COVID-19 vaccination and mask wearing behaviors in the United States, August 2020 - June 2021

ABSTRACT

Background

During the rollout of COVID-19 vaccination, many states relaxed mask wearing guidance for those vaccinated. The aim of this study was to examine the association between vaccination status and mask wearing behaviors.

Methods

Seven waves of surveys (n = 6721) were conducted between August 2020 and June 2021. Participants were asked about initiation of COVID-19 vaccination and mask wearing behavior at work/school or a grocery store. Odds ratios (ORs) and 95% confidence intervals (CIs) from logistic regression were used to estimate associations between vaccination status and mask wearing at work/school and at the grocery store.

Results

Between April and June 2021, mask wearing at work or school declined among both those vaccinated (74% to 49%) and unvaccinated (46% to 35%). There was a similar decline for mask wearing at grocery stores. The odds of wearing a mask were 2.35 times higher at work/school (95% CI: 1.82, 3.04) and 1.65 times at a grocery store (95% CI: 1.29, 2.11) among the vaccinated compared to unvaccinated.

Conclusion

Mask wearing decreased after mask guidelines were relaxed, with consistently lower mask wearing among the unvaccinated, indicating a reluctance among the unvaccinated to adopt COVID-19 risk reduction behaviors.

KEYWORDS:

• Pandemic
• masks
• vaccine hesitancy
• supermarkets
• schools

Acknowledgments

We appreciate the work of Kaitlyn Akel in cleaning the datasets and preparing them for analysis.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

A reviewer on this manuscript has disclosed grant funding from vaccine manufacturers on unrelated projects. Peer reviewers on this manuscript have no other relevant financial or other relationships to disclose.

Additional information

Funding

This project was supported by an award from the National Science Foundation, Division of Social and Economic Sciences [Award Number: #2027836]. JZ was supported by award #1 U01 IP001138-01 from the Centers for Disease Control and Prevention.