Status report of vaccines roll out in the USA — March, 12th, 2021

The COVID-19 US Vaccine Sentiment SeriesSnapshot #2: The Hurdles Ahead

Our previous vaccine sentiment snapshot explored the levels of vaccine hesitancy across US population segments.

We are now three months into COVID-19 vaccine distribution-and while many hurdles still lie ahead, we are beginning to look forward to a time when supply will not be the primary constraint limiting vaccination of the US population.

In response, from February 17to February 22, BCG conducted a second US COVID-19 Vaccine Sentiment Survey to explore the factors preventing or discouraging individuals who are currently eligible and want to get vaccinated from doing so.
The results offer some insights into the next steps of the journey to getting a vaccine.


Understanding eligibility and finding available and usable appointments were the two most significant hurdles that survey respondents identified. Levels of vaccine hesitancy have changed little since our first survey: the slight uptick in hesitancy percentage (from approximately 40% to approximately 45%) mainly reflects the fact that as more adults receive vaccinations, the size of the hesitant population increases as a proportion of the remaining pool. Nevertheless, about 50% of individuals in our survey who said that they want the vaccine were either unsure or misinformed about their current eligibility. (See Exhibit 1.)

Although eligibility was the step at which the largest absolute number of people dropped out of the vaccination process, ability to get an appointment was the most limiting step on a percentage basis: 75% of eligible people who tried to make an appointment could not find one.


Our survey results indicate that roughly half of the US’s adult population currently misunderstand their individual eligibility status for the COVID-19 vaccine-either expressing uncertainty about their status (33% of unvaccinated respondents) or wrongly self-identifying as eligible (7%) or ineligible (13), as determined on the basis of their demographic data matched against published state eligibility criteria. (See Exhibit 2.)

In comparison to the broader populace, members of the unsure and mistaken population tend to be twice as likely to be unemployed or to identify as a homemaker and twice as likely to have at most a high school education. The concentration of poorly informed individuals in these discrete categories poses a major hurdle that local and state governments must clear if they are to maximize the vaccination rates of priority groups (such as the sick or elderly) before opening appointments to the rest of the public. Clear, frequent, and carefully targeted communication will be critical until plenty of vaccine is available on demand to anyone who wants it.


The FDA’s recent Emergency Use Authorization of the single-shot Johnson & Johnson vaccine adds yet another tool to the nation’s arsenal for combating COVID-19 hospitalizations and deaths.

Equally important, both Pfizer and Moderna have promised to dramatically increase supplies of their two-shot vaccines to the US over the next few months, committing to provide a total of 220 million doses by the end of March and 600 million doses by July. (See Exhibit 3.)

Assuming that this trio of companies can deliver a steady supply of their novel vaccines, we expect that enough doses will be available by the end of May to vaccinate all US adults.
If the current array of hospital/provider systems, mass vaccination sites, and retail pharmacies can continue to deliver vaccines into people’s arms at a rate similar to the one they are managing now, appointment availability issues should soon cease to be a limiting factor in people’s efforts to get vaccinated in the US.


First, we must continue to improve the registration and scheduling infrastructure across the country.
States have begun consolidating their registration portals and leveraging the CDC’s new VaccineFinder website, a concerted effort to reduce the time and effort required to get a shot will be essential to avoid frustration among prospective recipients of the vaccine.
As the vaccination program shifts toward individuals who are at lower health risk from COVID-19 and have less motivation to seek immunization, maximizing the nation’s vaccination rates will depend on reducing barriers to inoculation.

The US will have enough supply to vaccinate all adults in the population by the end of May.
But vaccination rates across the nation will slow down long before that if the government does not address the remaining 45% of hesitant individuals.
Converting this hesitant population to a positive sentiment toward COVID-19 vaccination will be the next major hurdle for US communities and leadership.

About the authors

Lara Koslow, Managing Director & Senior Partner, Miami

Ankit Jain, Project Leader, Chicago

Marin Gjaja, Managing Director & Senior Partner, Chicago



We would like to thank key contributors to this article:

  • BCG Global COVID Response Team: John Rose, Tristan Hunt, Zhong Zhong Chen, Laura Mast, Elizabeth Henry, Vinit Parikh, Solomon Ravich, and Ian Faucher
  • BCG Center for Customer Insight: Greg McRoskey and the rest of the global team

Originally published at

Edited for Brazil by

Joaquim Cardoso (JC)
Senior Advisor for Health Care Strategy to BCG
Boston Consulting Group

Senior Advisor for Health Care Strategy to BCG — Boston Consulting Group