A nationwide survey by the COVID States Project found that a higher number of older Americans are unvaccinated and unboosted than widely reported in the CDC data used by most public health officials. At the Harvard T.H. Chan School of Public Health, researcher Benjy Renton writes that the survey “sheds light on the critical need to vaccinate and boost older Americans.” 

MATTHEW BAUM, matthew_baum@harvard.edu
    Baum is Marvin Kalb Professor of Global Communications and a professor of public policy at Harvard University’s John F. Kennedy School of Government. 

The preprint of the survey’s findings notes that “the risk of hospitalization and death from [Covid-19] is far higher for older adults, making vaccination particularly critical in reducing the impact of the pandemic.” The survey found that 13% of older Americans are still completely unvaccinated, and an additional 14% are fully vaccinated but have not received a booster––a significant gap considering the Omicron variants’ ability to evade immune defenses. 

The survey takes a second look at national CDC data, which oddly asserts that over 100% of the population of older adults are vaccinated. The “CDC data on vaccination rates are clearly significantly flawed,” the authors write, “because they indicate that there are more older Americans who have received at least one dose of vaccine than there are older Americans.”

Baum told the Institute for Public Accuracy today that there has been a need to critically assess the CDC data, which has been understood as “flawed ground truth” for the duration of the pandemic. According to Baum, the federal government has significant challenges to obtain “an accurate picture of first, second, and booster shots and then align [those numbers] with individuals. States are uneven in reporting data.” But now that some older Americans are receiving third and fourth shots, we start seeing “numbers over 100 percent.” 

The preprint notes that this is most likely because “the CDC attributes 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 survey data, however, are more sensitive to “discerning things like booster shots,” as it is an opt-in survey that can get a “critical mass of respondents in every state,” Baum says. 

In the past several months, much of the public, including many public health officials, have landed on a narrative that assumes older Americans are safely vaccinated and boosted. Yet Baum says that “there is still work to be done in that age group… Our evidence suggests it’s not over and done.”

Harvard public health researcher Renton told the Institute for Public Accuracy today that “while [older Americans] were prioritized during the initial rollout––with 91% having completed the primary series––there are currently 15.1-plus million Americans over the age of 65 who have not received their first booster. We must continue to bring vaccines to people where they are.”

The study also looked at the reasons older Americans cite for being unvaccinated. Contrary to depictions that all those who remain unvaccinated are ideologically opposed to it and are unpersuadable, the data found that many older Americans were not necessarily resistant to being vaccinated: Rather, they “indicated an openness to getting a booster but cited obstacles or a lack of urgency to do so.” Baum says that public health officials could address the concerns held by these older Americans who may be persuadable to be vaccinated ––but “that will take time and effort.”