Objectives: Despite the potential for COVID-19 vaccination to prevent severe disease and death, vaccine hesitancy is common in the United States, with more than a quarter of eligible Americans yet to receive the first dose. We draw on existing published studies on COVID-19 vaccine attitudes to estimate the overall prevalence of vaccine hesitancy and assess how it varies across demographic groups. Study design: A systematic literature search was conducted to identify and meta-analyze relevant studies, which examined vaccine acceptance and hesitancy in the context of the COVID-19 vaccine. Methods: We meta-analyzed the prevalence rate of vaccine acceptance across all participants as well as for specific demographic subgroups. To assess time effects, we coded each study for the month during which data were collected and subjected the meta-analytic data to a regression analysis. To assess the magnitude of differences between demographic subgroups, we conducted a separate meta-analysis of odds ratios. Results: Across the 46 samples, an average of 61% of participants indicated they were willing to receive the COVID-19 vaccine. The biggest demographic differences were found for race and political affiliation, with Black respondents and Republicans reporting significantly higher vaccine hesitancy than White respondents and Democrats. Conclusions: These results inform current vaccination efforts by identifying the groups that are least likely to get vaccinated and supporting the need for tailored vaccine strategies to alleviate the concerns specific to those populations. Comparing intentions to vaccinate with actual vaccination rates, vaccine hesitancy appears to have declined considerably among women and Black Americans. ?? 2022 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.