In the seven months since COVID-19 vaccinations first became available, Dr. Amy Crawford-Faucher, a family medicine specialist at Allegheny Health Network, has heard a variety of explanations from young adults who have not gotten vaccinated.
“In young folks, there’s this feeling of immortality: ‘I’m young, I’m healthy, I got COVID and I didn’t get that sick.’ There are people who just don’t like shots, and the thought of COVID doesn’t scare them,” said Crawford-Faucher.
Others have cited distrust of the vaccine, concerns about potential side effects, and distrust of the pharmaceutical industry and the government, she said.
Initially, health officials worried about vaccine hesitancy among minorities, but as vaccine rates climb among those groups, it’s young adults, especially those who live in rural areas, who are reluctant to get the vaccine.
According to the U.S. Centers for Disease Control and Prevention, about 34% of U.S. adults between 18 and 39 years old had gotten a first dose of a COVID-19 vaccine as of May 31.
The CDC estimates that only 58% of 18- to 29-year-olds will be vaccinated by late August, while 95% of those 65 and older are projected to be vaccinated.
In Pennsylvania – which, according to the CDC ranks fifth among all 50 states for total doses administered, with 61.3% of adults 18 and older fully vaccinated – less than half of adults under the age of 35 have had at least one dose of COVID-19 vaccine.
As the pace of COVID-19 vaccinations slows in the United States and in Southwestern Pennsylvania – nationwide, daily vaccination rates have dropped from a peak of 4.4 million a day to about 420,000 currently, and locally most mass vaccination clinics have shut down in recent weeks – health officials note that convincing skeptical young adults to get vaccinated has become an obstacle toward the goal of controlling the number of infections and preventing new outbreaks.
“I think overall, the concern is that the fewer people who are vaccinated, the more opportunity this virus has to duplicate and replicate and cause disease,” said Crawford-Faucher. “The vaccine-hesitant groups are evolving ... so it seems to be coming down to younger folks, more rural and more conservative people.”
The current worry is the highly transmissible delta variant, which is beginning to spread more widely across the United States as many COVID-19 restrictions are being lifted and students – including those under the age of 12 who are not eligible to get a COVID-19 vaccine – prepare to return to school in upcoming weeks.
“It’s concerning. If you look at the demographic of young adults, they are more likely to be socializing in large groups, attending sporting or music events, going to bars, or they have young children, so you have a group of people who are under-vaccinated and are out and about in the world, and who can really be putting those folks who cannot get vaccinated because they’re too young or they’re immunocompromised at risk,” said Crawford-Faucher. “That’s one of the big fears and frustrations.”
But how to motivate Gen Z and Millennials to get vaccinated, said Crawford-Faucher, “is the million-dollar question.”
“This is probably a population where you’re not going to make a lot of movement. It’s not a lack of information at this point, it’s a point of view, and we have to have dialogue,” said Crawford-Faucher. “We don’t want to make this a right versus wrong, us versus them, but one-on-one, small group to small group. And we need to engage community leaders that they trust and will listen to – teachers, religious leaders, family members.”
At California University of Pennsylvania, microbiology professor Dr. Michelle Valkanas undertook a 10-week science fellowship project addressing COVID-19 vaccine hesitancy and identifying concerns, fears and mistrust around it.
The goal is to develop no-conflict literature, materials, and programming to address those misconceptions and concerns surrounding the vaccine.
“We want to understand the reason for vaccine hesitancy and be proactive in finding ways to have meaningful conversations,” said Valkanas. “It’s important to put into perspective people’s hesitancy and have conversations about it. You have to have common ground, you have to be willing to sit down and have a conversation and let the walls come down. You can’t just throw out facts. Really, you can’t have effective conversations if you don’t have an understanding about why individuals have the feelings they do. You can’t disregard them. Their feelings about the vaccine matter.”
Valkanas and her co-lead, Dr. Kate Carter, director of science education at Frost Science Museum in Miami, along with seven undergraduate and graduate students at Cal U. and Duquesne University, are midway through the project and aim to complete it by the end of August.
Among the takeaways so far, though, are that the counties in the commonwealth with higher vaccination rates also have community-driven vaccine initiatives and provide access to the vaccines by delivering them to shut-ins and those with limitations for getting to vaccine sites.
“I think the other thing to take home from this would be the obvious importance of the vaccine,” said Valkanas. “I think that we’ve come into a sense of complacency now that everything is reopening. But those states with low vaccines are still being impacted. It’s still important that even though we’re opening up and going back to a sense of normalcy, the sense of normalcy came from the vaccine, and we need to keep that in mind.”
Crawford-Faucher, who herself grew up in a small town, remains concerned about rural communities, “where they have a sense of rugged individualism that this stuff isn’t going to touch us.”
“I worry about a whole swath of our population getting sick and dying, or getting a little sick and getting long-hauler symptoms. I think sometimes young folks aren’t thinking about this,” she said.
Dr. David Hess, CEO of WVU Medicine – Uniontown Hospital, agreed.
“We still don’t know the long-term effects of getting COVID,” said Hess. “It’s true that that age group goes through that invincibility stage, that nothing can happen to them, but we’ve also never faced a pandemic.
“Young adults don’t live in the long-term, they live in the short-term, and they have to overcome that. I agree their risk of getting seriously ill is low, but somebody in their family or who may be their friend can get sick. Some of the reason to get the vaccine is to protect themselves, but some of the reason is to protect their family and friends,” he said. “And, quite honestly, we’ve still seen kids and young adults can still get very sick.”
For young adults who are hesitant to get the vaccine, Hess – a father of six whose children are eligible for the COVID vaccine have gotten vaccinated – said the benefits of the vaccine far outweigh the risks.
“For me, it all came down to getting my children vaccinated to prevent any long-term effects,” said Hess. “It’s vitally important to get everybody vaccinated that can right now. It’s incredibly important to stop the spread.”