Generational differences in beliefs about COVID-19 vaccines

Vivian Hsing Chun Wang, Diana Silver, José A. Pagán

Research output: Contribution to journalArticlepeer-review


Vaccine uptake variation across demographic groups remains a public health barrier to overcome the coronavirus pandemic despite substantial evidence demonstrating the effectiveness of COVID-19 vaccines against severe illness and death. Generational cohorts differ in their experience with historical and public health events, which may contribute to variation in beliefs about COVID-19 vaccines. Nationally representative longitudinal data (December 20, 2020 to July 23, 2021) from the Understanding America Study (UAS) COVID-19 tracking survey (N = 7279) and multilevel logistic regression were used to investigate whether generational cohorts differ in COVID-19 vaccine beliefs. Regression models adjusted for wave, socioeconomic and demographic characteristics, political affiliation, and trusted source of information about COVID-19. Birth-year cutoffs define the generational cohorts: Silent (1945 and earlier), Boomer (1946–1964), Gen X (1965–1980), Millennial (1981–1996), and Gen Z (1997–2012). Compared to Boomers, Silents had a lower likelihood of believing that COVID-19 vaccines have many known harmful side effects (OR = 0.52, 95%CI = 0.35–0.74) and that they may lead to illness and death (OR = 0.53, 95%CI = 0.37–0.77). Compared to Boomers, Silents had a higher likelihood of believing that the vaccines provide important benefits to society (OR = 2.27, 95%CI = 1.34–3.86) and that they are useful and effective (OR = 1.97, 95%CI = 1.17–3.30). Results for Gen Z are similar to those reported for Silents. Beliefs about COVID-19 vaccines markedly differ across generations. This is consistent with the idea of generational imprinting—the idea that some beliefs may be resistant to change through adulthood. Policy strategies other than vaccine education may be needed to overcome this pandemic and future public health challenges.

Original languageEnglish (US)
Article number107005
JournalPreventive Medicine
StatePublished - Apr 2022


  • COVID-19
  • Generational cohort
  • Public health policy
  • Vaccine hesitancy

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health


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