Many U.S. Adults Wouldn't Test for Suspected COVID, Survey Shows

 

• In an online national survey, 70% of respondents said they would take a home test if they suspected they had COVID-19.
• Among the 30% who said they would not or might not test, 53.6% indicated that they didn't see a reason to test.
• Several variables appeared to play a role in the decision, including age, race, education level, and income.

Thirty percent of U.S. adults would not or might not test for suspected COVID-19, according to a cross-sectional online national survey.

Among just over 2,000 survey respondents, 70% said they would conduct a home test if they suspected they had COVID, with certain variables associated with being more likely to test, reported Kimberly Fisher, MD, of UMass Chan Medical School in Worcester, Massachusetts, and colleagues.

Among the 30% of people who said they would not or might not take a test, 53.6% said they didn't see a reason to test, 30.1% said it would not be helpful to know if they were positive for COVID, and 20.7% said they would not trust test results, the authors noted in a research letter in JAMA Network Openopens in a new tab or window.

"Early identification of infection enables prompt care and steps to reduce spread," Fisher and colleagues wrote, adding that hesitancy to do home testing could keep people from starting oral antiviral treatment and lead to missed opportunities to slow the spread of COVID.

More than 5 years after the pandemic's start, COVID remains a public health challenge. From October 2024 to April 2025, the CDC estimatedopens in a new tab or window 28,000 to 46,000 deaths and 230,000 to 390,000 hospitalizations due to COVID.

To assess Americans' views on COVID home testing, the researchers used the Ipsos KnowledgePanel to conduct an online national survey between Oct. 31 and Nov. 7, 2024. They asked about people's intent to conduct a home test if they suspected that they had COVID. They asked those who answered "no" or "not sure" for their reasons why they would not test.

Among those who said they might not or would not test, age appeared to play a role. While 23.2% of people ages 60 and older said they wouldn't self-test, 37.4% of those ages 18-29 years said they'd likely forgo testing. Education level also showed links to decision-making: 37.7% of those with no high school diploma or GED said they wouldn't test, compared with 27.2% of those with a bachelor's degree or higher.

Among white respondents, 34.6% said they likely wouldn't self-test, compared with 23.5% of Black respondents, 22.6% of Hispanic respondents, and 22.5% of those who were non-Hispanic other or at least two races.

Household income also showed a relationship with the decision to say no to self-testing. Those with annual incomes less than $25,000 answered "no" 25.5% of the time, compared with 32% of those with incomes of $100,000 or more.

People in non-metropolitan statistical areas were more likely than their metropolitan counterparts to skip COVID home testing, at 39.7% versus 28.5%, respectively. Whether or not a person has a primary care physician also may help determine a self-test decision. While 27.9% of people who had one said they would not test, 41.4% of those without one said they would skip a self-test.

Those who had heard about COVID medications such as Paxlovid were less likely to skip self-testing, at 26.7%, compared with 37.2% of those who didn't know about such treatments. Finally, among survey respondents who do not trust healthcare at all, 63.6% said they wouldn't self-test, compared with 16.2% of those who said they trust healthcare a great deal.

Of the 2,009 respondents to the question on COVID self-testing, mean age was 51.5, 51.2% were women, 60.7% were white, 12.1% were Black, 18% were Hispanic, and 9.2% were other, non-Hispanic or two or more races, non-Hispanic. The survey completion rate was 63.4%.

Study limitations included that people's self-testing intentions might vary from what they actually did. The survey also may not have captured all of the reasons why people might choose not to take a home test.

Disclosures

This study was supported by the National Institute of Biomedical Imaging and Bioengineering, the CDC, and the Administration for Strategic Preparedness and Response.

Fisher had no conflicts of interest.

A co-author reported receiving personal fees from Shields Pharmacy for consultancy for digital medicine and the Advanced Research Projects Agency for Health for an Expert in Residence Role to support program development, and is on the Digital Health Advisory Committee of the FDA.

Primary Source

JAMA Network Open

Source Reference: opens in a new tab or windowFisher KA, et al "Intent to test for COVID-19 in the postpandemic era" JAMA Netw Open 2025; DOI: 10.1001/jamanetworkopen.2025.18250.

https://www.medpagetoday.com/infectiousdisease/covid19/116303