19.7–20.3)
38.6 (37.9–39.4)
1.12 (1.09–1.15)
1.10 (1.07–1.13)
Aug 29–Sep 25
73,426
20.0 (19.7–20.2)
40.5 (39.8–41.2)
1.17 (1.14–1.20)
1.14 (1.10–1.17)
Age group, yrs
18–29
58,464
21.0 (20.7–21.3)
28.3 (27.6–29.0)
0.64 (0.62–0.66)
0.72 (0.69–0.74)
30–39
56,584
17.3 (17.1–17.6)
34.9 (34.2–35.7)
0.79 (0.77–0.81)
0.83 (0.80–0.85)
40–49
52,694
16.0 (15.7–16.2)
37.9 (37.1–38.7)
0.86 (0.83–0.88)
0.86 (0.83–0.89)
50–64
95,399
24.5 (24.2–24.8)
41.0 (40.4–41.7)
0.93 (0.91–0.95)
0.92 (0.89–0.94)
≥65
75,147
21.2 (20.9–21.5)
44.2 (43.5–45.0)
Ref
Ref
Sex
Male
168,106
48.4 (48.1–48.8)
34.4 (34.0–34.9)
Ref
Ref
Female
173,190
51.6 (51.2–51.9)
40.3 (39.9–40.8)
1.17 (1.15–1.19)
1.07 (1.05–1.09)
Transgender
Yes
13,287
4.5 (4.4–4.7)
36.5 (34.9–38.1)
0.98 (0.93–1.02)
1.01 (0.96–1.05)
No
309,379
95.5 (95.3–95.6)
37.4 (37.0–37.7)
Ref
Ref
Sexual orientation
Heterosexual
298,486
92.6 (92.4–92.7)
37.5 (37.2–37.8)
Ref
Ref
Gay or lesbian
8,857
2.3 (2.2–2.4)
41.0 (39.0–43.1)
1.09 (1.04–1.15)
1.12 (1.06–1.17)
Bisexual
9,745
3.3 (3.1–3.4)
34.1 (32.3–35.9)
0.91 (0.86–0.96)
1.02 (0.96–1.07)
Other
5,654
1.9 (1.8–2.0)
36.3 (33.8–38.8)
0.97 (0.90–1.04)
1.06 (0.98–1.14)
Race/Ethnicity
White, non-Hispanic
210,659
62.1 (61.8–62.4)
37.3 (36.9–37.7)
Ref
Ref
Black, non-Hispanic
40,610
12.0 (11.8–12.2)
38.4 (37.5–39.4)
1.03 (1.00–1.06)
1.02 (0.99–1.05)
Hispanic
43,420
17.2 (16.9–17.5)
37.2 (36.3–38.1)
1.00 (0.97–1.02)
1.09 (1.06–1.12)
Asian, non-Hispanic
17,859
4.2 (4.1–4.3)
40.0 (38.5–41.6)
1.07 (1.03–1.12)
1.11 (1.06–1.16)
American Indian or Alaska Native, non-Hispanic
8,319
1.3 (1.3–1.4)
38.8 (36.2–41.5)
1.04 (0.97–1.12)
1.13 (1.05–1.21)
Other or multiple races, non-Hispanic
12,865
3.2 (3.0–3.3)
36.2 (34.4–38.1)
0.97 (0.92–1.02)
1.03 (0.98–1.09)
Educational level
High school or less
85,450
39.1 (38.7–39.4)
33.5 (33.0–34.1)
0.74 (0.72–0.75)
0.83 (0.80–0.85)
Some college
94,461
30.5 (30.2–30.9)
37.6 (37.0–38.2)
0.82 (0.80–0.84)
0.88 (0.86–0.90)
College graduate
85,631
19.2 (18.9–19.4)
40.7 (40.1–41.4)
0.89 (0.87–0.91)
0.96 (0.94–0.99)
Above college graduate
68,286
11.2 (11.1–11.4)
45.6 (44.8–46.4)
Ref
Ref
Annual household income, USD
Below poverty
32,552
11.3 (11.1–11.5)
36.9 (35.9–37.9)
0.93 (0.90–0.95)
1.00 (0.96–1.03)
Above poverty and <$75,000
106,976
32.1 (31.8–32.5)
36.1 (35.5–36.7)
0.91 (0.89–0.93)
0.95 (0.93–0.97)
Above poverty and ≥$75,000
129,250
32.7 (32.4–33.0)
39.8 (39.3–40.3)
Ref
Ref
Unknown income
75,264
23.9 (23.6–24.2)
36.1 (35.5–36.8)
0.91 (0.89–0.93)
0.95 (0.92–0.97)
Health insurance status
Insured
306,694
89.5 (89.3–89.7)
39.1 (38.7–39.4)
Ref
Ref
Not insured
27,335
10.5 (10.3–10.7)
24.7 (23.8–25.7)
0.63 (0.61–0.66)
0.75 (0.72–0.78)
Essential worker status §
Essential health care
36,028
9.1 (8.9–9.3)
51.8 (50.8–52.9)
1.40 (1.37–1.43)
1.38 (1.35–1.42)
School and child care
12,789
2.9 (2.8–3.0)
38.8 (37.1–40.5)
1.05 (1.00–1.09)
1.02 (0.97–1.07)
Other frontline
24,835
8.4 (8.2–8.6)
32.3 (31.2–33.4)
0.87 (0.84–0.90)
1.02 (0.98–1.06)
Other essential
39,597
12.5 (12.2–12.7)
32.1 (31.2–33.0)
0.87 (0.84–0.89)
1.00 (0.97–1.04)
Not an essential worker
228,472
67.2 (66.9–67.5)
37.1 (36.7–37.5)
Ref
Ref
MSA
MSA, principal city
106,173
29.1 (28.8–29.4)
38.6 (38.0–39.2)
Ref
Ref
MSA, nonprincipal city
172,259
57.2 (56.9–57.5)
37.4 (37.0–37.8)
0.97 (0.95–0.99)
0.96 (0.94–0.98)
Non-MSA
65,610
13.7 (13.5–13.9)
34.9 (34.1–35.7)
0.90 (0.88–0.93)
0.92 (0.89–0.95)
U.S. Census region
Northeast
70,694
17.4 (17.3–17.6)
42.1 (41.4–42.7)
Ref
Ref
Midwest
54,434
20.8 (20.5–21.0)
36.7 (35.9–37.4)
0.87 (0.85–0.89)
0.93 (0.90–0.95)
South
70,212
23.8 (23.5–24.0)
36.3 (35.6–37.1)
0.86 (0.84–0.89)
0.88 (0.86–0.91)
West
126,934
38.0 (37.8–38.3)
36.0 (35.5–36.5)
0.86 (0.84–0.87)
0.92 (0.90–0.94)
Comorbidities**
Yes
102,135
29.2 (28.9–29.5)
50.4 (49.8–51.1)
1.57 (1.54–1.60)
1.47 (1.44–1.50)
No
237,651
70.8 (70.5–71.1)
32.1 (31.7–32.5)
Ref
Ref
Disability status ††
Yes
30,864
9.7 (9.5–9.9)
44.9 (43.8–46.0)
1.23 (1.20–1.26)
1.11 (1.07–1.14)
No
312,280
90.3 (90.1–90.5)
36.6 (36.3–36.9)
Ref
Ref
Work or school requirement §§
Yes
43,949
10.8 (10.6–11.0)
49.8 (48.8–50.7)
1.39 (1.36–1.42)
1.32 (1.29–1.36)
No/Other 297,453 89.2 (89.0–89.4) 35.9 (35.5–36.2) Ref Ref

Abbreviations: MSA = metropolitan statistical area; Ref = referent group; USD = U.S. dollars.

*Adjusted for age group, sex, transgender identity, sexual orientation, race/ethnicity, education, income, insurance status, MSA, U.S. Census region, comorbidity status, disability status, and essential worker status.

Household income is derived from the number of persons reported in the household, the reported household income, and the 2020 U.S. Census poverty thresholds.

§ Essential worker status was defined based on the following questions: “Are you a frontline or essential worker according to your state or region?” and “In what location or setting do you currently work?” Essential worker groups were categorized as “essential healthcare,” “school and childcare,” “other frontline,” “other essential,” and “nonessential.” Nonessential could include both employed and unemployed individuals.

MSA status was determined based on household reported city and county of residence and was grouped into three categories: MSA principal city (urban), MSA nonprincipal city (suburban), and non-MSA (rural). MSAs and principal cities were as defined by the U.S. Census Bureau (https://www.census.gov/programs-surveys/metro-micro.html). Non-MSA areas include urban populations not located within an MSA as well as completely rural areas.

** Comorbidity status was ascertained by the following question: “Do you have a health condition that may put you at higher risk for COVID-19?”

†† Disability status was ascertained by the following question: “Do you have serious difficulty seeing, hearing, walking, remembering, making decisions, or communicating?”

§§ Work or school requirement was assessed by the following question: “Does your work or school require you to get a COVID-19 vaccine?” Response options were yes, no, or unemployed/not applicable. Responses for “no” and “not applicable” were combined into one category.