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Public Knowledge Varies Greatly on Flu and Covid-19, Surveys Show

There is wide variability in what the U.S. public knows about the seasonal flu and Covid-19, but some facts are much more strongly associated with an individual’s vaccination behavior.

For several years, the Annenberg Public Policy Center’s nationally representative Annenberg Public Health and Knowledge Survey (ASAPH) has assessed public knowledge of vital health information, including how to prevent and treat the seasonal flu and Covid-19, two of the three illnesses in last year’s “tripledemic” outbreak that overwhelmed some health care facilities (the third was RSV, or respiratory syncytial virus).

Even after taking education into account, survey data reveal that the answers to just eight questions are better than many others at predicting whether a person has been vaccinated against the flu or is willing to get an annual Covid-19 vaccine if recommended by public health officials.

“Knowledge about the nature, effects, and prevention against a potentially deadly virus is valuable in its own right,” said Kathleen Hall Jamieson, director of the Annenberg Public Policy Center (APPC) of the University of Pennsylvania. “But some knowledge is more associated with vaccination than other knowledge.”

APPC research director Dan Romer said the ASAPH surveys, which were administered with a nationally representative panel of U.S. adults, posed two dozen questions to assess public health knowledge of the flu and Covid-19. All of those questions were related to forms of vaccination acceptance – either with having received a flu shot or expressing a willingness to get an annual Covid-19 vaccine. “Here, we’ve picked the eight questions – four for the flu and four for Covid – that had the strongest ability to independently predict taking either action,” Romer said. (See the “other items” on the topline* for the full list of questions.)

Background: The seasonal flu and Covid-19

The flu is a contagious respiratory illness caused by influenza viruses, according to the Centers for Disease Control and Prevention (CDC), which estimates that during the 2022-23 flu season, there were from 26 to 50 million flu illnesses, 290,000 to 670,000 hospitalizations, and 17,000 to 98,000 deaths. Last season, the CDC estimates that 46.9% of U.S. adults 18 and older received a seasonal flu shot, down about 2.5 percentage points from the prior flu season.

Since the onset of the pandemic early in 2020, Covid-19 has led to over 1.14 million deaths in the United States and nearly 6.37 million hospitalizations, the CDC says. This fall, the CDC recommends that everyone age five and older get one dose of the updated Covid-19 vaccine from Pfizer-BioNTech or Moderna to prevent against serious illness from Covid-19. In addition to those two vaccines, which use mRNA technology, a protein-based vaccine by Novavax has just won CDC and FDA approval.

We invite you to take our true-or-false quiz and test your knowledge against what the public knows. If you would rather see the full quiz in text format, download the PDF here.

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About the surveys and findings

The survey data come from the 10th and 12th waves of the Annenberg Science and Public Health Knowledge Survey (ASAPH), a nationally representative panel of U.S. adults first empaneled in April 2021 that was conducted for the Annenberg Public Policy Center by SSRS, an independent market research company.

The flu questions were asked in the 10th wave of the survey, which was conducted January 10-16, 2023, among 1,657 U.S. adults, and has a margin of error of ± 3.2 percentage points at the 95% confidence level. Individuals who got at least three questions right about the flu vaccine are more likely than average (50%) to say they had received a flu shot in the 2022-23 flu season.

The Covid-19 questions were asked in the 12th wave of the survey, which was fielded August 9-15, 2023, among 1,482 U.S. adults, and has a margin of error of ± 3.4 percentage points at the 95% confidence level. Individuals who got at least three questions right about the Covid-19 vaccine are more likely than average (51%) to say they were very or somewhat willing to get a yearly Covid-19 vaccination if the CDC were to recommend it.

For the survey question wording see the topline and for additional information see the methodology statements for Wave 10 (flu) and Wave 12 (Covid-19).

In addition to Jamieson and Romer, the team that produced the survey includes Patrick E. Jamieson, director of the Annenberg Health and Risk Communication Institute, who developed the questions; Ken Winneg, managing director of survey research; and research analyst Shawn Patterson Jr.

The topline was updated Nov. 9, 2023 to add the questions that were not used in the quiz to “other items.”