On September 1, 2022, CDC recommended an updated (bivalent) COVID-19 booster for everyone 12 and older. It targets the Omicron BA.4 and BA.5 subvariants as well as the original strain. Boosters are safe, help maintain protection after the primary series, and reduce the risk of emergency visits, hospitalization and death.
CDC's National Immunization Survey phone interviews (October 30–December 31, 2022) showed how few people had taken it — and how many more might.
Coverage and intent
Among people who had finished their primary series:
| Adults | Teens 12–17 | |
|---|---|---|
| Got the bivalent booster | 27.1% | 18.5% |
| Open to it (definitely or probably would; for teens, their parents) | 39.4% | 52.0% |
| Unsure | 12.4% | 15.1% |
| Reluctant | 21.1% | 14.4% |
Among everyone:
| Adults | Teens | |
|---|---|---|
| Completed a primary series | 84.2% | 58.3% |
| Up to date | 23.2% | 10.7% |
Coverage rose from November to December — among adults with a primary series, bivalent boosters went from 24.4% to 29.7%.
Who was left behind
- Race and ethnicity. Booster coverage among adults was 32.1% for White adults but 25.1% for Asian, 21.2% for Black and 15.0% for Hispanic adults. Among teens: 22.9% White, 14.6% Hispanic, 14.0% other or multiracial, 10.2% Black.
- Income and insurance. Adults below the poverty line, the uninsured and people in more socially vulnerable counties had lower coverage — yet were no more reluctant, pointing to hidden structural or access barriers. Teens showed the same pattern.
- Rural areas. Rural teens and adults had lower primary-series completion and up-to-date coverage.
What held people back
A doctor's recommendation matters. Adults who got a provider recommendation had 34.9% booster coverage, against 22.2% without one. Yet:
| Adults open to a booster | Adults unsure | |
|---|---|---|
| No provider recommendation | 58.9% | 71.3% |
| Safety concerns | 16.9% | 45.5% |
| Reported difficulty getting a booster | 4.4% | 6.6% |
Among teens whose parents were open to a booster, 32.4% had not had a provider recommendation for any COVID-19 vaccine, and 11.8% had parents with safety concerns. The most commonly reported barrier for adults was getting an appointment.
Still, most adults and parents said COVID-19 vaccination is important (54%–98% across groups) — even more than half of those reluctant to get a booster.
What would help
- Providers recommending the booster to every patient, with culturally appropriate information on benefits and safety.
- Trusted local messengers to counter misinformation.
- Vaccination in more places — churches, barbershops, mass-vaccination and community sites — and fewer barriers to getting it.
- Partnerships among medical providers, schools and community groups to vaccinate on site or refer.
Limits: response rates were low (18% for the child survey, 23% for adults); vaccination was self-reported; any booster after September 1, 2022, was assumed to be bivalent; and people in prisons or nursing homes weren't sampled.
Sources
Based on Peng-jun Lu, Tianyi Zhou, Tammy A. Santibanez and others, "COVID-19 Bivalent Booster Vaccination Coverage and Intent to Receive Booster Vaccination Among Adolescents and Adults — United States, November–December 2022," MMWR, volume 72, Centers for Disease Control and Prevention; a work of the United States government in the public domain. The report gives 5.2% of adults reporting any difficulty getting a booster but 5.5% reporting the most common single difficulty, so neither overall figure is given here.
Licence: CC0 1.0 (public domain) · Adapted from www.cdc.gov
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