(The Hill) – Nearly 60 percent of Americans living in the Midwest and surrounding states say they will not get the new COVID-19 vaccine this year, according to a survey from Emerson College Polling. 

The Food and Drug Administration (FDA) approved an updated new COVID-19 booster in September, targeting currently circulating variants of the disease.  

But more than three years since the onset of the pandemic, fewer Americans are opting to get booster shots. Only 16 percent of U.S. adults have gotten the newest vaccine, according to the Centers for Disease Control and Prevention (CDC).

The Emerson College survey found Americans overall are split down the middle on whether to get the updated vaccine.  

Americans in Minnesota, Illinois, Colorado and Iowa aligned with national attitudes toward the new shot — with about half of the residents in each state saying they would probably forgo the new vaccine.  

Wyoming has the largest percentage of residents who will most likely skip the new shot, with 74 percent of survey respondents saying as much.

Over 65 percent of residents in North Dakota, Oklahoma, Kentucky, West Virginia and Idaho also say they will probably not get the booster, according to survey findings.  

Many of the states with large percentages of residents who said they won’t get the new vaccine also hold negative opinions about the public health information available in their state.   

In Wyoming and Idaho, 37 percent of survey respondents said their state’s government agencies have a “poor” quality of public health information, according to the poll.

“These findings should be a wake-up call to health communicators, as we can no longer rely on mandates and must engage people in real conversations to encourage them to vaccinate themselves and their families,” said Kenneth Rabin, a scholar at the CUNY Graduate School of Public Health and Health Policy that commissioned the survey.  

Health experts are urging all Americans over the age of six months to get the updated vaccine to protect themselves from the virus as the country heads into peak respiratory illness season.  

“Here’s the bottom line: COVID-19 vaccine uptake is lower than we’d like to see, and most people will be without the added protection that can reduce the severity of COVID-19,” the CDC said in an update on the virus last month.  

Over 1,500 registered voters took part in Emerson College Polling national survey which was conducted between Oct. 16-17. About 500 residents in 22 states also took part in the school’s statewide surveys, which were conducted between Oct.1-4.

The margin of error for each survey ranges between 3.98 percent and 4.6 percent.