The U.S. has turned a corner in its vaccination effort, with widespread mandates prompting many holdouts to receive the jab. But while public focus has been on the domestic fight against COVID-19, the virus still rages around the globe — and inequities in vaccine access and distribution persist 10 months after vaccines first became available.

A new Kaiser Family Foundation survey found considerable uncertainty around the country’s role. Just over half of respondents said the U.S. was doing enough to help provide vaccines to other countries, while about 29% of respondents said the country was falling short. The remaining 20% said they weren’t sure.

“This is a small pulse check of how the public is feeling about the U.S. role in providing vaccines to other countries,” said Lunna Lopes, a KFF senior survey analyst. “The results indicate there’s a decent amount of additional information and knowledge that may help Americans better understand the role the U.S. government is playing. So as there’s more clarity on the country’s role, we might see these numbers shift.”

The Biden administration has pledged 1.1 billion donated vaccine doses to countries around the world. Experts, however, believe many more doses are needed.

Although 51% of the world population has received at least one dose of a COVID-19 vaccine, that figure drops to 4% in low-income countries, according to Our World in Data. Several African countries had less than 2% of their populations fully vaccinated as of early November.

Even though half of respondents to the KFF survey said the U.S. was doing enough, 62% said they believe that the U.S. should take a leading or major role in aiding international vaccine distribution. But when provided with messaging that the U.S. can help other countries without diminishing its own vaccine supply, the percentage spiked to 75%. It went up to 71% when survey participants were told helping other countries would assist in reaching herd immunity at home.

“We’re starting with six in 10 adults saying the U.S. should take a leading role in helping other countries,” Lopes said. “But then when they are given messages addressing some of those concerns, we see that share of the public inch up a bit.”

The survey didn’t examine public perception of the pharmaceutical industry vis-a-vis the global vaccine rollout, though even government officials have acknowledged the significant role it plays in global vaccine equity. In a recent interview with NPR, U.S. State Department coordinator for global COVID response and health security Gayle Smith noted that “it’s more ask than tell, but I think there are ways to ask [vaccine makers] with enthusiasm.”

Lopes said her main takeaway from the survey is that clearer information and communication is integral for shaping public perception of the U.S. role in global vaccine equity.

“The current coverage is focused on domestic vaccine issues, whether it’s boosters or mandates, and that overpowers the coverage of foreign vaccine issues,” she explained. “It will be interesting to see if there will be increased coverage over the role of the U.S. and other countries in helping provide vaccine doses to nations that need them, and if we might see some changes in the perception of whether the U.S. is doing enough in the future.”