The fight against vaccine hesitancy shifts to younger Americans

·10 min read

Amid a decline in the U.S. daily rate of coronavirus vaccinations, down from its peak levels two weeks ago, the focus has turned to young adults who may be resistant to getting vaccinated against the deadly disease.

Although a dip in vaccinations is expected to some extent — as more Americans become vaccinated, logically at some point the demand would go down — some health experts worry that this slowdown may be happening prematurely, considering that eligibility is now open to every American over the age of 16 and that supply doesn’t seem to be an issue. Medical experts have acknowledged that young adults seem to be getting vaccinated at a slower rate than older demographics.

According to a Yahoo News/YouGov survey conducted this week of 1,558 U.S. adults, 46 percent of respondents said they will not get vaccinated. The survey, which was conducted from April 27 to 29, found that 35 percent of young adults ages 18 to 29 were unwilling to get the shots. 

Now various efforts are underway, from both sides of the political aisle, aimed at encouraging and incentivizing young Americans to get the jab.

A medical worker administer the Jansen (Johnson and Johnson) Covid-19 vaccine to the public at a FEMA run mobile Covid-19 Vaccination clinic at Biddeford High School in Bidderford, Maine on April 26, 2021. (Joseph Prezioso/AFP via Getty Images)
A medical worker in Biddeford, Maine, administers the Johnson & Johnson vaccine on Monday. (Joseph Prezioso/AFP via Getty Images)

Former President Barack Obama took to TikTok on Friday to persuade young Americans to get vaccinated. In the PSA video, which first appeared on Yahoo News’ TikTok account, Obama told young Americans that he and his wife, Michelle, had gotten the vaccine, which is “safe, effective and free.” He urged them to get one too and said it is “the only way we are going to get back to all the things we love.”

Earlier this week, West Virginia Gov. Jim Justice announced that his state will use COVID-19 stimulus funds to give all residents ages 16 to 35 who would take the vaccine a $100 savings bond. In a press conference held Monday, the Republican governor told his constituents that if young people "step up in masses, we'll be done, and we'll be done soon" with COVID.

There’s no question that the U.S. has made remarkable progress on vaccination. On Jan. 20, when President Biden took office, the country was administering an average of 900,000 doses a day. Less than three months later, on April 16, reported daily vaccinations peaked at an average of 3 million. However, that pace has since declined by 12 percent.

Several factors have been attributed to the slowdown in inoculation rates, including the recent pause of the Johnson & Johnson vaccine. But with a younger population remaining to get the shots, there’s good reason to believe that vaccine hesitancy among this age group may also be a factor.

A few recent polls have tried to access information on how Gen Z feels about COVID-19 vaccines. A recent Stat-Harris poll found that 21 percent of Gen Z — defined in the survey as young adults ages 18 to 24 — were not willing to get vaccinated. Another 34 percent said they would “wait a while and see” before getting vaccinated.

People stand in line to get COVID-19 vaccines. At the site of a walk-up COVID-19 vaccine clinic at the St. Joseph's Community Campus in downtown Reading Wednesday afternoon April 21, 2021. (Ben Hasty/MediaNews Group/Reading Eagle via Getty Images)
People in line to get COVID-19 vaccines in Reading, Pa., on April 21. (Ben Hasty/MediaNews Group/Reading Eagle via Getty Images)

Another study, conducted by researchers from the University of Michigan who surveyed a national cohort of 14- to 24-year-olds in October 2020, found that although most of the youth they polled were willing to get the vaccine, 20.2 percent of the respondents were not. According to the study, “Black youth had 3.31 times the odds of being unwilling” to receive the shot.

Yahoo News Medical Contributor and primary care doctor Dr. Kavita Patel said many of her patients under the age of 20 have expressed reluctance to get the jab.

“In a panel of patients that I have, I had about 25 percent of them who were under the age of 20 — all of whom had not received a COVID vaccine,” she said. “All except one refused to get the vaccine.”

These patients, she said, cited different reasons for not wanting to be inoculated. Some expressed concerns over the possible side effects. Other reasons were more “concerning,” she said, because they had to do with false claims about the dangers of coronavirus vaccines that have been running rampant on social media.

“A number of young people were on social media groups, where they were told that taking the vaccine would alter their fertility; it would alter their genetics,” Patel said.

Young people may also not feel the urgency to get vaccinated because they believe that if they contract the virus, they’re at lower risk of severe disease or death.

But the idea that COVID is relatively harmless to young people, Patel said, is not true.

“The truth is that we're approaching 600,000 deaths, and tens of thousands of them were perfectly healthy young adults for whom we have no reason to understand why they died,” she said.

Critical care workers insert an endotracheal tube into a coronavirus disease (COVID-19) positive patient in the intensive care unit (ICU) at Sarasota Memorial Hospital in Sarasota, Florida, February 11, 2021. (Shannon Stapleton/Reuters)
Critical care workers insert an endotracheal tube into a COVID-19 patient in the ICU at Sarasota (Fla.) Memorial Hospital. (Shannon Stapleton/Reuters)

Research published last year in the Journal of the American Medical Association suggested that U.S. adults ages 25 to 44 were dying at historic rates. From March through the end of July 2020 alone, there were close to 12,000 more deaths than expected based on historical norms, according to the study.

Getting young adults vaccinated is particularly important given their role in spreading disease to more vulnerable individuals. It is also essential to stop the virus from mutating and for reaching herd immunity — the point when the virus begins to run out of unprotected hosts to infect.

In addition to that, young people may also experience “long COVID.” Some case studies have also indicated that children could experience long‐term effects similar to adults after contracting the disease.

Patel said the fact that young adults might not want the vaccine is not completely a surprise. Younger adults, she said, have historically had lower vaccination rates for seasonal infections such as the flu.

“People above the age of 17, between 17 and 40, are vaccinated for flu [at] about a 40 percent rate, versus people above the age of 50, where there's a higher chance of being hospitalized, which sees vaccination rates for the flu as high as 80 percent,” she said.

Similar challenges, Patel said, may exist for COVID vaccination. “But in this case we've never had such higher stakes than wanting to get any age that's eligible vaccinated,” she added.

So what can government and health officials do to make it easy and more appealing for young adults to get vaccinated?

Patel said that the first course of action would be to make it so “ridiculously convenient that you just can’t avoid it.” That, she says, would require taking down the complicated process of having to search for vaccination sites, register and wait in line for the shots.

In this photo made Tuesday, Dec. 5, 2017, Kavita Patel poses for a photo in Creve Coeur, MO. (Jeff Roberson/AP Photo)
Dr. Kavita Patel. (Jeff Roberson/AP)

Letting people know the vaccine is free is also important.

“We need to be able to put vaccines in a kind of cooler bag and stand outside of nightclubs and bars and places that people want to go to,” Patel said, “and try to get them in a convenient fashion.”

Other experts believe the vaccine reluctance issue among young people can also be solved with effective messaging and useful information that can be shared via social media platforms such as Facebook, Instagram and TikTok.

But that may be tricky when influential figures seem to discourage young people from getting the vaccine. This week, Joe Rogan, the host of the popular “Joe Rogan Experience” podcast on Spotify, told his listeners that young adults who are healthy don’t “need to worry” about getting vaccinated, Media Matters for America reported.

“But if you're, like, 21 years old, and you say to me, 'Should I get vaccinated?' I'll go 'No,'” he said. “If you're a healthy person, and you're exercising all the time, and you're young, and you’re eating well, like, I don't think you need to worry about this.” Rogan later clarified that he’s “not a doctor” and “not an anti-vax person.”

When asked about Rogan’s comments, Dr. Anthony Fauci, the White House’s chief medical adviser, told NBC’s Savannah Guthrie that Rogan is “incorrect,” and that healthy young adults should get vaccinated.

Melissa DeJonckheere is an adolescent-health researcher and assistant professor at the University of Michigan’s Department of Family Medicine. Using text-message polling taken at several points during 2020, she and a team of researchers found that young people between the ages of 14 and 24 had taken the pandemic seriously, and were very concerned about spreading COVID-19 to others.

Medical staff watch and advise walk-in patients who received their COVID-19 vaccination at a pop-up clinic at Western International High School on April 12, 2021 in Detroit, Michigan. (Matthew Hatcher/Getty Images)
Medical staff with patients who received their COVID-19 vaccination at a pop-up clinic in Detroit on April 12. (Matthew Hatcher/Getty Images)

Results from the study, which were published in the Journal of Adolescent Health's May issue, show that 86 percent of young people are moderately or very concerned about spreading COVID-19, and 89 percent said they wear masks or other face coverings all or most of the time. The most common reason they gave for donning a mask was to prevent themselves from spreading the coronavirus.

Even though the study focused on youths’ views on COVID-19 and the use of face coverings, not on vaccines, DeJonckheere said the findings could provide insights into the type of messaging that may be most effective for getting more young people vaccinated.

“This was one of our really important findings, is that youth really thought that they had a responsibility to their community to prevent the spread of illness," DeJonckheere said. "They talked a lot about how worried they were about asymptomatic spreads. They used words like 'responsibility' and 'obligation.' They also mentioned how terrible it would be to infect someone who was more at risk than they were.”

So far, a lot of vaccine messaging has been mainly focused on safety and efficacy, emphasizing the fact that getting these shots can prevent severe illness and death. Since many young adults already consider themselves at low risk for these outcomes, that message may not be as effective.

DeJonckheere said that “emphasizing their role in the community, transmission and community spread, and preventing that through vaccination” might be a more effective strategy.

Another finding from the study that DeJonckheere said is consistent with what experts know about youth is that they are influenced by their peers.

Sophie Nir, a young political consultant who created Vaccine Vigilantes, a volunteer-based group that has helped New Yorkers sign up for vaccine appointments, agreed.

Nurses fill syringes of Pfizer COVID-19 vaccines during a pop-up vaccination event at Lynn Family Stadium  on April 26, 2021 in Louisville, Kentucky. (Jon Cherry/Getty Images)
A nurse fills syringes of COVID-19 vaccine during a pop-up vaccination event in Louisville, Ky. (Jon Cherry/Getty Images)

“I think the best way to get young people vaccinated is for them to understand that all their friends are getting vaccinated too,” Nir said.

She said that part of the reason why her sister, who was reluctant at first, agreed to take the vaccine is because Nir got hers and encouraged her to do so as well.

“I think that people are really responsive to their immediate circle, having someone you trust, and also like being part of the team. I mean, it's like nobody wants to be the only unvaccinated person of their friend group. That is limiting, and embarrassing, and it makes you an outsider,” she added.

Finally, DeJonckheere said having that messaging come from young people themselves and sharing it in the platforms they engage with is another effective strategy.

“So with the mask use, we saw it go both ways,” she said. “They could be influenced to wear a mask, or they could be influenced not to wear a mask based on what others were doing. So building that in as a positive messaging, you know, sharing your vaccination card or communicating about why you're getting a vaccine amongst peers, I think regardless of platform, might be really effective.”


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