A new Pew Research Center survey finds that just 20% of Americans view the coronavirus as a major threat to the health of the U.S. population today and only 10% are very concerned they will get it and require hospitalization. This data represents a low ebb of public concern about the virus that reached its height in the summer and fall of 2020, when as many as two-thirds of Americans viewed COVID-19 as a major threat to public health.

Just 28% of U.S. adults say they have received the updated COVID-19 vaccine, which the Centers for Disease Control and Prevention (CDC) recommended last fall to protect against serious illness. This stands in stark contrast to the spring and summer of 2021, when long lines and limited availability characterized the initial rollout of the first COVID-19 vaccines. A majority of U.S. adults (69%) had been fully vaccinated by August 2021.

Underscoring the limited demand for the updated COVID-19 vaccines, a larger share of U.S. adults say they’ve gotten a flu shot in the last six months than the updated coronavirus vaccine (44% vs. 28%). And despite a public health push encouraging adults to get both vaccines at the same time, almost half of those who received a flu shot from a health care provider chose not to get the updated COVID-19 vaccine.

The vast majority of Americans have some level of protection from the coronavirus because of vaccination, prior infection or a combination of the two. This has led to a decline in severe illness from the disease.

Still, the virus continues to circulate widely in the United States, with wastewater data suggesting that cases in the early part of 2024 were among the highest they have been since the first omicron wave in 2022.  

Long COVID ranks among the concerns of public health experts. Long COVID refers to a variety of symptoms such as fatigue and brain fog that last longer than a month after a COVID-19 infection.

The survey – conducted among 10,133 U.S. adults from Feb. 7 to 11, 2024 – finds that 50% of Americans say it is extremely or very important for medical researchers and health care providers to understand and treat long COVID; 27% see this as a less important issue and 22% of Americans say they haven’t heard of long COVID.

Continuity and change: Partisan views of COVID-19

Partisanship remains one of the most powerful factors shaping views about COVID-19 vaccines and the virus. But the size and nature of differences between Republicans and Democrats have evolved since earlier stages of the outbreak.

For instance, the gap between the shares of Democrats and Republicans who view the coronavirus as a major threat to public health has fallen from 37 percentage points in May 2022 to 16 points today. In the pandemic’s first year, Democrats were routinely about 40 points more likely than Republicans to view the coronavirus as a major threat to the health of the U.S. population. This gap has waned as overall levels of concern have fallen.

When it comes to vaccination, Democrats and Democratic-leaning independents remain more likely than Republicans and GOP leaners to say they’ve received an updated COVID-19 vaccine (42% vs. 15%). This 27-point gap in recent vaccination is about the same as in January 2022 when 62% of Democrats and 33% of Republicans said they were up to date (i.e., fully vaccinated and recently boosted).

In addition to partisanship, age continues to matter a great deal in attitudes and behaviors tied to the coronavirus. And the intersection of partisanship and age reveals one of the biggest recent changes in the public’s response to the outbreak: a growing divergence between the oldest Republicans and oldest Democrats in vaccine uptake, which is explored below.

COVID-19 vaccination among adults ages 65 and older, by party

Older adults continue to be one of the most at-risk groups for severe illness and death from COVID-19.

When vaccines first became available in 2021, large majorities of both Republicans and Democrats ages 65 and older said they had received the vaccine. But as additional doses have become available, uptake among older Republicans has declined at a faster rate than among older Democrats.

In the current survey, 66% of Democrats ages 65 and older say they have received the updated COVID-19 vaccine, compared with 24% of Republicans ages 65 and older.

This 42-point partisan gap is much wider now than at other points since the start of the outbreak. For instance, in August 2021, 93% of older Democrats and 78% of older Republicans said they had received all the shots needed to be fully vaccinated (a 15-point gap). Go to the Appendix for more details.

How COVID-19 vaccination varies by age within parties

The impact of age is also striking when looking within political parties.

Among Democrats, about three-in-ten adults under 50 have received an updated COVID-19 vaccine, compared with 48% of those ages 50 to 64 and 66% of Democrats ages 65 and older.

Age differences within the GOP run in the same direction, but are much more modest, reflecting, in part, low overall levels of vaccine uptake.

How COVID-19 vaccination varies by race and ethnicity

Similar shares of White (28%), Black (29%) and Hispanic (27%) adults say they have gotten the updated vaccine. English-speaking Asian adults (35%) are slightly more likely to report receiving the updated vaccine.

As in past Center surveys, there are racial and ethnic differences in vaccine uptake among Democrats.

For instance, 50% of White Democrats and 42% of English-speaking Asian Democrats report having received the updated vaccine, compared with somewhat smaller shares of Black and Hispanic Democrats (32% each).

Views of long COVID

Half of Americans say it is extremely or very important for medical researchers and health care providers to understand and treat long COVID, considering all the different priorities they face.

About two-in-ten (21%) say it’s somewhat important for those in medicine to address long COVID, while 6% say it is not too or not at all important. Another 22% say they haven’t heard of long COVID.

More Democrats (61%) than Republicans (37%) say it is extremely or very important for medical researchers and health care providers to understand and treat long COVID.

A majority of women (56%) consider this extremely or very important; a smaller share of men (44%) say the same. The CDC has reported that women are more likely than men to develop long COVID symptoms.

Awareness of long COVID also shapes views on its importance: Those who have heard a lot about long COVID are more likely than those who have heard a little about it to say it’s extremely or very important for medical professional to address it (76% vs. 60%).

Views of the threat posed by the coronavirus

One-in-five Americans now say the coronavirus is a major threat to the health of the U.S. population, down from a high of 67% in July 2020.

Concern about the coronavirus as a major threat to the U.S. economy has also declined dramatically. Today, 23% of Americans say it’s a major threat to the economy, compared with 88% in May 2020. The pandemic spurred an economic recession in 2020 and a spike in unemployment that reached the highest levels since the Great Recession.

Federal policy on the coronavirus has changed as public concern – and the incidence of severe illness – has fallen. The Biden administration ended the public health emergency for the coronavirus pandemic in May 2023. And the CDC recently released updated guidelines with shorter isolation periods for adults testing positive for the disease.

While large partisan gaps characterized views of the coronavirus as a major threat to public health for much of the pandemic, those gaps were far smaller on views of the virus as a major threat to the economy. In the current survey, just a 6-point gap separates Republicans and Democrats with this view (20% vs. 26%, respectively) – similar to the 9-point party gap seen in May 2022.

Personal concern about getting or spreading COVID-19

About a quarter of Americans (27%) are very or somewhat concerned about getting a serious case of COVID-19 that would require hospitalization. A somewhat higher share (40%) say they are very or somewhat concerned they might spread the coronavirus to other people without knowing it.

Levels of concern for getting or spreading the coronavirus are about the same as they were in March 2023 and remain down dramatically from early in the pandemic.

The share of Americans who are very or somewhat concerned about getting a serious case is 26 points lower than in November 2020, before a COVID-19 vaccine was available to the public. And the share of Americans who are at least somewhat concerned about spreading COVID-19 without knowing it is down 24 points since November 2020.

Still, the current data shows how the virus remains a concern in daily life for many Americans, more than four years after the first confirmed coronavirus cases appeared in the U.S.

Consistent with past Center surveys, there are demographic and political differences in personal concern about getting a serious case of COVID-19 and unknowingly spreading the virus:

• Income: Lower-income Americans continue to be particularly concerned (38%) about getting a serious case of COVID-19. They’re also more likely than middle- and upper-income Americans to worry about unknowingly spreading COVID-19, but the differences are more modest.
• Party: Democrats (54%) are more than twice as likely as Republicans (24%) to be very or somewhat concerned about unknowingly spreading COVID-19. And they’re 16 points more likely to express concern about getting a serious case of the disease.
• Race and ethnicity: White Americans (20%) are less likely to be concerned about getting a serious case of COVID-19 than Black (43%), Hispanic (39%) and English-speaking Asian Americans (36%).

Some of the groups most personally concerned about getting a severe case of COVID-19 are also among the groups most concerned about the public health threat from the coronavirus. For example, Black adults and adults with lower incomes express more concern about the personal health and public health impact of the coronavirus than White adults and those with upper incomes.

Uptake of the flu shot

The survey finds 44% of U.S. adults say they have gotten a flu shot since August. This share is down slightly from last March, when 49% of Americans said they had recently gotten a flu shot.

Uptake varies by the following factors:

• Age: Older Americans continue to be more likely to report getting the flu shot. Two-thirds of Americans ages 65 and older say they have gotten the flu shot since August. By comparison, only about a third of those under age 50 say the same. These large age differences are seen among both Democrats and Republicans.
• Race and ethnicity: English-speaking Asian Americans (52%) and White Americans (48%) are more likely than Black Americans (38%) and Hispanic Americans (33%) to say they have gotten a flu shot since August. These racial and ethnic differences are consistent with past Center surveys.
• Partisan affiliation: Democrats are more likely than Republicans to say they got a flu shot this year (53% vs. 37%). This 16-point gap is twice as big now as it was in November 2020, during the pandemic’s first year. The current partisan difference in flu shot uptake is similar to the one recorded in March 2023.

The flu shot and updated COVID-19 vaccines are both recommended to protect against severe illness, but Americans approach these vaccines differently.

Americans are more likely to report that they received a flu shot than the updated COVID-19 vaccine this year (44% vs. 28%).

This gap in uptake between the flu shot and updated COVID-19 vaccine is more pronounced among Republicans than Democrats.

Republicans are more than twice as likely to say they’ve gotten a flu shot since August as to say they’ve received an updated COVID-19 vaccine (37% vs. 15%). Among Democrats, this difference is more modest (53% vs. 42%).

This report is made possible by The Pew Charitable Trusts. It is a collaborative effort based on the input and analysis of the following individuals. Find related reports online at: pewresearch.org/pewresearch-org/science.

Primary research team       

Alec Tyson, Associate Director, Science and Society Research
Brian Kennedy, Senior Researcher
Giancarlo Pasquini, Research Associate
Emma Kikuchi, Research Assistant    

Editorial and graphic design          

Rebecca Leppert, Copy Editor
Kaitlyn Radde, Associate Information Graphics Designer

Communications and web publishing      

Haley Nolan, Communications Manager
Talia Price, Communications Associate
Reem Nadeem, Digital Producer

In addition, the project benefited greatly from the guidance of the Pew Research Center methodology team: Courtney Kennedy, Andrew Mercer, Ashley Amaya, Dorene Asare-Marfo, Dana Popky, Anna Brown and Arnold Lau.

The American Trends Panel survey methodology

Overview

The American Trends Panel (ATP), created by Pew Research Center, is a nationally representative panel of randomly selected U.S. adults. Panelists participate via self-administered web surveys. Panelists who do not have internet access at home are provided with a tablet and wireless internet connection. Interviews are conducted in both English and Spanish. The panel is being managed by Ipsos.

Data in this report is drawn from ATP Wave 142, conducted from Feb. 7 to 11, 2024, and includes an oversample of non-Hispanic Asian adults, non-Hispanic Black men, and Hispanic men in order to provide more precise estimates of the opinions and experiences of these smaller demographic subgroups. These oversampled groups are weighted back to reflect their correct proportions in the population. A total of 10,133 panelists responded out of 11,117 who were sampled, for a response rate of 91%. The cumulative response rate accounting for nonresponse to the recruitment surveys and attrition is 3%. The break-off rate among panelists who logged on to the survey and completed at least one item is less than 1%. The margin of sampling error for the full sample of 10,133 respondents is plus or minus 1.5 percentage points.

Panel recruitment

The ATP was created in 2014, with the first cohort of panelists invited to join the panel at the end of a large, national, landline and cellphone random-digit-dial survey that was conducted in both English and Spanish. Two additional recruitments were conducted using the same method in 2015 and 2017, respectively. Across these three surveys, a total of 19,718 adults were invited to join the ATP, of whom 9,942 (50%) agreed to participate.

In August 2018, the ATP switched from telephone to address-based sampling (ABS) recruitment. A study cover letter and a pre-incentive are mailed to a stratified, random sample of households selected from the U.S. Postal Service’s Delivery Sequence File. This Postal Service file has been estimated to cover as much as 98% of the population, although some studies suggest that the coverage could be in the low 90% range.¹ Within each sampled household, the adult with the next birthday is asked to participate. Other details of the ABS recruitment protocol have changed over time but are available upon request.²

We have recruited a national sample of U.S. adults to the ATP approximately once per year since 2014. In some years, the recruitment has included additional efforts (known as an “oversample”) to boost sample size with underrepresented groups. For example, Hispanic adults, Black adults and Asian adults were oversampled in 2019, 2022 and 2023, respectively.

Across the six address-based recruitments, a total of 23,862 adults were invited to join the ATP, of whom 20,917 agreed to join the panel and completed an initial profile survey. Of the 30,859 individuals who have ever joined the ATP, 11,920 remained active panelists and continued to receive survey invitations at the time this survey was conducted.

The American Trends Panel never uses breakout routers or chains that direct respondents to additional surveys.

Sample design

The overall target population for this survey was noninstitutionalized persons ages 18 and older living in the United States, including Alaska and Hawaii. It featured a stratified random sample from the ATP in which Hispanic men, non-Hispanic Black men, and non-Hispanic Asian adults were selected with certainty. The remaining panelists were sampled at rates designed to ensure that the share of respondents in each stratum is proportional to its share of the U.S. adult population to the greatest extent possible. Respondent weights are adjusted to account for differential probabilities of selection as described in the Weighting section below.

Questionnaire development and testing

The questionnaire was developed by Pew Research Center in consultation with Ipsos. The web program was rigorously tested on both PC and mobile devices by the Ipsos project management team and Pew Research Center researchers. The Ipsos project management team also populated test data that was analyzed in SPSS to ensure the logic and randomizations were working as intended before launching the survey.

Incentives

All respondents were offered a post-paid incentive for their participation. Respondents could choose to receive the post-paid incentive in the form of a check or a gift code to Amazon.com or could choose to decline the incentive. Incentive amounts ranged from $5 to $15 depending on whether the respondent belongs to a part of the population that is harder or easier to reach. Differential incentive amounts were designed to increase panel survey participation among groups that traditionally have low survey response propensities.

Data collection protocol

The data collection field period for this survey was Feb. 7 to 11, 2024. Postcard notifications were mailed to a subset of ATP panelists with a known residential address on Feb. 7.³

Invitations were sent out in two separate launches: soft launch and full launch. Sixty panelists were included in the soft launch, which began with an initial invitation sent on the morning of Feb. 7. The ATP panelists chosen for the initial soft launch were known responders who had completed previous ATP surveys within one day of receiving their invitation. All remaining English- and Spanish-speaking sampled panelists were included in the full launch and were sent an invitation on the afternoon of Feb. 7.

All panelists with an email address received an email invitation and up to two email reminders if they did not respond to the survey. All ATP panelists who consented to SMS messages received an SMS invitation and up to two SMS reminders.

Data quality checks

To ensure high-quality data, the Center’s researchers performed data quality checks to identify any respondents showing clear patterns of satisficing. This includes checking for whether respondents left questions blank at very high rates or always selected the first or last answer presented. As a result of this checking, two ATP respondents were removed from the survey dataset prior to weighting and analysis.

Weighting

The ATP data is weighted in a multistep process that accounts for multiple stages of sampling and nonresponse that occur at different points in the survey process. First, each panelist begins with a base weight that reflects their probability of selection for their initial recruitment survey. These weights are then rescaled and adjusted to account for changes in the design of ATP recruitment surveys from year to year. Finally, the weights are calibrated to align with the population benchmarks in the accompanying table to correct for nonresponse to recruitment surveys and panel attrition. If only a subsample of panelists was invited to participate in the wave, this weight is adjusted to account for any differential probabilities of selection.

Among the panelists who completed the survey, this weight is then calibrated again to align with the population benchmarks identified in the accompanying table and trimmed at the 2nd and 98th percentiles to reduce the loss in precision stemming from variance in the weights. This trimming is performed separately among non-Hispanic Black, non-Hispanic Asian, Hispanic and all other respondents. Sampling errors and tests of statistical significance take into account the effect of weighting.

The following table shows the unweighted sample sizes and the error attributable to sampling that would be expected at the 95% level of confidence for different groups in the survey.

Sample sizes and sampling errors for other subgroups are available upon request. In addition to sampling error, one should bear in mind that question wording and practical difficulties in conducting surveys can introduce error or bias into the findings of opinion polls.

Dispositions and response rates

How family income tiers are calculated

Family income data reported in this study is adjusted for household size and cost-of-living differences by geography. Panelists then are assigned to income tiers that are based on the median adjusted family income of all American Trends Panel members. The process uses the following steps:

1. First, panelists are assigned to the midpoint of the income range they selected in a family income question that was measured on either the most recent annual profile survey or, for newly recruited panelists, their recruitment survey. This provides an approximate income value that can be used in calculations for the adjustment.
2. Next, these income values are adjusted for the cost of living in the geographic area where the panelist lives. This is calculated using price indexes published by the U.S. Bureau of Economic Analysis. These indexes, known as Regional Price Parities (RPP), compare the prices of goods and services across all U.S. metropolitan statistical areas as well as non-metro areas with the national average prices for the same goods and services. The most recent available data at the time of the annual profile survey is from 2021. Those who fall outside of metropolitan statistical areas are assigned the overall RPP for their state’s non-metropolitan area.
3. Family incomes are further adjusted for the number of people in a household using the methodology from Pew Research Center’s previous work on the American middle class. This is done because a four-person household with an income of, say, $50,000 faces a tighter budget constraint than a two-person household with the same income.
4. Panelists are then assigned an income tier. “Middle-income” adults are in families with adjusted family incomes that are between two-thirds and double the median adjusted family income for the full ATP at the time of the most recent annual profile survey. The median adjusted family income for the panel is roughly $71,800. Using this median income, the middle-income range is about $47,900 to $143,600. Lower-income families have adjusted incomes less than $47,900, and upper-income families have adjusted incomes greater than $143,600 (all figures expressed in 2022 dollars and scaled to a household size of three). If a panelist did not provide their income and/or their household size, they are assigned “no answer” in the income tier variable.

Two examples of how a given area’s cost-of-living adjustment was calculated are as follows: The Anniston-Oxford metropolitan area in Alabama is a relatively inexpensive area, with a price level that is 16.2% less than the national average. The San Francisco-Oakland-Berkeley metropolitan area in California is one of the most expensive areas, with a price level that is 19.8% higher than the national average. Income in the sample is adjusted to make up for this difference. As a result, a family with an income of $41,900 in the Anniston-Oxford area is as well-off financially as a family of the same size with an income of $59,900 in San Francisco. 

A note about the Asian adult sample

This survey includes a total sample size of 651 Asian adults. The sample primarily includes English-speaking Asian adults and, therefore, may not be representative of the overall Asian adult population. Despite this limitation, it is important to report the views of Asian adults on the topics in this study. As always, Asian adults’ responses are incorporated into the general population figures throughout this report.

© Pew Research Center, 2024