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Publication Briefs

Veterans' Intentions and Attitudes Regarding COVID-19 Vaccines

Trust in government is an important predictor of vaccine acceptance, thus vaccine hesitancy among Veterans receiving VA healthcare requires examination, considering Veterans have a complex relationship with the government compared to the general population. More than 3 million Veterans have been vaccinated within VA; however, little is known about the attitudes and intentions of Veterans regarding COVID-19 vaccination. The goal of this study was to assess Veterans’ attitudes and intentions regarding COVID-19 vaccination within the VA healthcare system, in order to inform ongoing, system-wide communication efforts to increase uptake of the vaccines. Between March 12-28, 2021, investigators sent a 58-item online survey to 3,420 Veterans (1,178 responded) who were part of the VA Survey of Healthcare Experiences of Patients’ (SHEP) Veteran Insights Panel (VIP), which provides information to VA facility managers about an array of issues related to patients’ experiences with VA care. The survey assessed Veterans’ experience with, and exposure to COVID-19, as well as various issues concerning vaccination.


  • Of the Veterans in this study, 71% (n=817) reported being COVID-19 vaccinated.
  • The main reasons for not being vaccinated included skepticism (36% concerned about side effects from COVID-19 vaccines, 20% prefer using few medications, and 19% prefer gaining natural immunity); deliberation (22% prefer to wait because vaccine is new); and distrust (19% do not trust healthcare system).
  • Among Veterans who were vaccinated, preventing oneself from getting sick (57%) and contributing to the end of the COVID-19 pandemic (56%) were the main reasons for getting vaccinated.
  • The proportion of Veterans who trusted their VA healthcare provider as a source of vaccine information was higher among those unsure about vaccination compared to those who indicated they would definitely not – or probably not get vaccinated (26% vs 15%).
  • Among Veterans reporting they would “definitely not” or “probably not” get vaccinated, their most trusted source of information (31%) was news on TV, radio, or online.


  • These findings provide information needed to develop trusted messages used in conversations between VA providers and Veterans addressing specific reasons for COVID-19 vaccine hesitancy, especially to those in worse health. Targeting Veterans’ concerns around the adverse effects and safety of COVID-19 vaccines through conversations with trusted VA providers is key to increasing vaccine acceptance.


  • The survey was limited by capturing attitudes toward and intentions to receive a COVID-19 vaccination at only one point in time.
  • As with any self-report data, response bias might have impacted study results.

This study was funded by VA/HSR&D QUERI. Drs. Jasuja, Carbonaro, Clayman, McInnes, Midboe, Asch, Gifford, and Elwy, and Mss. LoBrutto, Miano, and Maguire are part of Bridge QUERI. Dr. Meterko and Ms. Bradshaw are part of VA’s Office of Analytics and Performance Integration, Washington, DC.

Jasuja G, Meterko M, Bradshaw L, Carbonaro R, Clayman M, LoBrutto L, Miano D, Maguire E, Midboe A, Asch S, Gifford A, McInnes DK, and Elwy AR. Attitudes and Intentions of U.S. Veterans Regarding COVID-19 Vaccination. JAMA Network Open. November 3, 2021.

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What are HSR Publication Briefs?

HSR requires notification by HSR-funded investigators about all articles accepted for publication. These journal articles are reviewed by HSR and publication briefs or summaries are written for a select number of articles that are then forwarded to VHA Central Office leadership to keep them informed about important findings or information. Articles to be summarized are selected by HSR based on timeliness of the findings, interest of leadership, or potential impact on the organization. Publication briefs are written for only a small number of HSR published articles. Visit the HSR citations database for a complete listing of HSR articles and presentations.

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