Roughly one-third of Americans say they will decline a COVID-19 vaccine, according to research published in Social Science & Medicine. Researchers assessed vaccine intention among 5,009 US adults (May 28 to June 8, 2020) participating in an online survey administered through the Lucid Marketplace survey platform. The researchers found that 31.13% of respondents did not intend to pursue vaccination. The odds of COVID-19 vaccine refusal were significantly higher for blacks, women, conservatives, individuals who intended to vote for President Trump in 2020, and individuals with high levels of religiosity. The strongest associations were seen among women, who were 71% more likely not to pursue vaccination than, and Blacks, who were 41% more likely not to pursue vaccination than other races/ethnicities. Each one-unit increase in worry about COVID-19 was associated with a 23% decrease in intention to refuse a vaccine, and individuals who reported being tested for COVID-19 were 68% less likely to refuse vaccination. The two most common reasons individuals gave for not pursuing a vaccination were because they do not think the vaccine will be safe (17.83%) or effective (15.55%). “By identifying those most likely to refuse vaccination, public health experts can develop health messages targeted at encouraging vaccination among these groups,” the authors write. “This approach could prove vital to improving uptake of a COVID-19 vaccine.”