Coronavirus (Covid-19) and the vaccine: Why young people are choosing not to get vaccinated

Filed Under: Costs, Patients

- photo by Marek Studzinski on Unsplash

In late June, the Centers for Disease Control and Prevention (C.D.C.) released a study in which they revealed the surprising statistic that only 34% of younger adults, between the ages of 18 and 39, reported having received a Covid vaccine. This age group reportedly displayed the lowest vaccine coverage and intent to get vaccinated, despite the fact that all persons age 12 and older have been eligible for vaccination in the United States since May.

“Adults aged 18–24 years were least likely to report having received a COVID-19 vaccine,” the C.D.C. reported, “and were most likely to report being unsure about getting vaccinated.”

Vaccination status has increased since then, probably at least in part because of the emergence of the highly contagious Delta Covid variant, with adults aged 18-24 years and 25-39 years now reportedly 46% and 51% fully vaccinated, respectively, according to an August 25 C.D.C. data report.

However, vaccine rates of these age groups, as well as those of the ones below them, such as 16-17-year-olds, who show 44% total vaccination, still lag significantly behind those of older age groups, such as those of 40-49-year-olds, 50-64-year-olds, and 65-74-year-olds, who show 60%, 70%, and 83% total vaccination rates, respectively, according to the same August 25th C.D.C. report.

“There is just so much disinformation being spread amongst [people in my age group],” Benjamin Kagan, a 15-year-old high school student from Illinois, who volunteers his time as a vaccine angel helping people in the Chicagoland area find vaccine appointments, told ClearHealthCosts in a phone interview. “Ideas spread so fast on social media or even word-of-mouth.

“Some kids may just think it’s funny to be like, oh, you know, let me just spread this stupid rumor, it won’t affect anyone. But in the end result it does — it may end up affecting someone’s decision to get vaccinated. There’s a camp of people that take these rumors seriously…

“It’s really frustrating, because [young people] are the ones that are putting themselves most at risk by being in large groups and going to school. And if we don’t get the vaccine, and protect ourselves from this incredibly dangerous virus and all of its variants, we’re going to continue dealing with restrictions on the lives that we just want to get back to.”

Vaccine rates stalled, then declined

According to The Washington Post, after vaccine eligibility opened up in April, weekly vaccination rates stalled in adults ages 18 to 39, then declined significantly over the next few months (although rates have risen again, as of August).

To some degree, it makes sense that vaccination coverage would be stratified by age, as vaccine eligibility opened in age-stratified waves.

However, considering the fact that all individuals above the age of 11 have been eligible for vaccination since mid-May, considering the general ease of availability of vaccinations nowadays, and considering the ways in which state and city governments as well as universities, workplaces, and local groups have been encouraging vaccination, even offering cash incentives, scholarship opportunities, free public transit passes, and more to those who get vaccinated, it seems strange that some age groups would be lagging so severely behind others in terms of coverage.

A presumption of risk

There are a variety of factors that may be contributing to this rend. One of the primary reasons likely has to do with the idea perpetuated early on in the pandemic that younger people were not at risk of becoming seriously ill if they contracted Covid.

“The way that the pandemic has been framed, essentially what we heard at the beginning, is that if you were older, you’re more likely to face severe consequences related to Covid,” Rupali J. Limaye, a Johns Hopkins University researcher, told The Washington Post. “I think a lot of younger people were like, ‘It’s okay if I get it. I’m going to be able to survive it.’ ”

While the majority of younger adults may escape from Covid infection largely unscathed, it is simply untrue that they are unable to become seriously ill due to their age.

A UCSF study from last year of young adults ages 18 to 25 found that approximately one in three young adults may become seriously ill (requiring hospitalization) from Covid.

“Although the risk of serious illness or death from COVID-19 increases steadily with age, younger people can get sick enough from the disease to require hospitalization,” Harvard Health wrote on their website. “And certain underlying medical conditions may increase the risk of serious COVID-19 for individuals of any age.
“Everyone, including younger and healthier people, should get the vaccine once they are eligible, to protect both themselves and their community. Vaccines offer excellent (though not complete) protection against moderate to severe disease, hospitalization, and death.”

Danger of long Covid

Furthermore, young adults may also be susceptible to developing long Covid, the debilitating, lingering illness that develops in some individuals following Covid infection, even if they were asymptomatic at the time of initial infection.

​​“Young adults who have had Covid, regardless of symptoms, may be vulnerable to long-term complications and debilitating symptoms that may include respiratory difficulties, loss of smell and brain fog, often referred to as ‘long Covid,’ Sally Adams, PhD, RN, a specialist at the UCSF Division of Adolescent and Young Adult Medicine told UCSF News. “Estimates range from 10 to 50 percent for long Covid symptoms, which is a serious concern for young adults given their high infection rates and low vaccination rates.”

It is also possible for young children to become seriously ill from Covid, another age group commonly misconceived to be immune to severe Covid infection. Earlier this year, ClearHealthCosts reported on Multisystem Inflammatory Syndrome in Children (MIS-C), a life-threatening condition that can develop in children after a Covid infection.

Although youth may provide some protection against serious infection, it is not the fail-safe shield that many people believe it to be.

“Initially, it did seem like [young people] were not as affected,” Cree’Shaina Towery, whose  9-year-old daughter nearly died from Covid after an initially asymptomatic infection, told ClearHealthCosts in a phone interview. “It seemed like kids were spared from the more severe cases of Covid…just because your child gets Covid and is asymptomatic, that does not mean that they are out of the woods.

“If I had to summarize it in one statement, it would be that basically, prevention should be the goal. It shouldn’t be, you know, my child will get Covid and they’ll be fine…From a mother who watched her daughter cry in pain and suffer for five days: Take Covid seriously, because it is just as serious in kids as it is in adults.”

Contracting and spreading the virus

While younger people are less likely to become seriously ill from Covid, they can still, of course, contract and spread the virus, even without knowing it, such as in cases of asymptomatic infection.

Nationwide data from the C.D.C. indicates that, for the last several months, the average age of Covid patients is getting younger, primarily because of high vaccine coverage in older age groups.

According to a recent report from CNN Health, older teens, aged 16-17, are currently facing the highest weekly infection rates among not only children, but all age groups.

This is thought to be due largely to the rampant spread of the highly transmissible Delta variant this summer, and to the behavior of these young age groups, who are throwing caution to the wind as the pandemic drags on and, for those still in school, facing fewer restrictions during their summer vacations than they otherwise would while attending in-person learning.

“My suspicion is it probably has more to do with behavior than biology, in terms of, what are those kids doing?” Dr. Sean O’Leary, professor of pediatrics and infectious diseases at University of Colorado’s School of Medicine, told CNN Health. “They’re able to drive on their own, they’re hanging out after school, getting together with other kids their age, likely often without the mitigation measures that would be in place in school.”

Misinformation and disinformation

Another potential factor affecting vaccine hesitancy in younger people is the spread of misinformation on widely-used social media platforms, such as Facebook, Instagram, and Snapchat.

“I’ve seen a lot of disinformation on Snapchat and other social platforms,” Kagan said. “On Snapchat, because posts from your story will be taken down in 24 hours and because the messages you send disappear within seconds of being seen, it sort of feels like an unchecked place.

“The moderation and support team can’t really make the effort to take things down, because stuff disappears so quickly, unlike Facebook and Instagram and TikTok and other platforms where stuff gets stored for years. I’ve seen all kinds of disinformation, regarding vaccines, talking about how there are microchips in vaccines or, you know, if I get the vaccine, I’ll be tracked. Just lots of different conspiracy theories that have been already spoken by other media outlets regarding people that don’t believe that the COVID-19 vaccines are very much effective and a useful tool in fighting this pandemic.”

More testing?

“I don’t feel like it’s gone through enough testing,” J., an 18-year-old from New York who spoke with ClearHealthCosts on condition of anonymity, said in a phone interview. “And I also believe l it’s being pushed way too hard for a medical treatment … like the free doughnuts, all the free stuff, the money, the lotteries, it just doesn’t feel like normal medicine. I know it’s not normal times, don’t get me wrong. But especially with all the bots out there and the misinformation, all that — it just kind of makes me very unsure about whether this is truly a safe choice now, especially since we don’t really know much about the future long-term effects of the vaccine.”

“It hasn’t been through as much testing as regular vaccines, and I just don’t feel like that’s right. I feel like if someone wants to take it, they can take it, but I feel like someone else also has the right to not get it.”

J. was pushed by his parents to get vaccinated, and eventually ended up getting the vaccine in order to begin a new job that required its employees to be vaccinated.

But he still didn’t want to have his name used in connection with his views, saying he wanted to avoid repercussions from peers and potential future places of employment and education.