Understanding Vaccine Hesitancy in the Context of Economic Stress

What is it about?

We looked at how financial struggles during the COVID-19 pandemic were related to people’s feelings about COVID-19 vaccines in communities that faced higher risk of infection. Using survey data from a large health study, we grouped people based on their vaccine attitudes and behaviors, such as trust, concerns, and willingness to get vaccinated. We then examined whether financial difficulties—like losing a job, reduced income, or trouble paying for basic needs—were linked to greater vaccine hesitancy. Even though more than 97% of participants eventually received at least one COVID-19 vaccine, many still felt unsure or uncomfortable about it. In fact, nearly 4 in 10 people continued to have strong doubts or concerns about vaccines. This shows that getting vaccinated does not always mean people feel confident or trusting. People who experienced at least one financial hardship during the pandemic were much more likely to remain vaccine hesitant than those who did not face financial stress. Other factors related to higher hesitancy included employment status, having had COVID-19 before, level of education, and whether people completed the full vaccine series. These findings suggest that financial stress plays an important role in how people think and feel about vaccines. Efforts to increase vaccine confidence may work better if they also address economic challenges, such as providing financial support or policies that reduce hardship in vulnerable communities.

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Why is it important?

This study shows that money problems don’t just affect whether people get vaccinated — they affect how people *feel* about vaccines, even after they get them. First, the findings reveal an important gap: Almost everyone in the study got vaccinated, but nearly 4 in 10 still had serious doubts or fears about vaccines. This matters because vaccine hesitancy isn’t just about behavior—it’s about trust. People who feel pressured, uncertain, or mistrustful may be less likely to follow future public health guidance, such as booster shots or vaccines for new diseases. Second, the study highlights that "economic stress plays a major role in shaping health attitudes." People who struggled to pay rent, buy food, or meet basic needs during the pandemic were much more likely to remain vaccine hesitant. This suggests that hesitancy isn’t simply about misinformation or personal beliefs—it’s often rooted in daily survival pressures and long-standing economic inequality. Third, the research helps explain why traditional health messaging alone may not work. If people are worried about losing a job, missing work, or paying bills, vaccines may feel like a lower priority—or like something imposed by institutions they don’t fully trust. Finally, the study points to solutions. It suggests that building vaccine confidence may require more than education. Policies that reduce financial stress—such as paid sick leave, job protections, or easier access to care—may help people feel safer, more supported, and more trusting of public health efforts. In short, the study shows that public health and economic security are deeply connected, especially in communities that have been hit hardest by COVID-19.