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Over a Quarter Million Seniors Avoiding COVID-19 Vaccine Over Misguided Cost Concerns

Study explores the regions in America where vulnerable seniors are most at risk due to inaccurate information

Updated March 9, 2021

Key Findings

  • More than 312,173 older adults nationwide are not planning to receive the COVID-19 vaccine because they mistakenly believe they will have to pay for it. That’s slightly more than the number of adults age 65 and over who have died from COVID-19 since the pandemic began.2

  • Vaccine cost concern on a per capita basis is highest in Minnesota, Nevada, Pennsylvania, Virginia and Montana.

  • In terms of total numbers, Pennsylvania is home to nearly 60% more seniors who are avoiding the vaccine because of cost than any other state. 

Study Overview

Logistical challenges or vaccine trust aside, there’s at least one additional obstacle standing in the way of widespread COVID-19 vaccination among American seniors: cost.

Or at least, their incorrect perception of it. 

Despite the COVID-19 vaccine being free to every individual regardless of insurance coverage, the Census Bureau’s Weekly Household Pulse Survey found that a significant number of older adults will refrain from getting the shot because they mistakenly believe it will cost money. 

The map below shows where in America seniors are the most concerned about the cost of a COVID-19 vaccine. 

Click on image to enlarge in a new tab

National map graphic showing levels of COVID-19 vaccine cost concerns by state

"The federal government is providing the vaccine free of charge to all people living in the United States." – Centers for Disease Control and Prevention (CDC), Feb. 25, 2021

As stated by the CDC, “Vaccination providers can be reimbursed for vaccine administration fees by the patient’s public or private insurance company or, for uninsured patients, by the Health Resources and Services Administration's Provider Relief Fund. No one can be denied a vaccine if they are unable to pay a vaccine administration fee.” 

States With the Highest Levels of Cost Concern

Minnesota, Nevada and Pennsylvania display the highest rates per capita of seniors avoiding the vaccine out of mistaken concerns over the cost.

More than 6 out of every 100 seniors in Minnesota share false concerns over the cost of the COVID-19 vaccine. That represents 17,039 seniors in all, which is almost enough to fill half the seats at Target Field, the home stadium of baseball’s Minnesota Twins.

Nevada followed close behind, also with more than 6 out of 100 seniors having concerns over the cost of the vaccine. That’s 14,952 seniors in all, or enough to pack nearly 300 older adults into each of the 51 casinos on the Las Vegas strip.  

In Pennsylvania, 53,590 seniors also have cost concerns about the vaccine, which is roughly equivalent to the population of Bristol and higher than the population of the state capital of Harrisburg.  

Click on image to enlarge in a new tab

Table graphic showing the states with highest levels of COVID-19 vaccine cost concerns

While a small cluster of states with higher cost concerns can be found on the east coast (Pennsylvania, Virginia and North Carolina), misinformation surrounding the cost of the COVID-19 vaccine knows no boundaries. 

When comparing the map above with the CDC’s vaccine rollout map, there’s evidence of at least some correlation between cost concerns and vaccination rates. For example, several states with the highest vaccination rates — such as Connecticut and New Mexico — registered on the low end of the cost concern survey. 

Meanwhile, several states with lower vaccination rates such as Texas, Florida and North Carolina shared higher-than-average reports of concerns about the cost. 

Levels of Vaccine Cost Concern in Each State

The table below details the number of adults age 65 and over in each state who reported concerns about COVID-19 vaccination costs. 0 values indicate no relevant reported data from the U.S. Census Bureau report for that state.

COVID-19 Vaccination Cost Concerns by State
State Number of Seniors Reporting Cost Concerns
ALABAMA 0
ALASKA 802
ARIZONA 10,146
ARKANSAS 7,053
CALIFORNIA 0
COLORADO 9,920
CONNECTICUT 0
DELAWARE 1,071
DISTRICT OF COLUMBIA 198
FLORIDA 34,126
GEORGIA 2,637
HAWAII 1,486
IDAHO 826
ILLINOIS 12,383
INDIANA 3,413
IOWA 2,515
KANSAS 5,523
KENTUCKY 3,573
LOUISIANA 15,848
MAINE 1,370
MARYLAND 1,755
MASSACHUSETTS 2,540
MICHIGAN 2,829
MINNESOTA 17,039
MISSISSIPPI 860
MISSOURI 1,149
MONTANA 7,035
NEBRASKA 2,197
NEVADA 14,952
NEW HAMPSHIRE 386
NEW JERSEY 0
NEW MEXICO 536
NEW YORK 0
NORTH CAROLINA 28,356
NORTH DAKOTA 0
OHIO 0
OKLAHOMA 0
OREGON 8,520
PENNSYLVANIA 53,590
RHODE ISLAND 870
SOUTH CAROLINA 0
SOUTH DAKOTA 0
TENNESSEE 7,172
TEXAS 14,125
UTAH 767
VERMONT 157
VIRGINIA 24,087
WASHINGTON 8,865
WEST VIRGINIA 329
WISCONSIN 962
WYOMING 205

Sources of Vaccine Cost Misinformation

It’s difficult to fault older adults for having concerns over the cost. There have been numerous reports in the news of people being charged for the vaccine.  

  • A clinic in Chicago was giving the vaccine for free but was charging $200 for an “appointment fee.”

  • Facilities are allowed to charge and collect an “administration fee” for the shot but are not allowed to pass that fee on to the vaccine recipient. As a result, these administration fees have created confusion for both providers and vaccine recipients.

  • You will still typically be asked for your insurance information when making a vaccine appointment, but this is only to allow the provider to receive their proper reimbursement from your insurance company or from the federal government. Still, it’s causing some to balk at making their appointment. 

A number of scams have also surfaced in the wake of the COVID-19 vaccine rollout. The FBI has warned of several indicators of fraudulent activity, including: 

  • Requests for you to pay out of pocket to obtain the vaccine

  • Asking for payment to receive early access to the vaccine or to put your name on a waiting list for the vaccine

  • Attempts to perform unnecessary tests or procedures during one’s vaccine appointment to accumulate charges for additional services

And the group most vulnerable to such scams according to FBI Financial Crimes Section Chief Steven Merrill?

Older adults. 

Methodology

The data used for this report came from the U.S. Census Bureau’s Household Pulse Survey, specifically week 24. To calculate the per capita figures, the total number of responses for “Concerned about the cost” was divided by total number of responses and multiplied by 100.

More information about the Census Bureau’s methodology can be found here.

Fair Use Statement

Of course we would love for you to share our work with others. We just ask that if you do, please grant us the proper citation with a link to this study so that we may be given credit for our efforts.

Research and reports

Our research reports analyze a number of issues important to seniors, from health perceptions, medical communication, health habits, and more.