Reports

● Friends and family (29%) and news media (26%) are the top sources Americans use for voting information, with younger people (18-24) leaning more on personal networks, and the older population (65+) favoring news media.

● Americans with less formal education tend to rely more on friends and family for election information, while those with higher education and income are more likely to prefer the news media.

● Democrats and Independents are more likely to rely on news media (29%), whereas Republicans more often get information from friends and family (34%).

● Local media serve as the main election information source for 8% of Americans, while national media are preferred by 17%. Three quarters of Americans identify sources other than the news media as their main way of staying informed about the 2024 election.

● Older Americans, as well as those with lower income and education, are most likely to rely primarily on local news for 2024 election information.

● Across US states, the reliance on national news for election information is highest in Connecticut (26%), Massachusetts (26%), and Nevada (25%), while the states where people are most likely to rely on local news are Hawaii (14%), Louisiana (13%), and South Carolina (12%).

● Only 25% of Americans report being very or extremely satisfied with local political news, with satisfaction levels relatively higher among Black respondents (35%), Democrats (38%), and people living in urban areas (33%).

● Americans with higher income and formal education levels are more likely to report being satisfied with local political news.

● DC (48%), New York (42%), North Carolina (33%), Pennsylvania (33%), Michigan (31%), and Illinois (30%) reported highest satisfaction with local news about politics (percent respondents saying they were “very” or “extremely” satisfied).

● Conversely, Montana (50%), Idaho (49%), Wyoming (45%), New Mexico (45%), and New Hampshire (40%) were most dissatisfied with local news (percent respondents saying they were “not too satisfied” or “not at all satisfied”).

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• In the presidential election, AAPI respondents across the country and across Southern states preferred Vice President Kamala Harris over former president Donald Trump, more so than the general population did: 48% of AAPI respondents in the South preferred Harris, compared to 35% from that region more generally, while 50% of AAPI respondents nationally chose Harris, versus 31% for Trump. Nationally, the general population was roughly split, with 40% for Harris and 38% for Trump.

• AAPI respondents in the South were roughly split over whether Trump handled the job well when he was last president, with 40% saying they approved to some degree, compared to 43% saying they disapproved.

• However, AAPI respondents nationally disapproved of Trump’s handling of the job by a greater degree (48% strongly disapprove or disapprove, compared to 34% strongly approve/approve.) In this survey, the general population was also split, with 42% saying they strongly approved or approved of Trump’s performance, versus 41% disapproving.

• Asked to rate parties and candidates by degree of favorability, AAPI respondents nationally were more favorable to Democrats (61 points average on a 1-100 scale) than Republicans (52 points.) Southern AAPI respondents rated Donald Trump (60 points) higher than Joe Biden (54 points), but lower than Kamala Harris (65 points.)

• Compared to the general population, slightly fewer AAPI respondents in the South and nationally reported feeling “very safe” in their home. Among the general population, 55% said they felt very safe in their home, versus 49% among Southern AAPI respondents and 48% among AAPI persons nationally.

• 48% of AAPI respondents in the South and 51% of AAPI respondents nationally said that the way U.S. politicians talk about China may contribute to stereotypes either a lot or a fair amount. 40% of the general population also believed this to be the case.

• A national sample of U.S. persons of MENA (Middle Eastern and North African) descent (see below for precise definition) favored Vice President Kamala Harris (56%) over former president Donald Trump (32%).

• MENA respondents nationally ranked the economy, inflation, healthcare, and crime at the top of their list of issues affecting their decision for president.

• The MENA respondents favored Harris heavily on some domestic issues such as abortion: 62% said Harris would definitely or probably handle the issue better, compared to 26% who said Trump would definitely or probably handle better. However, MENA respondents rated abortion as only the 12th most important issue out of a list of 17.

• On handling the economy, 53% of MENA respondents said Harris would definitely or probably handle it better compared to 35% for Trump.

• Regarding the Israel-Gaza conflict, 50% said Harris would definitely or probably handle the issue better compared to 33% for Trump. For MENA respondents, this was the third-least important issue among a list of 17 issues.

• Generally, the MENA sample systematically rated all policy issues as more important than the general population; the biggest gap was for race relations and racism, followed by climate change, where the MENA respondents found the issue significantly more important than the general population.

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• Among the top election issues for North Carolinians were the economy, inflation, health care, and taxes. Issues such as gun control and abortion ranked significantly lower than economic issues.

• 74.5% of North Carolina voters indicated that they intended to vote, while 21% – 1 in 5 – were not sure if they would vote or indicated they would not vote.

• 61% of North Carolinians said that it was somewhat or very difficult to afford healthcare costs.

• 43% of respondents indicated they had ever received a medical bill with an error in it.

• About one-third (32%) of survey respondents in North Carolina said they had had to resort to using a credit card in order to cover medical costs they did not have enough money to cover.

• Near three-quarters (74%) of respondents said they were somewhat or very concerned about surprise medical bills.

• The general public in the United States has limited awareness ofcurrent events in Haiti, with just 9% saying they are very familiar and31% saying they are somewhat familiar with the current crisissituation in that nation.

• More people support increasing migration from Haiti than oppose it:34% of the general U.S. public somewhat or strongly supportsallowing more people from Haiti to immigrate, while only 29% of thegeneral public said they are somewhat or strongly opposed.

• A slight majority of the general public (51%) supports increasing aidto Haiti (based on respondents who said they “somewhat” or“strongly” support aid).

• 44% of Haitian-Americans said they felt the Biden-Harrisadministration’s policies had a positive effect on Haiti. Only 16% ofHaitian Americans felt that Biden-Harris policies had a negative effect.

• Persons of Haitian descent reported more favorability for Democrats,President Joe Biden, and Vice President Kamala Harris than thegeneral public did. They also indicated higher favorability forRepublicans, compared to average respondents.

• Regarding the debunked election campaign-driven story relating toimmigrants in Springfield, Ohio, eating pets, 62% of the generalpublic said they had heard about it.

• For those respondents who indicated awareness of the false “eatingpets” story, 69% recalled that it referenced Haitian immigrants, while18% were not sure. About 9% of respondents in total – nearly 1 in 10– falsely recalled that immigrants from four entirely different, butspecific, countries had been accused of eating pets: Mexico, China,Kenya, and Russia.

• American Jews expressed acute concern over issues of antisemitism in the United States, with 54% saying it is a “very serious” problem compared to only 27% of non-Jews who held the same view.

• On the issue of Islamophobia, Jewish Americans voiced much more concern than non-Jews, with 40% saying it is a “very serious” problem compared to only 25% of non-Jews expressing such high levels of concern.

• When asked whether they would support restrictions “prohibiting speech that opposes Israel’s existence as a Jewish state” on college campuses, Jews were significantly more likely to support such speech bans, with 39% of Jews and 21% of non-Jews strongly or somewhat in support.

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• American Jews are much more likely to indicate that they will vote for Vice President Kamala Harris than for former President Donald Trump, preferring her by a margin of 2:1 (60% for Harris, and 30% for Trump.)

• On Israel-Gaza issues, 27% of Jews and 28% of non-Jews said Trump would definitely handle the situation better, while 36% of Jewish respondents said Harris would handle the situation better, compared to 25% of non-Jews in the survey.

• American Jews in the survey saw Trump as strongly pro-Israeli, more so than non-Jews did. A majority of non-Jews (56%) believed Harris offers equal support to both Israelis and Palestinians, compared to 42% of Jews who believe Harris is even-handed.

● Almost one in four American adults (about 23 percent) report knowing someone who struggles with opioid addiction, while one in seven know multiple people

● Knowing someone who is addicted to opioids is significantly more likely in rural than in urban areas (29% versus 20%)

● Opioid addiction appears to cross partisan divides: we find small partisan differences in knowing someone addicted to opioids

● West Virginia stands out as the most affected state, with 47% of respondents indicating that they know at least one person addicted to opioids

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We compared the voting preferences of respondents who had previously participated in the April-May wave of CHIP50 to those of the same individuals reported during the week following the June 27 US presidential debate. Our results indicate a modest churn of voters’ preferences, with no substantial shift in the race between Biden and Trump.

2024 is the first time since 1892 that an incumbent President is facing a predecessor. This yields a potentially distinct dynamic. Elections may be viewed in significant part as an act of assessment of the incumbent, per Reagan’s famous query: are you better off than you were four years ago?1 The choice confronting the American voter in 2024 is, in a sense, a comparative assessment of two presidencies, that of Biden and that of Trump. CHIP50 has been tracking the approval of Biden and Trump for the last two years.

KEY FINDINGS

● Approval of both Biden and Trump has been low and fairly stable for the entire period, with more people disapproving than approving of both for the last two years.

● Approval of Trump has been higher than approval of Biden for the entire period. Disapproval of both was about the same in June 2022. However, Biden’s disapproval has slightly increased, while Trump’s disapproval has gradually declined during this time, yielding a substantially lower disapproval rate for Trump currently (43%) than for Biden (52%).

● The largest shifts towards Trump and away from Biden in approval have been in the younger cohorts. For example, for the 18 to 24-year-old cohort, the percentage of people disapproving of Biden has jumped from 40% in June 2022 to 57% now, while the disapproval of Trump has dropped from 55% to 42%.

● The shift in approval of Biden and Trump has been matched by a substantial shift in partisanship towards Republicans in the youngest cohort. In June 2022, Democrats had a 46% to 21% advantage in partisan identity; this has dropped to a 38% to 32% margin.

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How Do Americans Feel About Israel, Palestine, Jews, And Muslims?

Much has been made about young Americans’ reactions to the war between Israel and Hamas, as well as its implications for antisemitism and Islamophobia. A series of polls from October and December 2023, for example, reported that those between 18 and 24 were split 50/50 on whether they supported Israel or Hamas. In fact, this result gained so much traction that candidate for the GOP nomination for president, Vivek Ramaswamy cited it at a campaign event in November 2023. However, national surveys usually lack the sample size to confidently report percentages of small subgroups, like 18 to 24 year olds, raising questions about the validity of findings like these. Between December 21, 2023 and January 29, 2024, we surveyed 30,460 individuals aged 18 and older across all 50 states plus the District of Columbia. We included feeling thermometers for Israel, Palestine, Jews, and Muslims, asking people to separately rate how they feel about each group on a 0 to 100 scale, where 0 indicates feeling very unfavorable or cold, 50 indicates not feeling particularly warm or cold toward that group, and 100 indicates feeling very favorable or warm. Our survey’s sample size allows us to zoom in on subgroups within the population. For instance, it included 3,294 Americans between ages 18 and 24. This allows us to look within this age group and break young Americans down by partisanship, as our survey includes 1101 18-24-year-old Democrats and 676 18-24-year-old Republicans. In this report, we examine how responses to these four thermometer ratings varied by age, race, education, religion, and partisanship, as well as how the different thermometer scores are correlated with one another. 

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KEY FINDINGS

• Young Americans were less likely than older Americans to rate Israel favorably, but they still rated Jews highly. 18 to 24 year old Americans, for example, rated Israel at a 40/100 but Jews at 71/100. While ratings of Jews and Israel are correlated overall, the correlation is significantly weaker for younger Americans, relative to older ones. 
• Across all demographics, respondents rate Jews higher than Israel and Muslims higher than Palestine, but these gaps vary. The Civic Health and Institutions Project: A 50-State Survey (CHIP50) 5
• Democrats ages 18 to 24 rated Israel the lowest at a 36/100, but rated Jews higher than both Republicans and Democrats ages 25 to 44 and 45 to 64 at a 75/100.
• Republicans ages 18 to 24 rated both Israel (49/100) and Jews (66/100) lower than their older Republican counterparts. 
• Respondents with more education rated both Jews and Muslims higher than those with less education. 
• For every age group, ratings of Palestine and ratings of Muslims were positively and consistently correlated. 
• Ratings of Muslims and Jews are not zero-sum; instead, they were strongly and positively correlated; the higher one rated one group, the more likely they were to rate the other one highly as well. It is important to note that feeling thermometers are a blunt measure of how one feels toward a particular group or country, but they are nonetheless widely employed in social science research because of the variation they provide in telling us how cold or warm people feel about various groups.

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Winter 2023-24 has seen an unusual confluence of a variety of respiratory illnesses, ranging from flu to RSV (Respiratory Syncytial Virus) and COVID-19. Between December 21, 2023 and January 29, 2024, we surveyed 30,460 individuals aged 18 and older across all 50 states plus the District of Columbia. We asked them if they had experienced an Influenza-like Illness (ILI) defined as experiencing a fever and cough, or a fever and sore throat, and/or if they had been diagnosed with COVID-19, over the previous month. Amongst those who responded yes to such questions, we asked them whether or not they had sought medical attention. In this report, we summarize our findings across a variety of demographic subgroups, including age, race, education, income, gender, and geography.

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KEY FINDINGS

- Approximately 10% of Americans reported experiencing illnesses characterized by cough or sore throat in the month before taking the survey (presumably during December 2023 and January 2024).

- The likelihood of reporting such illnesses varied significantly with age, with younger individuals more frequently indicating they had experienced these symptoms.

- Among those who acknowledged having a fever accompanied by cough or sore throat, about 34% sought advice from medical professionals.

- The inclination to consult healthcare providers also showed age-related variation, with older generations being more prone to seek medical consultation.

- Around 28% of Americans have been tested for COVID-19 since October 1st, 2023, with 6% reporting a positive result. Notably, we do not observe significant variation across age groups in the self-diagnosis of COVID-19.

- Finally, 47% of Americans have received or intend to receive a flu vaccination for the current season. Older individuals are more likely to report having received the flu shot compared to their younger counterparts.

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● Rates of depression remain highest among those ages 18-24, with nearly half (47%) reporting levels that would be considered sufficient to require further evaluation and possibly treatment. (By comparison, a 2019 survey found rates of 7% among those 18-29, or 21% including mild depression).

● A similar proportion of young adults (44%) report levels of anxiety that could suggest the need for further evaluation.

● These rates are substantially greater than those in older age groups - for example, 32% of those 25-44, and 22% of those 45-64.

● Rates have remained elevated in this age group throughout the pandemic, with 2 spikes - one prior to the 2020 election, and another in summer 2022.

● We see substantial variation in rates of depression among all adults from state to state: Levels of depression are greatest in West Virginia and Alaska, followed by Idaho, Utah, Mississippi, Vermont, and North Dakota. Levels are lowest in Wisconsin and Minnesota.

● There are large differences in rates of depression among young adults; rates are highest in those without a high school degree, those with the lowest levels of household income, and those who are unemployed.

● Young adults who identify politically as Independents were most likely to report depression, followed by Democrats and then Republicans.

● There are also geographic effects among young adults, with more depression among those in more rural settings. Rates of depression are greatest in the West and Midwest, and least in the South.

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Estimating current vaccination rates

This report summarizes vaccination rates in the United States and compares estimates of vaccination rates from the COVID States Project (CSP), the Kaiser Family Foundation (KFF), and the Centers for Disease Control (CDC).

Key Findings

● Vaccination rates for the primary series of vaccinations have plateaued since the Fall of 2021.

● The regions with the highest vaccination rates are the Northeast and the West Coast plus Hawaii. The regions with the lowest rates are the South, and a block of adjacent states in the upper West/Midwest (the Dakotas, Montana, Wyoming, and Idaho)

● Less than a third of respondents report getting the bivalent booster, with majorities in every state reporting not getting the bivalent booster.

● CDC data deviate quite substantially from survey-based measures (CSP and KFF) of vaccination rates. These deviations almost certainly reflect errors in the underlying official records used by the CDC, driven by the inability of states to link records of multiple shots to a given individual. Official data thus offer a distorted picture of the trends in vaccination rates in the country, and where those distortions have grown over time.

We asked respondents to mark popular vaccine and political misinformation claims as true or false. When in doubt, they could also select “Not sure.” Here are some of the patterns we found:

● Overall, 20% of Americans endorsed at least one COVID-19 vaccine misperception. Another 45% did not endorse any misperceptions but did report being uncertain about the veracity of some claims.

● In the realm of politics, a very small proportion of respondents (8%) were able to correctly identify all false statements we asked about as inaccurate. Two-fifths (41%) believed at least one false statement, while just over half (51%) did not endorse incorrect items but still reported uncertainty about them.

● COVID-19 vaccine misperceptions were more common among younger people, with 25% of those ages 18 to 45 endorsing at least one. Both vaccine and political misperceptions were more prevalent among respondents with lower income, lower education level, and among those who identified as Republicans.

● People endorsing vaccine misinformation were considerably more likely to also endorse political falsehoods. Fully 71% of those who believed false vaccine statements also believed inaccurate claims related to politics. In contrast, 32% of those who correctly marked all false vaccine claims believed inaccurate political statements.

● Vaccine-related and political misperceptions were strongly associated with low trust in the government, science, and medicine. They were also associated with high trust in Donald Trump and high levels of conspiratorial thinking.

In our latest survey, 24% of Americans report levels of depression that would typically trigger a referral for evaluation and treatment. Among 18-24-year-olds, that number jumps to 44%, including 24% of 18-24-year-olds meeting the criteria for moderate to severe or severe depression.

• The rate of depression among 18-24-year-olds is slightly down over the last 12 months, and down from its peak at 53% in June 2022.

• Percentages of 18-24-year-olds who say they are avoiding public places, avoiding contact with others, or wearing face masks outside the home are the lowest they have been in any of our surveys since the beginning of the pandemic. However, despite continuing to return to pre-pandemic life, the rate of depression among 18-24-year-olds has not declined in kind.

• Young respondents identifying as gay, lesbian, or bisexual are significantly more likely than older and heterosexual respondents to report symptoms of depression and anxiety and higher levels of stress. Sixty-three percent of 18-24-year-olds identifying as gay, lesbian, or bisexual meet the criteria for at least moderate depression, while 56% report symptoms of generalized anxiety.

• While young people report higher rates of depression across the board, young people with lower household incomes are the most likely to meet the criteria for depression. Forty-nine percent of 18-24-year-olds with a household income of under $25,000 meet the criteria for depression.

• Young women report higher levels of depression, stress, and anxiety than young men.

• Young respondents report higher levels of self-reported stress and anxiety (based on the GAD-2 questionnaire) than any other age group, a finding that has been consistent throughout all of our surveys.

• A substantial subset of respondents between 18 and 24 report some elements of loneliness: Twenty percent say they often feel that they lack companionship, 27% say they often feel left out, and 31% say they often feel isolated from others.

● Comparing our October 2022 survey conducted immediately before Elon Musk purchased Twitter to our December 2022-January 2023 survey, the percentage of Americans who reported using Twitter dropped from 32.4% to 29.5%. This decline was driven by Democrats, 38% of whom reported using Twitter in our survey before Musk took over the company, which dropped to 33% after.

● 53% of Republicans trust Elon Musk to do what is right either somewhat or a lot, compared to just 24% of Democrats.

● Democrats were 15% more likely than Republicans to trust Twitter to do what is right before Musk purchased the site, but trust among Republicans and Democrats converged to equal levels following Musk’s takeover, with 34% of both parties trusting Twitter to do what is right.

● Republicans perceived a significant decrease in bias against conservatives on Twitter and an increase in neutrality after Musk took over, while Democrats saw a significant increase in bias against liberals and a decrease in neutrality since Musk bought Twitter.

1. About half of American adults report having been infected with COVID-19 at some point, with 35% saying they have tested positive for COVID-19 before.

2. Individuals vaccinated against COVID-19 report being sick for fewer days than unvaccinated individuals.

3. Due to the underreported use of at-home rapid tests, the data on reported tests are missing a significant number of positive cases.

4. At least 5 in 6 American adults likely have some level of immunity to COVID-19, either through vaccination or previous infection.

5. A substantial majority of American adults have not received the bivalent booster shot, but a majority of those who have not say they plan to or are open to getting the shot.

6. Antiviral medications are not being heavily utilized, even among higher risk American adults.

7. One in nine American adults report having continued symptoms from COVID-19 more than two months post-infection.

8. Nearly half of American adults are still wearing masks, but only a quarter say they are very closely following the recommendation to wear a mask when outside of the home.

9. Only 28% of American adults have received their flu shot.

10. There is a strong correlation between getting the bivalent booster and getting a flu shot. However, just 1 in 10 American adults have received both shots.

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● Half of the respondents in our survey (50%) were confident that votes in the 2022 congressional elections would be counted accurately. The other half reported no confidence in an accurate vote count (18%), or else said that they were not sure about it (32%).

● A total of 74% of Democrats had confidence in the fair counting of votes, compared to 35% of Republicans and 42% of Independents. Only 8% of Democrats lacked confidence in election integrity, while close to a third of Republicans (30%) did not think votes would be counted accurately.

● Confidence in fair elections increased consistently with higher income and education. Over 60% of those with graduate degrees and income over $100K thought the 2022 elections would be fair, compared to 40% of those with income under $25K and 30% of those who did not graduate from high school.

● While Americans were concerned about election fairness, very few named it among the most important problems facing the country. Only 3% of respondents listed elections as one of the top 3 problems facing the US.

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● Despite being featured less in popular news media, Americans remain concerned about Russia’s invasion of Ukraine, with 78% reporting that they are either somewhat or very concerned.

● In response to a hypothetical Russian use of nuclear weapons, there was broad bipartisan agreement for an aggressive response, even if it meant more direct NATO or American involvement.

● While Democrats are more concerned about the Russian invasion of Ukraine than Republicans and independents, strong majorities in all three groups report being concerned. Majorities of Republicans, Democrats, and independents across every age group are concerned about the invasion.

● In the event of a Russian nuclear attack, Republicans and Democrats both indicated support for tightening economic sanctions, increasing military aid to Ukraine, launching missile strikes aimed at taking out nuclear weapons that Russia could use on the battlefield in Ukraine, establishing a NATO-led no fly zone in Ukraine, and sending NATO troops to Ukraine. Very few indicated support for withdrawing all military aid from Ukraine.

● Americans across all age groups are concerned about the Russian invasion of Ukraine, but especially those 65 and older, where an overwhelming majority is concerned.

● Women are more likely than men to report being concerned over the invasion. Specifically, Republican and independent women are significantly more likely than Republican and independent men to report being concerned about the Russian invasion. Even so, concern among men is still high, with 75% reporting being somewhat or very concerned about the Russian invasion of Ukraine.

● Majorities of Americans across different levels of education all report concern over the invasion, but more highly-educated individuals are more likely to report being very concerned.

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• Inflation and the economy are Americans’ top ranked problems facing the country headed into the 2022 elections.

• Republicans and independents both rank inflation and the economy as their first and second most important issues, but Democrats rank climate change and racism as their top two issues, with inflation coming in a near third.

• Republicans and Democrats differ significantly in how high they rank immigration, climate change, racism, inflation, and the economy.

• Men and women do not differ as much as Republicans and Democrats in their issue rankings, but women are significantly more likely than men to list healthcare, women’s rights, and abortion as most important issues.

• Among those ages 18 to 24, racism and abortion were the top two most commonly identified most important problems. For every other age group, inflation was the most important problem facing the country.

• African Americans were significantly more likely than any other group to list racism as a most important issue, but Asian-American and Hispanic respondents were also significantly more likely to select racism than White respondents.

• Regardless of whether someone makes under $25,000 a year or over $100,000, inflation was the top-ranked problem for each income group.

• Those who see inflation, the economy, or crime and violence as their top issues are more likely to prefer that Republicans win control of the Senate, while those who see healthcare or racism as among their most important issues are more likely to prefer that Democrats maintain control of the Senate.

• A large majority of Americans quickly became aware of the Mar-A-Lago search. Overall, 81 percent reported that they were aware of the search. Additionally, 82 percent of those who took the survey within a week after the search were already aware of it.

• Overall, Americans approved of the search by a 51-27 margin. Another 22 percent neither supported nor opposed the search.

• Democrats overwhelmingly supported the FBI search of Mar-A-Lago by an 84-3 margin. Over two thirds (69 percent) of Democrats strongly supported the search.

• A strong majority of Republicans opposed the search by a 64-13 margin. Additionally, 47 percent of Republicans strongly opposed the search.

• Independents were nearly twice as likely to support the search as they were to oppose it, with a 47-24 margin. Close to a third (32 percent) of independents strongly supported the search.

• The intensity of Republican opposition to the search decreased slightly as time following the search increased. While Republican support for the raid remained very low in both cases, those strongly opposing the raid dropped from 54 percent of Republicans who responded within a week of the search to 46 percent of Republicans who responded at least one week after the search. Very few Republicans supported the search regardless of when they took the survey, but the percentage of those strongly opposing it dipped over time.

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The COVID States Project has issued a series of reports since the beginning of the pandemic regarding approval of how state governors and the President have handled the pandemic. We also have a dashboard that allows examination of the approval levels of each governor and of the President over time (the latter, both nationally and state-by-state). In this report, we update our discussion of the approval trends, adding analyses of the trends of overall approval of gubernatorial and presidential job performance (which we term “general approval”) and focusing especially on governors seeking re-election. We are at a rare moment where a single issue – COVID – has been the most important issue confronting every governor since they last faced the voters. A key question will be how assessments of each governor’s handling of COVID-19 affects their electoral success. A secondary question is how important approval of an incumbent governor will be for their re-election prospects. (Note that we report all state-level approval data by wave in the appendix.) Some key insights are as follows:

● Average approval of governors’ handling of the pandemic is low (39% for the pandemic; and 40% for general approval). But approval ratings havegenerally held steady since our prior survey wave in June 2022, arresting what had been a long term slide throughout the pandemic.

● Approval of President Biden is also low (37% for the pandemic, and 35% for general approval), but has increased significantly since our preceding wave (by 3 points for the pandemic; and 4 points for general approval).

● Approval ratings of incumbent Republican governors running for re-election are significantly lower than those of incumbent Democrats also running forre-election.

● A major driver of the gubernatorial partisan approval gap is that Republican respondents rate their fellow Republican governors lower than Democratic respondents rate Democratic governors. Important electoral questions are (a) whether this will translate into an enthusiasm gap and (b) how strong a predictor of vote choice job approval will be in 2022.

● A second reason for the partisan approval gap is that Independents tend torate Democratic incumbents more highly than they rate Republican incumbents.

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While Paxlovid has been available since December 22, 2021, there have been challenges in its clinical application. Of people infected with COVID-19 between May and early July, only 11% report having taken antivirals.

● Overall support for abortion across all nine scenarios increased following the Dobbs decision, with increases ranging from 1 to 5 percentage points. Among respondents for whom the abortion issue is “extremely important”, the corresponding increases were larger, ranging from 2 to 8 percentage points. 

● Support for abortion increases or remains the same between the pre- and post-Dobbs periods for all nine scenarios, regardless of intent to vote, but increases modestly more consistently among respondents who are not “very likely” to vote. 

● Across most demographic subgroups, we see little change in the overall probability of voting following the Dobbs decision. There are three exceptions – men, rural residents, and respondents with a high school education or less - each of whom are statistically significantly less likely to say that they are “very likely” to vote in the 2022 midterm election following the Dobbs announcement. 

● Overall, we find that individuals who consider abortion to be an “extremely important” issue are substantially more likely to support Democrats retaining control of both houses of Congress. These gaps, in turn, increase modestly following the Dobbs announcement. For the House of Representatives, the gaps prior to and following the Dobbs announcement are 11 and 14 points in favor of Democrats, respectively. For the Senate election, the corresponding gaps are 12 and 13 points in favor of Democrats, pre- and post-Dobbs, respectively. 

● In the 13 states with so-called “trigger laws” that automatically imposed restrictions or prohibitions on abortion following the overturning of Roe v. Wade, public opinion moved in the opposing direction as public policy – that is, toward greater support for abortion across the nine scenarios – by 3 to 9 percentage points. Such increases were even larger among respondents in those states who indicated that abortion was “extremely important”, with maximum increases in support of 12 to 14 percentage points. 

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● Nationally, roughly one-third of Americans do not offer an opinion on abortion across all nine scenarios. This lack of opinion is lowest for pregnancies caused by rape and for pregnancies that threaten the life of the woman (roughly three-quarters of Americans offered an opinion). 

● Support for abortion to save the pregnant woman’s life outpaces opposition in every U.S. state, with majorities in most states supporting life-saving abortion care. However, residents of states where abortion is legal up to viability are roughly 12 percentage points more likely to support life-saving abortion than in states where abortion is prohibited except for rape or incest (where 55% support abortions to save the life of the woman). 

● Laws prohibiting abortion without exception for rape are clearly at odds with public opinion of those states’ residents. A 55% majority of residents in states where abortion is currently banned without exception for rape or incest support abortion in pregnancies caused by rape. Just 17% oppose abortion in rape cases, with the remaining respondents not voicing an opinion. 

● In every U.S. state, more Americans oppose than support abortion after fetal viability, the prior point at which states could prohibit abortion established in Roe and Casey but recently struck down in Dobbs. Even in states where abortion is legal without gestational limits (AK, CO, NJ, NM, OR, VT, and DC), opposition to abortion after fetal viability is more than double the share that supports such abortions (46% oppose versus 21% support, with the remaining respondents not voicing an opinion). 

● In states where abortion is banned after 6 weeks of pregnancy, 37% of residents oppose abortions after 6 weeks compared to one-quarter (25%) who support such abortions – a 12 percentage point gap. Roughly 4 in 10 (38%) did not voice an opinion. Although not a majority of residents in these states, more residents say they oppose than support abortion in these cases, demonstrating some consistency of the law with opinion of these states’ residents. 

● In states where abortion remains legal, more residents support abortion if a woman does not want to be pregnant than oppose. For people in states where the future of abortion legality is uncertain, roughly equivalent shares support, oppose, and have no opinion about abortions for women who don’t wish to be pregnant. 

● Around half of Americans support abortion if the fetus could suffer from serious health problems or birth defects, compared to around two out of five Americans who oppose it. States with populations most opposed to this stance tend to be in the South - where it is not legal to get an abortion for fetal abnormalities in many states - while majorities in some northeastern states support abortion under these circumstances. 

● Nationally, around twice as many Americans support abortions when the woman’s health is endangered (44%) than oppose it (21%). In many southern states where this is not legally allowed, like Mississippi and Alabama, around equal shares of the population support and oppose abortion when a woman’s health is jeopardized (around three in ten support and oppose). Other states that do not allow this, like Idaho and Utah, have populations that support versus oppose this measure by two to one or higher. 

● Nationally, women overall, Hispanic women, young women, liberals and Democrats are most likely to rate abortion as an “extremely important” issue. 

● Nearly half of Democrats (48%) versus over one-third of Republicans (36%) rate abortion as “extremely important” – a 12 percentage point gap. Similarly, a 53% majority of those who self-identify as liberals rate abortion as “extremely important” compared to 39% of self-identified conservatives – a 14 percentage point gap. 

● Compared to the national average, support for abortion is significantly higher across each of the nine scenarios among individuals who found the abortion issue to be especially important. 

● Regionally, the Northeast consistently contains the highest support for abortions across all scenarios, followed by the West coast and parts of the upper Midwest. The South tends to be least supportive, followed by the great plains and the northern mountain states. This vaguely - with many exceptions - mirrors the gradient of policy restrictiveness by region. 

To see all the charts in one place, please go to this Interactive Charts page.

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● When given a list of possible information sources consulted for child health or vaccine information, parents most commonly selected news and the government followed by television, Facebook, and YouTube.

● Parents most commonly discussed child health and vaccination decisions with their own parents, in-laws, and other relatives when given a list of sources by researchers.

● When we gave parents an open-ended response question about where they got information to decide whether to vaccinate their kids against COVID-19, health care professionals were the most commonly cited source of information overall, followed by news, government, and online/social media sources.

● However, parents of vaccinated children ages 5-18 were much more likely to mention health care professionals - as well as the government and schools - compared to those with unvaccinated children ages 5-18.

● Conversely, parents of unvaccinated kids ages 5-18 were much more likely to say their own general research, and their own decisions and values, were important sources in decision-making compared to parents of vaccinated kids ages 5-18. Parents of unvaccinated children ages 5-18 were also more likely to say that they did not know where they got information, or they did not look for or receive information.

● Relatively few Americans (14%) believe false claims about Ukraine – fewer than those who believe false claims about COVID-19 vaccines (18%). Still, as many as 50% of our respondents report being uncertain about the veracity of at least one false claim regarding Ukraine.

● Misperceptions about COVID-19 are by far the strongest overall predictor we have identified of holding misperceptions about Ukraine. Nearly half (45%) of respondents who hold at least one misperception about Ukraine also hold misperceptions about COVID vaccines. In contrast, fewer than one in ten (8%) of those who marked all false Ukraine claims as inaccurate believed any false vaccine claims.  

● Republicans are 5 percentage points more likely than Democrats to believe false claims about Ukraine; the partisan gap is three times larger (15 points) for COVID-19 vaccine-related false claims.

● The most widely-used source of news about Ukraine is social media, cited by 37% of respondents. Of these respondents, 16% hold at least one misperception about Ukraine. In comparison, 25% of respondents cite social media as a source of news about COVID-19. Twenty percent of these respondents hold at least one COVID vaccine-related misperception.

● Americans feel much warmer toward Ukraine than toward Russia, by an average of 60 degrees on a 100-point feeling thermometer (77 vs. 17 degrees). The gap is considerably smaller (+37) among respondents who hold at least one misperception about Ukraine (64 vs. 27 degrees). The gap is also notably smaller for Republicans (+59 degrees warmer for Ukraine) and Independents (+56) than for Democrats (+69).

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● 13% of older Americans are completely unvaccinated against COVID-19, while an additional 14% are fully vaccinated but have not received a booster, and 3% report having received a single shot of Moderna or Pfizer.

● The CDC data on vaccination rates are clearly significantly flawed, because they indicate that there are more older Americans who have received at least one dose of vaccine than there are older Americans. This is because they attribute the boosters (and perhaps second shots) that many people have received to being first shots, likely due to poor vaccination record linkage for those individuals. As a result, CDC data likely understate how many people are completely unvaccinated and how many people have received boosters, and overstate the number of individuals who have received only a single dose.

● The unvaccinated and unboosted are disproportionately less educated, lower-income, rural, and Republican.

● The main reasons cited by older Americans for being unvaccinated were worries about side effects and a lack of trust in the process by which the vaccines were developed, similar to concerns we found in an earlier report on the reasons reported by the unvaccinated for their vaccination decision.

● In the open-ended responses, many of the vaccinated but unboosted indicated an openness to getting a booster but cited obstacles or a lack of urgency to do so.

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● 4 out of 10 American adults know at least one person who died of COVID-19, including 7% who know 3 or more people who died.

● 15% of American adults report that a family member died of COVID-19.

● Black and Hispanic adults are more likely than others to know someone who died of COVID-19 (46% and 45%, respectively, versus 38% for White and 36% for Asian respondents).

● About 1 in 4 U.S. adults (27%) report moderate or greater symptoms of depression, generally similar to rates throughout the pandemic.

● These rates of depression are highest among those 18-24, lowest among those 65 and older.

● Rates of depression vary substantially by state, from a low of 20% to a high of 32%. They remain highest among those who identify politically as Independents, followed by Democrats and then Republicans.

● Among those with a family member who died, rates of depression were 31% compared to 26% among those without a family member who died; these effects were not explained by differences in age, gender, race and ethnicity, income, or U.S. region.

● There are two hopeful observations in our data. First, while rates of depression remain higher among adults in households with children compared to those without, this difference has progressively diminished, and is now less than 5%.

● Second, rates of suicidal thoughts have steadily diminished since May 2021, although nearly 1 in 5 adults (19%) still reports such thoughts.

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The Covid States Project has been tracking trends in executive approval of management of the COVID-19 outbreak throughout the pandemic. We find:

● Generally, there has been a downward trend for approval of all governors since the beginning of the pandemic.

● Republican respondents in particular have trended downwards in their approval of governors. Republican approval of Democratic governors has dropped from a high of 57% in April 2020, to 19% in April, 2022. Approval of Republicans for Republican governors has fallen almost as quickly, from a high of 77% in April 2020, to 44% currently.

● In the early stages of the pandemic, President Trump had notably low approval for his handling of the pandemic, far below the average approval levels of governors. President Biden has generally had approval levels above those of President Trump, peaking in the spring of 2021, and declining steadily since. This decline has been somewhat faster than the decline in approval of governors, reaching a nadir in April 2022 one point below that of the average governor at 38%.

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We asked respondents to mark four popular vaccine misinformation claims as true or false. When in doubt, they could also select “Not sure.” Here are some of the patterns we found: 

● While we observe a decline in believing misinformation since the early days of COVID-19 vaccination efforts in 2021, 16% of Americans still hold vaccine misperceptions. Close to half (46%) are uncertain about the veracity of at least one vaccine misinformation statement. 

● People aged 25 to 44, parents with children under 18, Americans who did not go to college, and Republicans are most likely to hold vaccine misperceptions, with over 20% of the respondents in each group marking at least one misinformation statement as true. 

● Early in the pandemic, people with high socioeconomic status were amongst the most likely to hold vaccine misperceptions. Over time, people with graduate degrees and those with high income made large shifts towards rejecting misinformation. The groups least likely to espouse false claims now include graduate degree holders, Democrats, Asian Americans, and those over 65 years of age. 

● A third of the people who believe vaccine misinformation statements are aware that scientific and medical experts reject those claims as false. Additionally, over a fifth of Americans (21%) are aware that science considers a particular claim to be false, but still say they are not sure whether to believe it or not. 

● People who think they know a lot about COVID-19 vaccines are more likely to hold vaccine misperceptions. Among those who claimed to have expert knowledge, 48% believed false claims compared to only 16% of those who said they knew almost nothing about vaccines. 

● Compared to those with no vaccine misperceptions, Americans who believe misinformation claims are less likely to trust the government, news media, science, and medicine. That pattern is reversed with regard to trust in Fox News and Donald Trump. 

● Vaccine misinformation beliefs, uncertainty about false claims, trust in government and science remain among the most important predictors of getting vaccinated, even after accounting for demographic and other factors. 

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The parent-reported COVID-19 vaccination rate for youth ages 12-18 has very slightly risen from 54% in September 2021 to 57% in January 2022. 

● The parent-reported COVID-19 vaccination rate for kids ages 5-11 has increased from 27% in November 2021 to 36% in January 2022. 

● However, the rise of the Omicron variant over the winter holiday season does not appear to increase the reported likelihood that parents would vaccinate their children against COVID-19; if anything, likelihood of vaccinating kids under 12 decreased between November 2021 and January 2022.1 

● Parental vaccination likelihood for youth ages 12-18 increased from September to November 2021, then stabilized from November 2021 to December 2022 at just over two-thirds of parents expressing likelihood. 

● Partisan gaps have increased from September 2021 to January 2022 - in all child age groups, this gap has widened to over 30 percentage points in the most recent wave. 

● Parents of kids under 5 report the lowest percent likelihood of vaccinating their kids: only 54% of parents with kids under 5 said they would likely vaccinate their children against COVID-19. 

● Significant demographic differences emerge among parental likelihood of vaccinating their kids against COVID-19; these relative cross-subgroup differences roughly hold for all childhood age groups. 

1 Vaccination likelihood is measured via the response to two questions: 1) whether the parent said vaccinating their kids against COVID-19 was somewhat likely or very likely, and 2) whether the parent said their kids already received at least one vaccine against COVID-19. If they said it was likely or that they had already vaccinated their kids at least once, the parents were coded as “likely” to vaccinate their kids.  

● Overall, nearly one-quarter (23%) of Americans say it is “definitely” or “probably” justified to ever engage in violent protest against the government. 10% say it is “definitely” or “probably” justified to engage in violent protest against the government right now. 

● Men, younger Americans, and ideologues (liberals and conservatives) are more likely than women, older Americans, and ideological moderates to say it is “definitely” or “probably” justified to ever engage in violent protest against the government. 

● Although the gap between Democrats and Republicans overall is relatively small (Republicans are just 4 points more likely than Democrats to agree that violent protest can be justifiable), Democratic men are much less likely to say violent protest is ever justifiable than Republican men and Independent men (23% versus 32%). Similarly, Democratic men are significantly less likely than Republican and Independent men to say violent protest against the government is justifiable right now. 

● Republicans and ideological conservatives are most likely to say that violent protest against the government is justifiable right now. 

● Among those who say it is justified to engage in violent protest against the government, most (two-thirds) say that the federal government is an appropriate target. Smaller shares think that their own state’s government (35%), another state’s government (20%), or local government (21%) are justifiable targets for violent protest. 

● Among those who say violent protest is justified right now, Republicans are more likely to target the federal government than are Democrats (71% versus 62%) while more Democrats say violence against their state’s government is justified (43% versus 26%). Independents are more likely than Republicans to say violent protest against their state’s government is justified (38% versus 26%) and are more likely than both groups of partisans to say violence against their local government is warranted. 

● Among Republicans who say violent protest against the government is currently justified, a larger share (37%) say violent protest against their state’s government is justified when that state is controlled by a Democratic governor than those who say it is justified in state’s controlled by a governor from their own party (18%). 

In our most recent wave, out of 10,759 respondents: 

● 63% reported ever having been tested for COVID-19. 

● 18% reported ever having tested positive using any type of test. 

● 4% reported testing positive using an at-home test. 

● 31% of individuals who had a positive test at home did not follow up with a test at their doctor’s office or a testing facility, and thus are likely not captured in official data. 

● We estimate that cases have been undercounted by about 6% on average among adults, and likely more so for demographics that use at-home tests more heavily (younger individuals, those with higher income and education, Democrats). 

● 64% of Americans use cloth masks, with just 21% saying they use N95 or equivalent masks. 

● A majority (54%) think that the CDC currently recommends N95 masks for all Americans. Note that these data were collected prior to the CDC’s change in guidance of January 14, 2022, which “Clarified that people can choose respirators such as N95s and KN95s.” 

● Democrats, vaccinated individuals, Whites, those with higher incomes, and respondents with more education are more likely to incorrectly identify N95s as the CDC’s recommended mask-type. 

● Roughly two-thirds (66%) of Americans correctly identify N95 masks as more protective than cloth masks, while roughly one-quarter of respondents (26%) are unsure of whether cloth or N95 masks offer the wearer more protection. 

● Vaccinated individuals, Democrats, those with more education, higher incomes, Whites, and older Americans (50 and above) are more likely to correctly say that N95s offer greater protection than cloth masks. 

● The vast majority of healthcare workers perceive misinformation to be negatively influencing both patient decisions to get vaccinated against COVID-19 (72%), and patient care during the pandemic (71%). 

● A sizable plurality of healthcare workers - around a third - perceive misinformation as an “urgent” problem for patient healthcare during the pandemic, and also as the single most important factor influencing unvaccinated patients’ decision not to get the COVID-19 vaccine. 

● The most commonly cited sources of misinformation negatively impacting patient healthcare, according to healthcare workers, are social media (73%) - particularly Facebook - as well as family and friends (64%). 

The COVID states project conducted a survey and issued a report in the immediate aftermath of the storming of the Capitol building on January 6, 2021. Here, we revisit some of the opinions regarding January 6th, a year later. 

• Overall, 30% of respondents indicated that they had received a COVID-19 booster shot. 

• Older respondents are much more likely than their younger counterparts to have received a booster shot, with respondents over age 65 four times as likely as Gen Z respondents (ages 18-24), by 53% to 13%. 

• Democrats are more likely than Republicans to have received a booster shot (33% vs. 27%). However, partisanship is a far less strong predictor of having received a booster shot – either nationally or comparing Democratic and Republican-leaning states, contingent on having previously been vaccinated – than of having been vaccinated in the first instance. 

• As education increases, the probability of having received a booster increases (from 22% among respondents with a high school education or less to 46% among their counterparts with graduate degrees). 

• We find only small differences in the probabilities of being vaccinated or having received a booster, as well as in respondents’ reasons for getting a booster, before vs. after the WHO Omicron announcement. 

• Nearly half (47%) of previously vaccinated respondents are booster hesitant or resistant. 

● The biggest concerns for parents have consistently been the long term side effects of the COVID-19 vaccine on kids, and whether the COVID-19 vaccine has been tested enough for kids; for every wave of our survey, over half of all parents mention these as major concerns. 

● A handful of groups continued to hold elevated levels of certain concerns from September to November, such as Republican, Asian, and rural parents. Some others (like Democrats, Hispanics, older fathers) returned to the lower initial (June) levels for most concerns after the September spike. College educated parents have stayed at essentially stable (and low) levels of concern over time for almost all concerns examined. Overall, these trends not only suggest that groups are polarized over COVID-19 vaccine concerns for kids, but also that certain groups are still polarizing over time - particularly vaccine novelty and risk for long term side effects of the vaccine. 

● Overall, parental concerns over the COVID-19 vaccine for kids were the lowest in June 2021, peaked in September 2021, and then decreased somewhat in November 2021. 

● Republican, Black, and rural parents, as well as younger (under 35) mothers and parents who say they are unlikely to vaccinate their children, are among the groups with the greatest proportion of people expressing various concerns. 

● College-educated and Democratic parents, as well as parents who will likely or who have already vaccinated their kids, have consistently been among the groups with the fewest expressing concerns. Fathers - particularly fathers 35 or older - also tend to have some of the lowest levels of parental concerns. 

● Large majorities of Americans, overall, across parties and demographic groups are concerned with how history is being taught in schools. 

● In a survey experiment, we find that Americans express greater support for teaching “how racism continues to impact American society today” than support for teaching “Critical Race Theory (CRT)” in public schools. Overall, a 52% majority of Americans support teaching the legacy of racism versus just 27% who support teaching CRT. 

● Support for teaching CRT and the legacy of racism varies widely by socio-demographic factors. Democrats are roughly 50 percentage points more likely to support teaching the legacy of racism than are Republicans. A smaller gap, 37 percentage points, separates partisans in their support for teaching CRT. 

● Despite the increased focus on persistent racial disparities in American society following the 2020 murder of George Floyd by Minneapolis police, a majority of Whites do not support teaching how racism continues to impact American society today in public schools. Just 46% White respondents support teaching the legacy of racism, compared to 73% of Black respondents – a 27 percentage point gap between the racial groups. Black respondents were also 19 points more likely to support teaching CRT than White respondents (42% vs 23%). The racial divide is mostly driven by exceptionally low support among White Republicans, whereas there is no significant difference between support for teaching the legacy of racism and support for teaching CRT between White Democrats and Black Americans overall (most of whom identify as Democrats). 

● The public’s attitudes toward CRT have no consistent relationship with state policy on CRT. Opposition to CRT is identical in states that have enacted legislative bans on CRT and in states where no state action has been taken. 

● Despite its prominent place in news headlines in recent months, most Americans don’t know what CRT is. A large majority of Americans are not at all or not very familiar with CRT, with 7 in 10 respondents saying they aren’t familiar with the theory. 

● When asked how well they think CRT describes how American society works, about 1 in 5 (21%) of respondents say it describes society well, 35% think it does not, and 44% say they don’t know. As with support for CRT, state policy on CRT has no clear relationship with citizen’s familiarity with the theory nor with how well they think CRT describes American society. 

● Overall, roughly 1 in 5 (22%) say they voted in a school board election in the past year and 4% said they attended a school board meeting in the past 6 months. 

● Partisans were more likely than independents to say they voted in a school board election, as were wealthier respondents, those with higher education, and older Americans. Similar shares of parents and non-parents report voting for school boards. 

● Majorities of school board meeting attendees were parents of minor children, Democrats, college educated, and below age 50. 

● Overall, the most frequently cited issues motivating school board voters were school safety and requiring COVID-19 vaccines. Together, pandemic-related concerns (vaccines, masks, and mode of instruction) motivate 3 in 10 voters while school safety and mental health combined are the top concern of 1 in 5 voters. 

● The top issue concerning school board voters varies by partisanship, race, vaccination status, and age. Democrats, those vaccinated for COVID-19, and older Americans were more likely to cite COVID-19 vaccine requirements as their top issue for school boards. Younger and Hispanic voters were more likely to prioritize mental health than older and non-Hispanic voters. Black voters and Republican voters were more likely to rank teaching about race/racism as their top issue compared to White voters and Democratic voters. 

● Parent-reported COVID-19 vaccination rates of youth ages 12 to 18 have plateaued between September and November 2021, with 55% reporting that their children receiving at least one COVID-19 vaccine as of November, compared to 54% in September. While such vaccines only recently became available for younger children, 27% of parents with kids ages 5 to 11 have reported their children receiving at least one dose. 

● Despite the surge of children vaccinated since June, the proportion of vaccine-enthusiastic parents (parents who have either had their children vaccinated, or say they are likely to do so) has dropped since June, 2021, from 64% to 57%. 

● College-educated, urban, Democratic, Asian, and older parents are more likely than average to report that their child has already been vaccinated. Rural, Republican, Independent, non-college educated, and younger parents are less likely. 

● College-educated, Democratic, and Asian parents, as well as fathers, on average report a higher likelihood of vaccinating their children against COVID-19. Vaccination likelihood is lowest among Republican parents and younger mothers. 

● According to our November 2021 survey, roughly half (54%) of Massachusetts residents approve of Baker’s overall performance as governor. However, Baker’s support continues to come mostly from outside his own party: Over 6 in 10 (64%) Democrats and 46% of independents approve of Baker, compared to about one-third (35%) of Republicans. Baker also performs better among more educated Massachusetts residents and those with higher incomes than among those with a high school degree or less and those with lower incomes. 

● Baker’s overall job approval (54%) is higher than the average gubernatorial approval across the U.S. of 42%. 

● When it comes to handling the pandemic, Baker again receives higher marks than the national average (58% vs. 45%), although his COVID-19 approval has dipped significantly since his high of 80% in April 2020. 

● Approval of Baker’s handling of the pandemic declined significantly since September 2021, driven mostly by a steep decline in approval among Republicans. 

● Approximately half of all enrolled university students attend institutions with some type of COVID-19 vaccine mandate. 

● Students with Democratic state governors, students at private institutions, and students at medium- to larger- sized institutions are more likely to report having vaccine mandates at their university. 

● A little over two-thirds of students stated that they knew their university’s COVID-19 vaccine policy, and around two-thirds of these students accurately characterized their institution’s policy. In other words, only around half of all university student respondents surveyed accurately knew their university’s policy. 

● University mask and student/faculty/staff vaccination mandates garnered the highest student approval rate for their school administration’s handling of COVID-19 vaccinations. 

● College students who were required to attend any in-person classes were less likely to approve of their school’s handling of COVID-19 vaccinations. 

● Republican college students and unvaccinated college students were less likely to approve of their institution’s handling of COVID-19 vaccinations. Hispanic students and White students were generally less approving than Black students and Asian students, and approval did not vary by gender. 

● All investigated parental concerns about vaccinating children against COVID-19 have increased significantly from June 2021 to September 2021 across all demographic groups. A few of these jumps were as high as 15 percentage points or more for certain concerns and for demographic groups. 

● Certain groups of parents are more likely to express major concerns about the COVID-19 vaccine for their kids, including younger mothers, parents of younger children, parents of children who have not yet been vaccinated, Republicans and Independents, Hispanic and Black parents, the non-college educated, and rural residents. 

● Long-term effects of the COVID-19 vaccine, followed by whether the COVID-19 vaccine has been tested enough, were often the top concerns among parents. 

● Both the likelihood of vaccinating children under 12 and vaccination status in children ages 12 to 18 are strongly related to parent vaccination status, as well as student mode of school instruction. 

In mid-August 2021, the Centers for Disease Control and Prevention (C.D.C.) issued a recommendation for both vaccinated and unvaccinated Americans to begin wearing masks in public again, particularly in places experiencing outbreaks of COVID-19, driven by the Delta variant. Further compounding this concern is the lower propensity of unvaccinated individuals to wear masks. For example, a report from July 2021 found that unvaccinated Americans, on average, tended to wear masks less than vaccinated Americans by a margin of 25 percentage points. 

● Despite a drop in President Biden’s approval rating on the pandemic since June (overall and among key groups), Biden maintains a higher coronavirus approval rating than did Trump at this point last year (49% vs. 34%). 

● President Biden’s approval rating on his handling of the coronavirus pandemic (49%) and the average governor’s approval rating on their handling of the pandemic (45%) are similar. This is in contrast to President’s Trump’s approval rating on coronavirus at this point last year, which was significantly lower than respondents’ approval of their governor’s handling of the crisis (34% vs. 48%). 

● Governors of states with prohibitions on vaccine mandates garner the lowest approval ratings. This relationship holds even after accounting for partisanship, race, gender, vaccination status, the governor's party, and the state's average per capita COVID-19 cases. 

● Governors of states with higher average COVID-19 cases per capita receive lower approval ratings than governors of states where cases are lower. 

In our previous reports on healthcare worker's vaccination rates and attitudes, we found that their behavior was a harbinger of trends in the general population. The historical data serves as evidence that because healthcare workers had priority access to vaccines their vaccination rates have been consistently higher compared to non-healthcare workers. These data suggest that nationally, vaccine mandates for healthcare workers have had, at most, a modest impact. 

● Overall, public support for federal, state, and local governments requiring that everyone get vaccinated remains very strong, at 65%. 

● Support for narrower mandates for returning to in-person school (63%) or university (68%) or getting on an airplane (71%) also remains high. 

● Six in 10 respondents support requiring large companies to require that their employees be vaccinated or regularly tested for COVID-19. 

● Public support for such mandates has modestly increased (by 1-2 percentage points) since June/July, both overall and in specific circumstances, like getting on an airplane and returning to school or a university. 

● Majorities of respondents -- in most instances large majorities -- support every mandate we surveyed across nearly all partisan and demographic subgroups we investigated. The notable exception is Republicans, among whom fewer than half support an overall mandate (43%), or narrower mandates for kids attending in-person school (41%), returning to university (47%), or for employees of large businesses (35%). A bare majority of Republicans (51%) support mandating vaccines to get on an airplane. 

● Majorities of respondents in nearly all states and the District of Columbia support all four types of vaccine mandates we consider. At the high end, majorities in every state support mandating vaccines for getting on an airplane, while at the low end, majorities of respondents in 45 states and the District of Columbia support requiring vaccination for children to return to school. 

● The biggest expressed concern of the unvaccinated is the safety of the COVID-19 vaccines. 

● The unvaccinated are much more likely to be skeptical of the efficacy and safety of vaccines more generally. 

● A relatively modest share of the unvaccinated have logistical and cost concerns; but among the unvaccinated but vaccine willing, logistical and cost concerns loom substantially greater. 

● Underlying many of the concerns regarding the COVID-19 vaccines is a lack of trust in the institutions that oversee and vouch for their safety. 

● Trust in relevant institutions is strongly associated with vaccination rates at the individual and state levels. 

● Healthcare workers are currently more vaccine enthusiastic than the general population, although prior to vaccines being available vaccine attitudes of the two groups were nearly identical. 

● From March to July, there has been sharp decreases in vaccine resistance across all demographic subgroups. 

● As of July, 27% of healthcare workers are unvaccinated and 15% are vaccine resistant, suggesting that, absent mandates, most of the currently unvaccinated health care workers will remain unvaccinated, potentially fueling outbreaks in health care facilities. 

● The current surge of cases due to the Delta variant will continue to exert pressure on health care providers to mandate vaccinations for their employees. 

● The most cited major concerns of parents are whether the vaccine has been tested enough (51%), the potential for long-term health effects (50%), and how new the vaccine is (46%). 

● Republican and Independent parents are more likely than Democratic parents to cite whether the vaccine has been tested enough and long-term health effects as a major concern. 

● Mothers are more likely than fathers to rate considerations about COVID-19 vaccinations for their children as major concerns, especially whether the vaccine has been tested enough (58% vs. 44%) and how new it is (52% vs. 39%). 

● Young mothers are more likely than older mothers as well as fathers of all ages to express major concerns with whether the vaccine has been tested enough (62%) and long-term health effects (60%). 

● Large gaps exist between parents based on educational attainment. Parents with some high school education are 28 percentage points more likely to cite whether the vaccine has been tested enough as a major concern than parents with bachelor’s degrees (68% vs. 40%). 

● Parents in the lowest income bracket are most likely to cite whether the vaccine has been tested enough (62%) and long-term health effects (59%) as major concerns. 

We asked respondents to mark four popular vaccine misinformation claims as true or false. When in doubt, they could also select “Not sure.” Here are some of the patterns we found: 

● Twenty percent of Americans report believing at least one vaccine misinformation statement. More than half (51%) say they are not sure whether to believe at least one false claim. 

● Belief in vaccine misinformation is associated with lower vaccination rates and higher vaccine resistance. Among respondents who did not mark any misinformation items as true, 70% reported being vaccinated, while 15% were vaccine resistant. Among those who thought multiple misinformation statements were true, 46% said they were vaccinated and 42% were vaccine resistant. 

● Uncertainty about misinformation is also linked to lower vaccination rates and higher vaccine resistance. Among respondents who identified all four misinformation claims as false, only 5% were vaccine resistant and 85% were vaccinated. Among those who did not identify any claim as true but were uncertain about at least one, 25% were vaccine resistant and 56% were vaccinated. Among respondents who thought at least one of the false statements was accurate, 39% were vaccine-resistant and 44% were vaccinated.

● Misperceptions and uncertainty emerge as important predictors of vaccine attitudes even when we account for other factors including geography, demographic characteristics, political affiliation, trust in institutions, news consumption, and personal experience with COVID-19. 

● People aged 25 to 44, those with high socioeconomic status, and Republicans are most likely to hold vaccine misperceptions, with over 25% in each group marking at least one misinformation statement as true. 

● Women, African-Americans, young people, and those with lower socioeconomic status are most likely to report uncertainty as to whether misinformation statements are true or not. 

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● On average, Americans have warmer feelings towards people who are vaccinated against COVID-19. On a thermometer scale from 0 to 100 degrees, the average feeling towards people who are vaccinated is 78 degrees, versus 45 degrees for those who are not vaccinated. 

● In particular, people who are vaccinated themselves tend to report an average of 86 degrees towards others who are vaccinated and 35 degrees towards those who are not. In contrast, those who are not vaccinated feel the same towards other people regardless of vaccination status, reporting an average of 64 degrees for both groups. 

● Among partisans, Democrats and Biden voters, feel warmest towards people who are vaccinated (85 degrees average) and coldest towards those who are not vaccinated (38 degrees average). However, even Republicans and Independents feel substantially warmer towards vaccinated individuals than they do towards the unvaccinated (average difference of 22 degrees for Independents and 17 degrees for Republicans for feelings towards people who are vaccinated compared to people who are not). 

● Americans over 65 report the coldest feelings towards people who are not vaccinated (average 36 degrees) and warmest towards people who are vaccinated (average 85 degrees), compared to all other age groups. 

● Overall, public support for federal, state, and local governments requiring that everyone be vaccinated remains very strong, ranging from 61% to 70%, depending on the specific type of mandate. 

● Public support for such mandates has increased since April/May, both overall and in specific circumstances, like for getting on an airplane and returning to school or a university. 

● These over-time increases in support emerge across nearly all partisan and demographic subgroups we investigated. 

● Majorities of respondents in nearly all (45+) or all states and the District of Columbia approve of all four types of vaccine mandates we consider. 

Earlier this month, we witnessed a vigorous back and forth between the White House and Facebook regarding the role of the company in circulating health misinformation. On the White House side, the Surgeon General released an Advisory declaring misinformation a public health threat to the nation, highlighting, in part, the role of social media. This was followed the next day by a pointed statement by President Biden-- “They’re killing us!” Facebook responded with a blog entry, Moving Past the Finger Pointing, asserting that it was not responsible for the plateauing vaccination rates in the US. The company pointed to the fact that 85% of Facebook users in a large survey by Carnegie Mellon (supported by Facebook) reported being vaccinated or wanting to be vaccinated. 

Major gender and age gaps remain, with young mothers and mothers of young children being the most resistant to vaccinating their kids and requiring COVID-19 vaccination for in-person school attendance. 

● Among older mothers, vaccine resistance is declining and support for school vaccine mandates is increasing. 

● Black parents have become substantially less resistant to vaccinating their kids. However, among Democrats, Black parents remain by far the most vaccination-resistant group, followed by Hispanic Democrats, then White Democrats, due in part to lower levels of trust in government and healthcare institutions. Asian American parents are the most pro-vaccine among both Democrats and Republicans. 

● Support for school vaccine mandates has grown substantially from 54.4% in the winter to 61.3% in the summer. Support has grown among both Republicans and Democrats, though a major partisan gap 

The COVID-19 Consortium for Understanding the Public’s Policy Preferences Across States 6 

persists. Overall, Americans who are more liberal, educated, higher income, and urban are more likely to support school vaccine mandates. ● Among parents specifically, every group except young mothers and mothers of young children has become more supportive of requiring vaccination to attend school. 

Overall, the levels of social isolation have increased since the first waves of the pandemic, in spring, 2020, but have been showing signs of improvement since January 2021. After its initial increase, the percentage of socially isolated respondents declined most among those with high income and education. We also observed a relatively faster drop in isolation among religious and older Americans. Conversely, unemployed and low SES respondents have barely recovered from the increases in social isolation suffered earlier in the pandemic. In addition, different types of support are not equally available across demographics. Men are substantially more isolated than women with respect to emotional support (but about equal in terms of economic); and white respondents are more socially isolated with respect to economic support; but less isolated emotionally relative to other racial/ethnic groups. Finally, we find a strong association between social isolation (specifically, in terms of relationships available for emotional support) and moderate to severe depressive symptoms. 

● We do not see evidence of an improvement in the prevalence of depression and other measures of mental health, despite marked improvement in the pandemic in the United States since the winter. 

Overall, 28% of those surveyed report levels of depression that would typically trigger a referral for evaluation and treatment; these numbers have diminished slightly compared to their peak of 30% in December 2020 but remain about three times those observed in the pre-COVID era, and elevated compared to the low of 25% in late June 2020. Rates of anxiety also remain elevated at 25%, but down from 28% in December 2020. Notably, 23% of respondents still endorse thoughts of suicide at least occasionally, similar to the rates observed in December. 

● Young adults continue to be the hardest hit, with 42% meeting at least moderate depression severity criteria, followed by 25-44 year olds at 32% and 45-64 year olds at 20%. Respondents age 65 and older are the least impacted, on average, with 10% meeting criteria for moderate or greater depression. 

● Parents with children at home have consistently experienced elevated rates of depression, with a gap of about 10% between parents and nonparents - currently 35% versus 25%. Some of this difference likely reflects age - that is, parents are generally younger than nonparents. The remainder may reflect such additional stresses as remote education. 

● Respondents without college education continue to report higher levels of depression (30%) than their college educated counterparts (23%). 

● Similarly, those earning less than $30,000 per year continue to demonstrate the highest rate of depression (35%) - but the pattern among those earning more is less clear, with lowest levels of depression reported among those earning $50-150,000 per year (23-24%). 

● The rate of depression among Asian American respondents has increased since March 2021 from 22% to 27%; while these numbers have generally been lower than any other racial/ethnic group, they are now similar to all except Latino respondents. 

“Vaccine certification” requirements were first introduced in the United States in response to smallpox in the 1800s. Today, physicians routinely provide certification that students have received an array of vaccinations that are required in order to attend school or summer camp, or to participate in sports or other group activities. A similar concept -- recently labeled “Vaccine Passports” (“VPs”) -- has been suggested with respect to COVID-19 vaccination, requiring individuals to provide proof of vaccination in order to engage in certain activities, such as indoor dining or shopping, flying on an airplane, or attending school. However, requiring that Americans prove that they have been vaccinated in order to participate in such activities has generated fierce opposition. The success or failure of these initiatives likely rests on a better understanding of the breadth and depth of this opposition, and its basis. Is it simply that the term “vaccine passport” has been politicized? Or is the underlying concept viewed by Americans as problematic? Or, in the wake of a year of lockdowns and mask mandates, are Americans concerned about yet another government mandate? 

The purpose of this report is thus to explore two questions. First, is public resistance to vaccine passports mainly due to the politicization of the term itself, or is the public genuinely opposed to any sort of vaccine mandate? Second, do those who oppose vaccine passports object only to the government requiring them, or do they object to any institution, public or private, making them a requirement? 

● A majority of Americans (62%) support “Requiring everyone to get a COVID-19 vaccine.” Even higher percentages support mandatory vaccines “to get on an airplane” (67%) and “to go back to university” (65%). 

● A majority of respondents in every state support some form of vaccine requirement. Air travel requirements are the most popular, with majority support in all 50 states, followed by university requirements (supported by majorities in 49 states), and finally requirements for children to return to school (majority support in 43 states). Men are more supportive of each potential vaccine requirement than women. This mirrors the gender divide we see in vaccine hesitancy (see Report #48) and willingness to vaccinate one’s own children (see Report #45). 

● Higher income, more highly educated, and non-White (particularly Asian American) respondents show greater support for vaccine requirements. Nevertheless, a majority of people in every racial, educational, and income group supports requiring “everyone” to get vaccinated, as well as supporting mandatory vaccines for boarding airplanes, children attending schools, and returning to universities.

●Despite widespread efforts by Republican politicians to mobilize opposition, more than four in tenRepublican respondents support requiring everyone to get vaccinated (42%). Support among Democrats is nearly twice that (81%).

While, on average, adherence to health and safety guidelines has slightly decreased since the spring, spikes in caseloads near the end of 2020 may have contributed to higher rates of social distancing, safer behaviors outside of the home, and stricter following of public health recommendations in California. Our survey data suggest that since the start of the new year, as more Californians have been getting vaccinated, they have begun to relax some of their adherence to social distancing and other public health recommendations. 

We evaluate whether the temporary pause of the Johnson & Johnson vaccine on April 13 negatively affected vaccine attitudes. We find no evidence that the pause affected vaccine intentions. However, the rapid rate of vaccinations has largely exhausted the number of vaccine enthusiastic people, likely driving the current slow down in vaccination rates. 

In our Report #48 from April 2021, we showed findings from our most recent survey indicating that the FDA and CDC’s recommendation to temporarily pause the Johnson & Johnson vaccine did not affect overall trends in intentions to vaccinate in the United States, despite a majority of respondents indicating that they were aware of the decision. Here, we briefly elaborate on those findings using a multivariate regression. 

● Since February, the gap in attitudes between fathers and mothers has widened. While fathers became marginally less resistant, falling from 14% to 11% since February, over a quarter of mothers still say they are “extremely unlikely” to vaccinate their children. 

● Educational, income, and partisan divides in childhood vaccination attitudes have become more pronounced. Parents in households making less than $25,000 per year, parents without a college degree, and Republican parents have become more resistant to vaccinating their children. Resistance has decreased for college-educated, high income, and Democratic parents. 

● Parents of teenagers are less resistant to having their children vaccinated than parents of small children, and—in the case of mothers—slightly more supportive of school vaccination requirements. 

● Support for school vaccination requirements has grown slightly from 54% to 58%. This increase holds for most gender, race, and income categories. However, among Republicans, support remains virtually unchanged. 

● Mothers are less likely to support school vaccination requirements than other women, while fathers are more likely to support school vaccination requirements than other men. 

● Among youth who are old enough to get vaccinated without parental consent (18-21-year-olds), one five are vaccine resistant. 

Our survey suggests that awareness of the J&J pause was extremely high. Despite this, vaccine hesitancy/resistance did not increase for responses received after the pause, and our analysis of repeat respondents suggests a small but systematic shift decrease, largely because a fair number of people who were vaccine hesitant in early April were vaccinated by late April. In short, it seems very unlikely that the pause had major negative effects on vaccine attitudes. Our confidence in this finding is increased by the observation that we see these effects using two different kinds of analysis: comparing over-time changes across different subjects and, separately, within the same subjects interviewed before and after the pause. Still, it is highly likely that vaccine rates will continue to decelerate over the next few months as those who intend to get the vaccine as soon as they can are able to do so. 

This report is an update of our February report on attitudes and vaccination rates of healthcare workers. The essential patterns are similar, with the obvious exception being the increased rates of vaccination. We focus on vaccination, vaccine resistance, vaccine hesitancy, vaccine access, and vaccine refusal. These are measured as follows: 

Vaccination status is based on self-reports that someone has “already” been vaccinated. Note that we do not ask whether someone has received one or two doses of a vaccine, or which vaccine they have received. 

Vaccine resistance is the proportion of individuals in a given category who indicate that they “would not get the COVID-19 vaccine” if/when it is available to them. 

Vaccine hesitancy is defined as preferring to get the vaccine “after at least some people I know” or “after most people I know.” 

Vaccine access considers those in one of the high priority groups—individuals 65 and older or healthcare workers—who report having the vaccine available to them. This is defined as anyone in this group who says they have already been vaccinated or have a vaccine available to them (regardless of whether they have been vaccinated). 

Vaccine refusal is when an individual in a high priority group reports having the vaccine available to them, but that they will not get vaccinated. 

Vaccination rates are higher among healthcare workers than among non-healthcare workers;1 however, vaccine resistance (24% for healthcare workers versus 21% for non-healthcare workers) and hesitancy rates (29% versus 31%) are nearly identical (see Figure 1). 

Vaccine resistance has remained level since January for both healthcare workers and non-healthcare workers; however, hesitancy has dropped substantially for both groups since January (from 37% to 29% among healthcare workers, and from 41% to 31% for non-healthcare workers). This suggests that as the vaccine campaign moves forward, as one would expect, there has been a gradual shift from those who are vaccine hesitant to being willing to be vaccinated. 

● Parents are more vaccine hesitant and resistant than non-parents (in terms of willingness to vaccinate themselves) across all socioeconomic and demographic groups we compared. However, this pattern is largely driven by younger mothers, who are far more vaccine resistant than younger women who are not mothers. Older parents and fathers show little difference from their non-parent peers. 

● Parents’ willingness to vaccinate their children closely matches their willingness to get vaccinated themselves. Mothers are far more reluctant than fathers to do both. 

● Parents without a 4-year college degree are far more likely to be vaccine hesitant and resistant than their counterparts with a 4-year college degree or higher. Among the more highly educated, parents and non-parents hold similar views. 

● Parents who earn less than $75,000 per year are far more reluctant to get vaccinated than their non-parents counterparts. The gap is far smaller in households earning over $75,000 per year. 

● Parents of all races are more reluctant than non-parents to get vaccinated themselves, but this gap is largest among African American parents, nearly three quarters of whom are vaccine hesitant or resistant. 

● We see similar gaps between parents and non-parents across party and regional lines, and between urban, suburban, and rural residents. 

● Parents are more vaccine hesitant and resistant than non-parents (in terms of willingness to vaccinate themselves) across all socioeconomic and demographic groups we compared. However, this pattern is largely driven by younger mothers, who are far more vaccine resistant than younger women who are not mothers. Older parents and fathers show little difference from their non-parent peers. 

● Parents’ willingness to vaccinate their children closely matches their willingness to get vaccinated themselves. Mothers are far more reluctant than fathers to do both. 

● Parents without a 4-year college degree are far more likely to be vaccine hesitant and resistant than their counterparts with a 4-year college degree or higher. Among the more highly educated, parents and non-parents hold similar views. 

● Parents who earn less than $75,000 per year are far more reluctant to get vaccinated than their non-parents counterparts. The gap is far smaller in households earning over $75,000 per year. 

● Parents of all races are more reluctant than non-parents to get vaccinated themselves, but this gap is largest among African American parents, nearly three quarters of whom are vaccine hesitant or resistant. 

● We see similar gaps between parents and non-parents across party and regional lines, and between urban, suburban, and rural residents. 

In this report, we analyze the trajectory of the pandemic in Massachusetts, from late April 2020 to March 1, 2021, examining public health behaviors and approval of Governor Charlie Baker’s handling of the crisis. For information on other states, please consult our interactive dashboard. 

● Education is strongly correlated with vaccination rates (29% of respondents with graduate degrees vs 9% of those with a high school education or less) and vaccine resistance (8% vs 30%). 

● Higher income respondents are far more likely to be vaccinated than lower income (24% for highest income cohort vs 9% for lowest income cohort); and have much lower levels of vaccine resistance (11% vs 29%). 

● Asian Americans (17%) and Whites (16%) have the highest vaccination rates, and African Americans (12%) and Hispanics (9%) the lowest. Asian Americans have by far the lowest levels of vaccine resistance (10%), with Whites (21%), Hispanics (22%), and African Americans (26%) all at far higher levels. 

● Democrats and Republicans have similar vaccination rates (17% vs 16%), but only 9% of Independents have been vaccinated. Independents (31%) and Republicans (30%) have far higher levels of vaccine resistance than Democrats (11%). 

● Women are less likely to be vaccinated than men (13% vs 17%), and more likely to be vaccine resistant (25% vs 18%). 

● Rural areas have lower vaccination rates (12%) than urban and suburban (15% each), and far higher vaccination resistance (29% for rural areas; 22% for suburban; 16% for urban). 

● There are substantial variations of vaccine resistance by state: Massachusetts with the lowest levels (9%) and Oklahoma and North Dakota with the highest (33%). 

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The major pattern we find in the data is a substantial relaxing of social distancing behaviors since the spring of 2020, with some tightening in the late fall/early winter that year. In Figure 1, we show trends in 8 different activities outside of the home that people reported engaging in within the 24 hours prior to taking our survey. The activities include going to work, to the gym, to a bar or café, to a place of worship, to the doctor, visiting a friend, taking mass transit, or being in a room with people who live outside one’s household. 

Residents of New Jersey closely followed the social distancing guidelines in the spring of 2020, but progressively relaxed their adherence to health recommendations over the summer and early fall of 2020. People once again became more careful about social distancing as COVID-19 case counts increased towards the end of 2020. Our most recent data indicate that as case numbers decreased in 2021, behaviors relaxed as well. 

In Figure 1, we show trends in 8 different activities outside of the home that people reported engaging in within the 24 hours prior to taking our survey. The activities include going to work, to the gym, to a bar or café, to a place of worship, to the doctor, visiting a friend, taking mass transit, or being in a room with people who live outside one’s household. 

The data show a notable uptick in all of these behaviors from April to mid-November. We observed a similar trajectory for each of the eight activities: low points in spring 2020, followed by high points in the fall, declines in the early winter, and finally a recent increase in February 2021. For instance, there was a large surge in people going to work outside of their home from late April to mid-November 2020 (19% to 40%), a subsequent drop to 31% in January 2021, and then a jump to 39% in February 2021. 

The percentage of New Jersey residents who reported having been in a room with people other than members of their household more than doubled from late April to mid-November 2020 (21% to 45%) and was at 36% in February 2021. Reports of most other indoor activities also increased from late April to mid-November, although less dramatically. The percentage of people who reported going to a cafe, bar, or restaurant jumped from 5% to approximately 12%, the percentage that indicated going to a doctor or hospital increased from 7% to 11%, and the percentage taking mass transit rose from 1% to 7%. Visiting a friend represents a minor exception: such reports increased between April and late August, decreased until mid-November, and then peaked in early December. 

In this report, we examine the demographic correlates of vaccination, vaccine hesitancy, and vaccine resistance among the subset of 1,797 respondents in the COVID states survey who indicated that they are healthcare workers. We find that education, income, gender, race/ethnicity, and partisanship are strong predictors of vaccination rates recorded thus far, as well as of vaccine hesitancy and resistance. 

Healthcare workers represent a microcosm of US society, and a consequential one. They are polarized in terms of income and education, ranging from physicians with extensive postgraduate education, to cleaning staff with less than a high school education. Healthcare workers also have taken a disproportionate brunt of the national response to COVID-19, in terms of the physical and emotional labor to care for millions of sick people; to bid goodbye to hundreds of thousands; and to confront, by the nature of their work, the increased risks of exposure to the virus. 

The 2020 election produced two distinct perceived realities for the United States public. The first perceived reality holds that the election was conducted fairly, and that Joe Biden won. Individuals who hold this vision of reality feel their votes were counted accurately, and that the events of January 6th were repugnant. This is also the version of reality for 60-70% of the US population. This reality is documented by court cases, our government officials (Republican and Democratic) in charge of administering the election, and the credible news media. 

The second vision of reality holds that the election was essentially corrupt—driven, in particular, by illegal mail-in ballots, noncitizen voting, and voting machine fraud. In this perceived reality, Biden is a usurper to the presidency. Further, the people who stormed the Capitol had a point, although the worst actions were taken by individuals affiliated with Antifa activists masquerading as Trump supporters. This is the expressed reality of former President Trump, certain Republican leaders, a subset of conservative media, and certain corners of the social media ecosystem. This is also the reality for 25-30% of the US population, and roughly half of Republicans. 

These two perceived realities are not created equal. The facts, as presented by the fact sorting institutions of the government and media, unambiguously support the first. However, perceptions—especially when they are shared by a sizable number of people and organized in a way that provides access to power—have consequences. The data below suggest that these two perceived realities will continue to define US politics, at least for the near future, because they are clustered around the two parties, and in each perceived reality, the other party is not just an opponent, but an enemy of democracy. In each case, the logical conclusion is that the assumption of power by the other party represents a potentially permanent surrendering of power. Below, we summarize public opinion regarding election integrity and the events of January 6th, and close by discussing the implications of these findings for American politics over the next 4 years. 

In our December 2020 survey wave, we included a series of questions aimed at assessing the state of opinion regarding these topics. Some key findings are: 

● Two thirds of respondents are at least somewhat concerned about the quality of the education they (if they are students) or their children (if they are parents) are receiving during the pandemic. This is true across partisan, racial, and income groups. 

● A majority of parents of K-12 students indicate that their children learned less than they would have without the pandemic, including pluralities of primary school (grades K-5) parents and majorities of parents of middle (grades 6-8) and high (grades 9-12) school-age children. This also includes, at minimum, substantial pluralities, and in most instances, majorities, across all demographic groups across all grade levels. 

● We find some evidence of a socio-economic divide, with wealthy Americans more likely than other income groups to believe their high school-age children are learning less during the pandemic than other income groups. But this pattern does not extend to younger children. 

Gun purchases in the United States have increased dramatically since the start of the COVID-19 pandemic. Based on FBI data, the National Shooting Sports Foundation reported 21 million background checks for firearms sales in 2020, up from 13.2 million the previous year and surpassing the previous record of 15.7 million in 2016. The biggest spikes occurred in March and June, as shown in Figure 1. While March is typically a month of high gun buying, this year saw a much sharper surge. June’s spike in gun purchases is even more abnormal compared to previous years when gun purchases are typically close to their low point. 

Our survey helps in understanding this increase. We find that gun purchases were particularly likely among attendees of protests against racism or police violence. These protests reached massive proportions during the first week of June, the second-highest week ever for background checks at the time. However, it is doubtful that protesters themselves—about 5% of the adult population by our estimates—can fully account for this increase. 

Others may have purchased guns in reaction to this widespread unrest, as well as the sweeping government-mandated closures that coincided with the first peak in March. First-time gun purchases were more likely among African Americans, while existing gun owners were significantly more likely to buy guns if they reported not wearing masks or if they had contracted COVID-19. The most common reasons for purchase, by far, were protection against crime (70%) and target shooting or hunting (47%), though over a quarter (32%) said they were reacting to lockdowns, fears of the government, COVID-19, or the 2020 election. 

We evaluate the results of two experiments testing different communication strategies to increase people’s willingness to take the COVID-19 vaccine. Key findings are that a variety of messages are effective for reducing vaccine hesitancy and resistance, while messengers are less effective and − in the case of partisan messengers − have the potential to increase resistance among political out-groups. The most effective strategies evoked scientists and people’s own doctors as endorsers of vaccination. We found, also, that messages evoking harm reduction and “people you know” were more effective in counties where the virus is spreading more quickly. 

We present a variety of descriptive results on attitudes and beliefs regarding COVID-19 vaccines. We find a notable consensus across population subgroups regarding order of prioritization for receiving vaccines, which roughly aligns with current policies. We additionally find that while there are generally positive attitudes and beliefs regarding vaccines, there are also some negative attitudes and misbeliefs that are especially common within certain demographics (political independents and, to a lesser extent, Republicans; Black respondents; and individuals ages 25-44). 

The reported results are based on data collected from 24,682 people between December 16, 2020 and January 10, 2021. For these descriptive analyses, we apply survey weights using national benchmarks for race, gender, age, education, Census region, and urbanicity. 

Public health officials have expressed concern that multi-household holiday gatherings might have driven a January surge of COVID-19 cases. As noted in report 31, social distancing behaviors have generally been improving since late October, including in our most recent wave conducted over the holidays. However, the scope of our data collection regarding social distancing, which focused on proximity to others in the 24 hours preceding survey response, might have missed important spikes in proximity around Thanksgiving, Christmas and New Year. Therefore, here we evaluate the responses from a survey conducted between December 16th and January 10th, to a separate question asking whether people had gathered for the holidays in November and December. 

1) Average wait times for COVID-19 test results continue to fall steadily (from 3.9 days in March to 2.2 days in December). 

2) Racial disparities still exist in testing times: in December, Hispanic and Black respondents waited 0.7 and 0.4 days longer than white respondents, respectively. 

3) In December, the average respondent waited 2.4 days between seeking a test and obtaining a test. They waited another 2.2 days to receive test results. 

4) Testing is still too slow to support effective contact tracing. 

In report 25, published in November, we evaluated public support for taking more aggressive measures to limit the spread of COVID-19. The key finding is that there is broad support for taking more steps to limit the spread of the disease. In a just completed survey, we repeated these questions, finding that opinions are virtually unchanged since November: large majorities across the 7 issue areas support taking more aggressive steps (see Figure 1). The measure with the least support, which would be the most drastic step − requiring most businesses other than grocery stores and pharmacies to close − has exactly the same level of support we observed in November: 60%. The only step that has seen statistically significant erosion in support is restricting international travel, which has edged downward from November, from 88% to a still quite high 84%. 

Since April 2020, the COVID States Project has been surveying respondents regarding social distancing behaviors and adherence to health recommendations more generally. Our November report, looking at the data from April to November, with a partial exception of mask wearing, found a steady relaxation of these behaviors over time. In this report, we update our November results, finding that this trend has partially reversed, perhaps due to the surge of COVID-19 cases in the last two months. Mask wearing reached its all-time high in our December/January survey, and social distancing behaviors have substantially increased since October (though still far from April levels). 

● Parents with children at home are more likely than respondents without children at home to have experienced all five economic hardships, while women with kids at home are more likely than men with kids at home to have experienced four of the five hardships. The overall gaps range from a low of 4 percentage points for eviction from their home (6% for parents vs. 2% for non-parents), to highs of 11 points for taking pay cuts (26% vs. 17%) and being unable to make a rent or mortgage payment (21% vs. 10%) 

● Economic hardships are fairly evenly distributed across partisan groups and regions of the country. 

● Respondents who report having had COVID-19 (whether diagnosed by a medical professional or otherwise) are more likely than respondents who report not having had had COVID-19 to have suffered a series of five economic hardships we included in the survey, including losing a job, being evicted from their home, being unable to pay rent or their mortgage, taking a pay cut, or having to cut back on work to take care of a child. 

● Hispanics are more likely than other racial/ethnic groups to have experienced all five economic hardships. 

● We find fairly wide variations across the 50 states in the percentages of residents having experienced economic hardships, and no consistent geographic patterns. COVID-related hardships appear to be generally widespread across the country. 

• While 67% of Americans say President-Elect Biden won the election, 17% suggest that Donald Trump is the winner. Thirty-nine percent of Republicans and 3% of Democrats reported thinking Trump is probably winning or definitely winning. 

• Overall, 38% of Americans lack confidence in the fairness of the 2020 presidential election. That number is especially high among Republicans (64%) and Trump voters (69%) compared to Democrats (11%) and Biden voters (8%). 

• There are large partisan gaps (over 40 percentage points) in public concerns about mail-in fraud (85% of Republicans, 38% of Democrats), inaccurate or biased vote counts (84% of Republicans, 44% of Democrats), and illegal votes from non-citizens (81% of Republicans, 34% of Democrats). 

• Asked about acceptable reactions to an unfair election, 45% of Americans approved of protesting on social media, 38% of protesting in person, 18% approved of violating laws without violence, and 8% of using violence. Non-violent law breaking was approved by 23% Democrats and 17% Republicans, violence by 10% Democrats and 8% Republicans. 

• 69% of Americans trust the Supreme Court to handle the election, 43% trust the news media, 31% trust social media companies. Trump is trusted by 39%, Biden by 59%. 

In November, we find quite high levels of support for all seven restrictive measures, ranging from lows of 63% of Massachusetts residents supporting closing most businesses and 71% supporting prohibiting in-person teaching in K-12 schools, to highs of 89% and 88% supporting restricting international travel to the US and imposing stay-at-home requirements, respectively (Figure 1). Between the extremes, 76% support restricting domestic US travel, 79% support restricting restaurants to take-out only, and 82% support canceling major sports and entertainment events. These numbers are generally slightly higher than national support for these measures (identical for restricting international travel, and up to six points higher in every other case).1 

The percentages varied only modestly from October levels, with the largest change being a 3-percentage point decline in support for closing businesses. For all other measures, the difference from October to November is 2 points or less. 

The number of COVID-19 cases in Illinois has risen sharply over the last two months, from about 2,000 new cases a day in late September to 10,000 or so currently. In this report we evaluate whether there have been significant changes in the behaviors that facilitate the spread of the disease. The COVID States Project has been conducting a 50-state survey roughly once a month since April about attitudes and behaviors around COVID-19. Here we focus on public-health related behaviors that facilitate/inhibit the spread of the disease. It has become apparent that behaviors of particular importance are (1) those which bring people into indoor proximity; and (2) mask wearing. 

COVID-19 is transmitted from human to human, and as such, the key behavior that drives the spread of COVID-19 is close proximity among people. In particular, large groups of people indoors facilitate the occurrence of super-spreading events, where a single contagious individual may infect multiple people at once. Recent research highlights, in particular, the role of restaurants and gyms in driving the early spread of COVID-19. Figure 2 presents the trends for a set of activities that bring people from different households into indoor spaces. We note the general upward trend in many of these activities since April, with reports of having been in a room with people who are not members of the household in the preceding 24 hours jumping from 26% in April to 45% in October. Large group activities have particularly jumped in frequency. Reports of being in groups of 11 to 100 or more in the preceding 24 hours more than doubled, from 2.4% of respondents in April to 6.4% in October (Figure 3). 

(1) Substantial majorities (6 in 10, or more) of Americans support all seven restrictive measures. 

(2) Majorities of Americans -- and in most cases large majorities -- in every state support five of the seven restrictive measures. The exceptions are prohibiting K-12 schools from teaching in-person classes and closing most businesses other than grocery stores and pharmacies. In the latter two cases, support falls below 50% in three states for businesses and two states for schools (yet both are still supported by majorities in all other states). 

(3) Support is particularly strong for prohibiting international travel and requesting that people stay at home and avoid large gatherings. 

(4) Americans across nearly all subgroups (partisanship, race, gender, age) and states are, in general, least supportive of closing businesses other than grocery stores and pharmacies, followed by prohibiting K-12 schools from teaching in-person. 

(5) The greater a respondent’s concern about contracting COVID-19 for either their family members or themselves, the greater their support for restrictive measures. Similarly, belief that COVID-19 is increasing in a respondent’s state is also positively related to their support for restrictions. 

(6) Families with children at home are about as likely as other respondents to support restrictive measures, including closing K-12 schools to in-person classes. 

(7) Americans are starkly divided along partisan lines. Democrats and Biden voters are substantially more supportive of nearly all of the queried measures than Republicans or Trump voters, especially for closing in-person K-12 schools, non-essential businesses, and eat-in restaurants. Nevertheless, all four subgroups (Democrats, Republicans, Trump Voters, Biden Voters) are least supportive of closing non-essential businesses. 

The critical question we address in this report is how have behaviors changed during the pandemic? Our data confirm a substantial relaxation of many of the behaviors that helped slow the spread of the disease in the spring (see Figures 1 and 2). For example, take restaurants: in April and May, in Massachusetts, fewer than 5% of respondents reported going to a restaurant in the preceding 24 hours. This number rose to 15% in October. For other kinds of proximity to non-household members in enclosed spaces, the number of people taking part doubled from 22% in April to 45% in October—i.e., twice as many respondents said they had been close to non-household members. Going to a gym jumped from less than 1% to 7%. These patterns are not just the result of individual choices, but of policy decisions, since many of these establishments were closed in the spring. 

The next US President will confront impacts far broader than COVID-19 infection alone in trying to deal with the pandemic. Neither candidate provided much detail about their response to the mental health consequences of the disease and efforts to contain it. In line with our May results, our survey indicates that the next administration will lead a country where unprecedented numbers of younger individuals are experiencing depression, anxiety, and, for some, thoughts of suicide. These symptoms are not concentrated among any particular subgroup or region in our survey; they are elevated in every group we examined. Our survey results also strongly suggest that those with direct economic and property losses resulting from COVID-19 appear to be at particular risk, so strategies focusing on these individuals may be critical. 

Despite the headwinds confronting the country in facing COVID-19, approval of most governors’ and President Trump’s COVID-19 response did not change greatly between September and October in our survey. President Trump’s approval has ticked up a point to 35%, which is still problematically low approval for the most salient issue in the 2020 election by far (in 49 out of 50 states, Alaska being the one exception, COVID-19 is ranked as ”the most important problem”). More generally, after suffering a decline in the spring, the President’s approval rating has been flatline around his October rating of 35%. (For all approval ratings for the President and all of the governors, see the tables in the appendix.) To compare, governors, as a group, have seen a gradual decline in their approval ratings between late April and September; a 1 point increase from September (47%) to October (48%) marks the first time they have improved, or even held steady since our initial survey wave. Despite this, approval of governors is generally higher than that of the President. In 42 states, the governor has a higher approval level than the President, and in 2 states the levels are the same; in 6 states, the President has a higher approval level, but in no state does the approval of the President exceed that of the governor by more than the margin of error for the survey in that state.1 Per-state approval of the President roughly tracks partisanship of the state, and the only state where his approval is above 50% is Alabama. In most of the 10 swing states, the President hovers around 35%, from a low of 29% in New Hampshire to a high of 42% in Ohio. Alaska and Iowa stand out as states that he won handily in 2016, but now finds very low approval -- 34% and 32%, respectively. Other states he won in 2016 and now lingers at the national average or below are Michigan and Wisconsin. Pennsylvania --perhaps the most pivotal state in the 2020 election -- runs against the trend somewhat, showing approval ratings below the national level in April, and now several points above (at 38%). 

Perhaps unsurprisingly, the most highly cited issue is COVID-19, mentioned as the top problem facing the nation by nearly one third (32%) of all respondents nationally. While the percentages vary widely, from a low of 13% in Wyoming and Alaska, to highs of 44% and 42% in the District of Columbia and Hawaii, respectively, COVID-19 was the number one problem mentioned by respondents in every state except Alaska, where climate change comes out on top. (In Alaska, 16% named climate change as the number one problem facing the nation.) Figure 1 presents the percentages of respondents naming COVID as the number one problem facing the nation in each state. 

Other problems mentioned by at least 5% of respondents include racism (10%), the economy (8%), healthcare (7%), and crime and violence (6%). These topline figures suggest that the issues both candidates have sought to emphasize are indeed among the most frequently cited problems. Yet, they also suggest that the campaign, in the aggregate, is being fought out more squarely on turf preferred by Biden. Biden's preferred issues rank 1st (COVID-19), 2nd (racism), and 4th (health care) among the public; in contrast, Trump's preferred issues rank 3rd (the economy) and 5th (crime and violence). 

In every month, April through October of 2020, we surveyed individuals in every state about how federal and state governments are reacting to the pandemic. We found a remarkably consistent picture of public opinion: respondents prefer state governments over the federal government when it comes to COVID-19. Out of 8 waves in 50 states & DC − a total of 408 surveys at the state level − in 402 state-level surveys more people in the state felt the state government was reacting “about right” to the COVID-19 outbreak as compared to the federal government; and only 6 times did people in a state choose the federal government over their state government. 

The COVID-19 pandemic has been the defining issue of the 2020 general election, and the major party candidates have sent markedly different signals regarding its severity, how the federal government should respond, and which behaviors individuals should and should not be engaging in while the virus continues to spread. As such, it is perhaps unsurprising that there is a small but significant amount of movement between candidates − on net, away from Donald Trump − associated with levels of concern regarding the pandemic and perceptions regarding the federal government’s response. 

Of course, it is important to note that despite the patterns we observe here, the vast majority of voters’ behavior has remained stable over time, and not all of the changes we observe are attributable to the pandemic. However, these results do suggest that, when provided with a strong signal regarding significant material differences between the major party candidates on an extremely salient issue, some voters are willing to update their candidate preferences accordingly. With days remaining until election day, and with the number of COVID cases surging, there is likely little the president can do to change voters’ evaluations of his pandemic response. 

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COVID-19 has been a massive disruption in 2020, exacerbated by the spread of misinformation on social media. In this report we ask who is sharing COVID-19 fake news on Twitter, and which URLs are being shared? We show that older people are more likely to share URLs from fake news domains, despite being less likely to believe COVID-19 misinformation. We also show that Republicans are more likely to share fake news than Democrats and Independents. Finally, the fake news domain that has been shared the most in COVID-19 tweets is the Gateway Pundit, which, throughout the COVID-19 pandemic, has received an order of magnitude more shares than even the second most popular fake news domain. 

● Average testing times have fallen since April (from 4.0 days to 2.7 days in September) 

● Across all months, Black respondents wait almost an entire day more than white respondents for their test results (4.4 days to 3.5 days, on average) 

● In our September and August waves, the average respondent waited 6.2 days between seeking a test and receiving test results 

● Only 56% of those who tested positive for COVID-19 report being contacted as part of a contact tracing attempt 

The above analysis highlights the potential for the popular vote and the electoral college to shift toward Biden after election night. Trump will have a substantial lead among those who vote the day of the election; and Biden an even large margin lead those who vote by mail. How much this translates into a post-election-day blue shift depends on how quickly states count votes by mail. There are 9 competitive states that, because they either allow votes to arrive after election day or do not start counting until election day, will plausibly lag substantially in counting votes. This possibility puts a particular onus on the media and on political elites: For the media, to set expectations that vote totals may shift substantially after election day, very likely toward Biden; and for political elites, to make sure the voting systems are well resourced and to not exploit the time lag in reporting results to undermine the legitimacy of the election. 

To date, Congress has passed four COVID-19 relief packages totaling about $3 trillion, the most recent of which, the CARES Act, was passed on March 27th, 2020. The House of Representatives subsequently passed the $3 trillion Heroes Act on May 15th. The Senate has yet to take up the legislation or pass a fifth bill of its own. Throughout the summer, the House, Senate, and White House have engaged in on-again, off-again talks aimed at agreeing on a fifth relief package. The Senate has consistently favored a smaller bill, ranging from $500 billion to $1 trillion. Most recently, the House introduced a revised bill valued at about $2.2 trillion. The White House, represented by Steven Mnuchin, along with the Speaker of the House, Nancy Pelosi, have resumed negotiations over the shape of the package. 

While both sides claim to support such a package, they disagree not only on the amount, but also on the targets for this funding. Democrats favor a combination of direct payments to Americans, extended unemployment insurance, and aid to hospitals, schools, small businesses, the Post Office, and state and local governments. Republicans oppose aid to state and local governments and favor more limited unemployment insurance benefits. 

But what does the public think? We surveyed 20,315 respondents between September 4-27, 2020 on attitudes regarding the next COVID-19 relief bill. We asked respondents if they supported such a bill, as well as the types of relief they believed it should include. We also probed whether or not they had received the $300-$400 supplemental unemployment benefit authorized by President Trump’s executive order of August 5th. 

Scholars and public health officials have expressed growing alarm over what some have termed a “misinfodemic” − a parallel epidemic of misinformation − around COVID-19. Indeed, conspiracy theories, from the Plandemic pseudo-documentary to QAnon, fuel rising skepticism about scientific facts across many areas of public life, and in recent months especially with respect to COVID-19. Misperceptions, which can rapidly spread from obscurity to mass exposure via social media, may have the capacity to hinder the efficacy of public health efforts aimed at slowing the spread of the pandemic. Especially concerning, encountering false claims online may ultimately reduce the willingness of some Americans to get a COVID-19 vaccine when it becomes available. 

In this report, we assess respondents’ acceptance of 11 false claims that have circulated online since the beginning of the pandemic. The statements we use include six false claims about conspiracies or risk factors and five false purported preventive treatments for COVID-19. For the conspiracies/risk factors, we asked respondents whether or not they thought each claim was accurate, or whether they were unsure about its accuracy. For the false preventive treatments, we asked participants whether or not they believed the purported treatment was effective, or whether they were unsure about its efficacy.