Behavioral and Social Drivers of COVID-19 Vaccination in the United States, August-November 2021.

INTRODUCTION: COVID-19 vaccines are safe, effective, and widely available, but many adults in the U.S. have not been vaccinated for COVID-19. This study examined the associations between behavioral and social drivers of vaccination with COVID-19 vaccine uptake in the U.S. adults and their prevalence by region. METHODS: A nationally representative sample of U.S. adults participated in a cross-sectional telephone survey in August-November 2021; the analysis was conducted in January 2022. Survey questions assessed self-reported COVID-19 vaccine initiation, demographics, and behavioral and social drivers of vaccination. RESULTS: Among the 255,763 respondents, 76% received their first dose of COVID-19 vaccine. Vaccine uptake was higher among respondents aged ≥75 years (94%), females (78%), and Asian non-Hispanic people (94%). The drivers of vaccination most strongly associated with uptake included higher anticipated regret from nonvaccination, risk perception, and confidence in vaccine safety and importance, followed by work- or school-related vaccination requirements, social norms, and provider recommendation (all p<0.05). The direction of association with uptake varied by reported level of difficulty in accessing vaccines. The prevalence of all of these behavioral and social drivers of vaccination was highest in the Northeast region and lowest in the Midwest and South. CONCLUSIONS: This nationally representative survey found that COVID-19 vaccine uptake was most strongly associated with greater anticipated regret, risk perception, and confidence in vaccine safety and importance, followed by vaccination requirements and social norms. Interventions that leverage these social and behavioral drivers of vaccination have the potential to increase COVID-19 vaccine uptake and could be considered for other vaccine introductions.

Parental autonomy support and ethnic culture identification among second-generation immigrants.

Born and raised in the United States, children of immigrants often face conflict over whether to endorse the norms and traditions of the family's country of origin (the natal culture) or those of mainstream U.S. society (the host culture). The authors hypothesized that when immigrant parents allow children to make their own choices concerning their cultural identity, their children will be more likely to internalize the natal culture and will experience greater well-being. Ninety-nine college-aged 2nd-generation immigrants rated their well-being, perceptions of their mother's and father's autonomy support, and their endorsement of both natal and U.S. cultures. Results demonstrated that paternal, but not maternal, autonomy support predicted greater well-being and greater endorsement of the natal culture and that immersion in the natal culture predicted some indices of well-being. Several explanations for the possibly greater significance of paternal versus maternal autonomy support in the context of immigrant families are considered.