The release of COVID-19 vaccinations has been a symbol of hope to many people — -and a source of hesitancy to some. For our second survey on COVID-19 vaccination perceptions and behaviors (which we will refer to as “survey 2” throughout this blog post), we wanted to understand how people were feeling about the vaccines as people first started getting access to them. We launched the survey in January 2021, and are excited to share some preliminary results with you!

Participants

100,080 people (“participants”) completed survey 2. 54,701 have completed all surveys in the study so far. The mean age of survey 2 participants was 37.4 (standard deviation: 12.2 years). The majority of survey 2 participants identified as female (80.8%) and identified as white (78.0%).

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Vaccination Likelihood and Hesitancy

One of our main focuses for this survey was to examine how COVID-19 vaccination likelihood and hesitancy has evolved over time.

11.4% of participants had already gotten a COVID-19 vaccine when they took the survey, with an additional 0.6% reporting participating in COVID-19 vaccination trials:

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Overall, survey 2 participants reported being more positive about COVID-19 vaccination than they had been previously. 30% of participants reported feeling more likely to get a COVID-19 vaccine than they had been a month ago:

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People reported a range of reasons for their likelihood of vaccination increasing, with some common responses including:

• Feeling more informed about COVID vaccination overall (for example, “learned more information about it”, “just thinking and researching”)
• Feeling more confident about COVID vaccination safety as more data and research were released (for example, “more data on potential side effects”, “studies are getting better and more people are receiving it.”)
• Feeling more confident about COVID vaccination safety as they saw their friends, family, and community starting to get vaccinated (for example, “seeing those I respect get it”, “watching people I know get it with little adverse side effects”)

We saw a similar trend looking at the differences between reported vaccination likelihood in the first and second surveys; mean reported likelihood was 4.93 in survey 1 (median=5), and 6.53 in survey 2 (median=8.0):

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Although the majority of participants (51.5%) still report being more hesitant about COVID-19 vaccines than other vaccines, a higher percentage of survey 2 participants reported being equally or less hesitant than survey 1 participants:

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Vaccination Informedness

As mentioned above, one common reason people gave for their increase in vaccination likelihood was feeling more informed about the vaccines. Our data reflect this increase in self-reported informedness; in survey 1, only 27.1% of participants reported feeling “informed” or “very informed”, but 53.3% did so in survey 2:

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The most common pieces of information unvaccinated participants reported needing to know before deciding to get the COVID-19 vaccine were all potential side effects (62.7%) and possible long-term impacts of vaccination (58.9%).

We look forward to further investigating these current perceptions and behaviors and see how they change as more people become eligible for vaccination!

Next Steps

To understand how people’s perceptions and behaviors related to COVID-19 vaccination continue to evolve as vaccines become available more broadly, we will send additional surveys over the following months asking for Evidation Members’ perceptions and behaviors. The exact dates of these future surveys will depend on developments in the pandemic and COVID-19 vaccination, so stay tuned for more!

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If you’d like to get vaccinated, see this CDC page with resources to find appointments near you.

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Our Research, Analytics, and Learning team is exploring and analyzing data from our Evidation platform, where members contribute to research and help us uncover insights that could improve their health and the health of others.

During this year’s presidential election there was high voter turnout which included record-breaking numbers of mail-in ballots due to COVID-19. As we now know, this high volume of ballots required multiple days to count, so no final winner could be projected on Election Day. We decided to look at Evidation Members activity data to see what changes the election may have caused for our members.

We used Fitbit data contributed by Evidation Members, to explore sleep characteristics and schedules for the month leading up to Election Day in 2020. We looked specifically at the time that each member went to bed in their local timezone. Equivalent time periods in 2017–2019 were used for comparison. These periods were aligned across years based on week rather than calendar date, so that differences in weekend and weekday sleep cycles would line up. This also syncs the end of daylight saving time, which happened on November 1, 2020, the Sunday two days before Election Day, and temporarily shifts our sleep cycles earlier. Positioning the data in this way allows for appropriate comparisons of data across years.

So, did anything about our sleep change? This plot shows the average time Evidation Members started sleeping on the weeks leading up to and immediately after daylight saving time from 2017–2020:

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There is a clear weekly pattern: we go to bed later on Friday and Saturday nights, when we have a weekend day ahead of us. On daylight savings weekend we started sleeping slightly earlier as we adjusted to the end of daylight saving time, a trend which continues through the following week as we slowly adjust to going to bed later again. However, on Election Day 2020 this pattern was disrupted; bedtimes spiked up over 20 minutes from Sunday and Monday night.

You may also notice the interesting pattern of later bedtimes in 2017, leading up to daylight saving time. This lines up with Halloween night and games 6 and 7 of the 2017 World Series. We’ve examined the impact of the 2017 World Series on sleep in the past.

As we looked closer at our sleep data, we were curious to see if members on the East Coast stayed up later in their time zone than those on the West Coast while they waited for results, so we examined average bedtimes in each time zone. On election night, members on the East Coast stayed up the latest (11:51 PM), compared to members in the Central (11:39 PM), Mountain (11:39 PM), and Pacific (11:43 PM) time zones. Compared to the previous night, members in Eastern Standard Time stayed up 22 minutes later, Central Standard Time 20 minutes later, and Mountain Standard Time 23 minutes later, while members in Pacific Standard Time stayed up only 14 minutes later.

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Regardless of where we live, sleep is an important part of our health. Fortunately, later bedtimes due to the election were confined to Tuesday night. Bedtimes returned to normal after Election Day, as it became clear that election results would take at least several more days to be projected.

Did you stay up late on Election Day? If you have tips to reduce stress or improve sleep, we’d love to hear them.

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We are all looking forward to the end of the COVID-19 pandemic and the disruptions it’s caused in our lives. A safe and effective COVID-19 vaccine will form part of the public health strategy to help us reach this endpoint faster. As many organizations work to develop and release such a vaccine, we wanted to understand people’s evolving perceptions and behaviors related to COVID-19 and vaccinations. We launched the first set of surveys in our study in October, and are excited to share some preliminary results with you!

Objectives

This study’s goal is to describe people’s perceptions and behaviors around the COVID-19 vaccine. For example, what reasons do people have for getting or not getting the COVID-19 vaccine? How likely are they to get it once it’s released? Has the pandemic encouraged people to get the flu shot? This study will investigate whether and how these perceptions and behaviors change over time, as COVID-19 vaccines are developed and released.

Methods

To describe people’s perceptions and behaviors, and how those perceptions and behaviors change over time, we are asking for people’s input through a series of online surveys. These surveys will be sent throughout the development and release of COVID-19 vaccines.

So far, we’ve launched 2 surveys: one to understand the backgrounds of the people participating (for example, their demographics, where they live, whether they’re at risk for COVID-19), and one to characterize current perceptions and behaviors. We have started analyzing the data collected between October 9th, 2020 and November 11th, 2020. We won’t be able to understand how perceptions and behaviors have changed until we launch the next survey, but we can start to describe how people are currently feeling about the COVID-19 vaccine!

Preliminary Results

Here are some preliminary results from our first 2 surveys.

Participants

64,750 people (“participants”) have completed the first perceptions and behaviors survey. Mean age was 38.5 (SD: 11.7 years), and the majority of participants identified as female (79.7%) and identified as white (80.0%).

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All 50 states (plus Puerto Rico and Washington, DC) are represented:

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Vaccination Likelihood, Motivators, and Barriers

On average, participants were on the fence in terms of likelihood of getting the COVID-19 vaccine when it’s released (mean=4.93, median=5). The distribution shows a wide range of opinions, with the largest numbers of people reporting at:

• 0 (“Very unlikely”): 18.8%
• 5: 13.6%
• 10 (“Very likely”): 14.3%

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The most common reasons people reported for getting the COVID-19 vaccine were to:

• help protect their family, friends, or community (59.9%)
• lower their chances of getting COVID-19 (56.7%)
• lower their chances of having to go to the doctor or getting hospitalized due to severe COVID-19 symptoms (53.7%)
• feel more comfortable spending time with their friends, family, or community (55.7%)

The most common reasons people had to not get vaccinated were because they were:

• concerned the vaccine is being approved too quickly (61.3%)
• concerned about possible side effects (60.1%)
• not sure the vaccine will be safe (56.2%)
• not sure the vaccine will be effective (57.0%)

Relative Vaccination Hesitancy

Most participants reported feeling more hesitant about the COVID-19 vaccine than other vaccines (68.0%), with 24.9% feeling equally hesitant and 7.1% feeling less hesitant:

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Vaccination Informedness

We’ve also found that people don’t feel particularly well-informed about the COVID-19 vaccine in general. 19.8% of participants report feeling “Not at all informed”, 22.7% “Slightly informed”, 30.4% “Moderately informed”, 19.2% “Informed”, and only 7.9% “Very informed”:

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Pandemic Influence on Flu Shot Plans and Behavior

The CDC has stressed that getting the flu shot this season is more important than ever, to help protect oneself and others and to minimize burden on the healthcare system. Many participants seem to agree: of the 35,997 participants who had not gotten the flu shot yet (or were unsure), 20.2% reported being more likely to get it this season due to the pandemic:

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Of the 28,753 participants who had gotten the flu shot, 20.0% reported that the pandemic encouraged them to get it, and 9.1% reported the pandemic was the primary reason they did so:

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We are excited to continue to investigate these current perceptions and behaviors and see how they change over the coming months!

Next Steps

To understand how people’s perceptions and behaviors related to COVID-19 vaccination evolve over the development and release of vaccines, we will send more surveys over the following months asking for Evidation Member’s perceptions and behaviors. These surveys will be sent as big events happen around the vaccine’s development, like its approval or release. The exact dates of these future surveys will depend on when these events happen, so stay tuned for more!

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Historically, minorities have been inadequately represented in research studies. We’re committed to enrolling a more diverse and representative population in Evidation for studies.

We’re collaborating with BlackDoctor.org to ensure that the effects of COVID-19 are investigated in a representative population.

We, in partnership with BlackDoctor.org and Myovant Sciences, have launched Forward Momentum, a cross-sector coalition working to improve the lives of men with prostate cancer. Forward Momentum is committed to addressing the complex set of challenges that hold back the representation, information, and conversations that all men deserve. By bringing together organizations from diverse sectors and investing in novel digital initiatives, Forward Momentum strives to accelerate progress for men with prostate cancer.

Stay tuned for more updates from us on these research efforts!

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This February, in honor of Heart Health Awareness Month, we partnered with the data science team at Evidation to look at patterns of some of our heart healthiest members.

Resting heart rate (your pulse rate while awake, relaxed, and stationary) has been shown in several large epidemiologic studies to be an independent predictor of cardiovascular disease and all-cause mortality in both men and women. Given the importance of resting heart rate for heart and overall health, the team looked at all of the Evidation Members who contributed resting heart rate data in 2018. We explored the trajectory of resting heart rate from week to week and selected a handful of members that significantly dropped their resting heart rate over the year. The individuals we selected had a wide range of resting heart rates to begin the year.

Of the members we selected, 96% were within the normal range of 60–100 beats per minute. According to the Harvard Health blog, “while a heart rate is considered normal if the rate is between 60 and 100 beats per minute, most healthy relaxed adults have a resting heart rate below 90 beats per minute.” Only 4% had resting heart rates below 60 beats per minute at the beginning of the year. Resting heart rates below 60 bpm are often indicative of people who get a lot of physical activity. Near the end of the year, over 30% had reduced their resting heart rate to 60 beats per minute or lower. Overall, we observed an average drop of 11 beats per minute, which corresponds to an average decrease of 15% from the beginning of the year.

We then asked these resting heart rate improvers to tell us a little bit more about what they did in order to better understand their habits throughout the year — everything from how often they checked their heart rate, to the frequency of their workouts, to dietary changes they had made throughout 2018.

Here’s what we found!

Most members who had a significant decrease in resting heart rate in 2018 also noticed the same thing!

Most of our heart healthy members said they checked their resting heart rate frequently — if not every day, then at least a few days per week.

The most common changes that Evidation Members made to their diet included the following:

• Adjusting their portion sizes
• Limiting consumption of fast food
• Consuming more vegetables and fruit

The most common types of physical activity included:

• Walking
• Lifting weights
• Running
• Hiking
• Yoga

When we took a closer look at activity data, we actually saw an increase of 871 steps per day (12.3% increase) for members who had lowered their heart rate. Those who responded that they did more walking in 2018 truly did up their step count.

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Evidation Members overwhelmingly said that they had lost weight, made changes to their diet, exercised more often and regularly, and focused on maintaining a healthy weight when sharing some of the changes that they made to their lifestyle in 2018.

In fact, when we took a look at weight tracking for our heart healthy members, the data matched up with the responses. For those who tracked their weight at least once per week for 30 weeks or more, the average weight loss was 12 pounds (a 6% decrease on average).

Not surprisingly, mental health and improved sleep can significantly influence an individual’s overall quality of health. Did you know that sticking to a sleep schedule can help you improve your heart health?

Our community of heart healthy members have recommended to others the value of maintaining a healthy diet, exercising more, and managing stress as tips to improve heart health.

For advice on how to take action today to make your lifestyle a little healthier, check out these additional suggestions from some trusted sources:

• Heart Healthy Recipes from the NIH
• CDC Heart Month Feature from the CDC
• Taking Care of Our Hearts, Together from National Heart, Lung, and Blood Institute‍