Factors related to adherence to public COVID-19 prevention behaviors, United States, April–July 2021

INTRODUCTIONOmicron cases are surging in a pandemicweary US population.As breakthrough infections increase, and with just about a quarter of the US vaccinated population having received a booster dose, adherence to non-pharmacological anti-contagion measures is critical.We examined prevalence, trends, and correlates of adherence to non-pharmacological anti-contagion measures.METHODS We used cross-sectional data from six cycles of the Household Pulse Survey during April-July 2021.The Pulse Survey is a telephone-based survey of adults aged ≥18 years in all 50 US states and D.C. Between 66262 and 78467 US adults completed each survey cycle (pooled n=425460).RESULTS During the most recent cycle analyzed (23 June-5 July 2021), 13.6% of US adults reported ever COVID-19 diagnosis, ranging from 5.0% in Hawaii to 20.5% in North Dakota; in New York State, prevalence was 14.0%.Overall, 80.9% reported having received ≥1 dose of a COVID-19 vaccine during 23 June-5 July 2021, ranging from 93.5% in D.C. to 60.1% in Wyoming; in New York State, prevalence was 83.0%.Within trend analysis over the six survey cycles (14 April-5 July 2021), the percentage of vaccinated adults who reported 'I have decreased prevention behaviors since getting a vaccine' increased from 10.1% at baseline during 14 April-26 April 2021, to 52.5% during 23 June-5 July 2021 (p<0.01).Significant increases occurred in all 50 US states and D.C.Those with reduced adherence were more likely to be males, more educated, married, younger, living in the Midwest, and residing in a one-family house.CONCLUSIONS During April-July 2021, the percentage of vaccinated US adults reporting reduced adherence to public COVID-19 prevention behaviors increased five-fold, suggesting growing fatigue with COVID-19 prevention measures, with major implications for community spread from omicron and possibly future variants.Intensified efforts to increase vaccine coverage, including booster doses, may benefit public health.

Abstract licence: CC BY-NC

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