JAMA Health Forum – Health Policy, Health Care Reform, Health Affairs | JAMA Health Forum | JAMA Network
[Skip to Navigation]
Sign In
Table 1.  Demographic Characteristics of the Full Cohort and the Vaccine-Willing Sample
Demographic Characteristics of the Full Cohort and the Vaccine-Willing Sample
Table 2.  Questions, Themes, Responses, and Representative Quotes
Questions, Themes, Responses, and Representative Quotes
1.
United States Centers for Disease Control and Prevention. COVID Data Tracker Weekly Review. Accessed April 29, 2021. https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covidview/index.html
2.
Brandt  EJ, Rosenberg  J, Waselewski  ME, Amaro  X, Wasag  J, Chang  T.  National Study of Youth Opinions on Vaccination for COVID-19 in the U.S.   J Adolesc Health. 2021;68(5):869-872. doi:10.1016/j.jadohealth.2021.02.013PubMedGoogle ScholarCrossref
3.
United States Centers for Disease Control and Prevention. Guidelines for Mass COVID-19 Vaccination. Accessed April 29, 2021. https://www.cdc.gov/vaccines/covid-19/index.html
4.
Mahase  E.  Covid-19: Expedite vaccination or deaths will surge, researchers warn.   BMJ. 2020;371:m4958. doi:10.1136/bmj.m4958PubMedGoogle Scholar
5.
DeJonckheere  M, Nichols  LP, Moniz  MH,  et al.  MyVoice National Text Message Survey of Youth Aged 14 to 24 Years: Study Protocol.   JMIR Res Protoc. 2017;6(12):e247. doi:10.2196/resprot.8502PubMedGoogle Scholar
6.
The White House COVID-19 Response Team. Comments by Andrew Slavitt, Senior Advisor to the COVID-19 Response Coordinator. Accessed April 29, 2021. https://www.whitehouse.gov/briefing-room/press-briefings/2021/04/19/press-briefing-by-white-house-covid-19-response-team-and-public-health-officials-30/
Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words
    Research Letter
    August 20, 2021

    Youth Perceptions of Vaccination for COVID-19 in the United States

    Author Affiliations
    • 1Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor
    • 2Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Michigan, Ann Arbor
    • 3Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor
    • 4Section of General Pediatrics, Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut
    • 5Department of Family Medicine, University of Michigan, Ann Arbor
    • 6University of Michigan, Ann Arbor
    JAMA Health Forum. 2021;2(8):e212103. doi:10.1001/jamahealthforum.2021.2103
    Introduction

    Recent increases in COVID-19 cases are associated to infections among a younger population in the US.1 In a focused survey administered prior to vaccine emergency use authorizations (EUAs), 2 in 5 US youths reported willingness to vaccinate against COVID-19, whereas 1 in 3 were uncertain.2 Since then, the US has implemented a mass immunization campaign.3 Widespread vaccine uptake among youth is essential to achieve adequate community immunization levels to attenuate the COVID-19 pandemic.4 We therefore collected the thoughts and opinions from a diverse sample of US youth after the initiation of mass immunization campaigns regarding COVID-19 vaccine acceptability, perceived barriers to vaccination, and anticipated changes in behavior.

    Methods

    Respondents were part of the MyVoice Poll of Youth, a national text message survey that collects the perspectives of youth (aged 14-24 years) on health and policy issues.5 Youths are recruited on a rolling basis to match national demographic benchmarks, including self-reported age, sex, race and ethnicity, education, and region of the country, based on weighted samples from the American Community Survey. This study was approved by the University of Michigan institutional review board, including a waiver of parental consent for minor participants. This study followed the American Association for Public Opinion Research (AAPOR) reporting guidelines. Online consent was obtained from all participants. Five open-ended questions were fielded on March 12, 2021, via text message regarding COVID-19 vaccination.

    The authors developed a codebook through qualitative thematic analysis of responses. Responses were independently coded by 2 investigators (S.M.G., E.J.B., J.R., M.W., X.A.) using discussion to reach consensus. When appropriate, close-ended questions were first categorized (eg, yes, no) and the associated open-ended questions (“Why or why not?”) were then coded using thematic analysis to provide additional insight into these questions. Summary statistics of demographic data and code frequencies were calculated. Analyses were completed using Stata statistical software (version 16; StataCorp, LLC).

    Results

    Of 1155 participants, 1074 responded to at least 1 question (response rate, 93%). The demographic characteristics of these respondents are shown in Table 1. In brief, respondents most commonly identified as male (n = 526 [49.0%]), and non-Hispanic–White individuals (n = 661 [61.7%]), with a mean (SD) age of 19.3 (2.4) years.

    Table 2 summarizes the major themes, with representative quotes by question. Overall 797 of 1068 youth respondents (74.6%) were interested in getting vaccinated to protect themselves and return to normal (“Yes I will because I want to help stop the spread as well as get back to normal as soon as possible”). Of 1009 youth respondents, most were concerned about adverse effects (422 [41.8%]) and the effectiveness if the vaccine (118 [11.7%]), whereas 324 (32.1%) had no concerns. Of 990 youth respondents, 721 (72.8%) believed the vaccines are safe and/or effective, citing their trust in science (145 [20.1%]) and data (221 [30.7%]). To facilitate vaccination, youths indicated that they seek an easy sign-up process (“A simple streamlined process that’s centralized”) and locations close to them. Most youth also reported that they will continue mitigating behaviors such as wearing a mask even after vaccination.

    Discussion

    Whether or not to vaccinate against COVID-19 is an important health care decision many parents will soon make for their children and young adults must make for themselves. These findings indicate that youth respondents in this large, diverse sample were interested in receiving a COVID-19 vaccination. Our findings are limited to self-reported perceptions at the time of survey and do not necessarily predict future behavior. As younger demographic groups become eligible for vaccination,6 vaccination sites must be located in places that are convenient for youth and families, reduce complexity around making appointments, and must be prepared to administer vaccines to children.

    Despite widespread trust in science and data, and a desire to return to normalcy, youth reported being concerned about short- and long-term adverse effects. Campaigns and educational programs can emphasize the safe and effective vaccination of millions of recipients in the US thus far and the integral role that widespread vaccination plays in returning to their usual activities.

    Back to top
    Article Information

    Accepted for Publication: June 18, 2021.

    Published: August 20, 2021. doi:10.1001/jamahealthforum.2021.2103

    Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2021 Gorga SM et al. JAMA Health Forum.

    Corresponding Author: Stephen M. Gorga, MD, 1500 E. Medical Center Dr, F-6890, Ann Arbor, MI 48109 (smgorga@med.umich.edu).

    Author Contributions: Dr Gorga had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

    Concept and design: Waselewski, Brandt, Amaro, Chang.

    Acquisition, analysis, or interpretation of data: All authors.

    Drafting of the manuscript: Gorga, Brandt, Chang.

    Critical revision of the manuscript for important intellectual content: All authors.

    Statistical analysis: Gorga, Amaro.

    Obtained funding: Chang.

    Administrative, technical, or material support: Waselewski, Amaro, Chang.

    Supervision: Waselewski, Chang.

    Conflict of Interest Disclosures: None reported.

    Funding/Support: This research was funded by the Michigan Institute for Clinical & Health Research and the University of Michigan Departments of Internal and Family Medicine.

    Role of the Funder/Sponsor: The Michigan Institute for Clinical & Health Research and the University of Michigan Departments of Internal and Family Medicine had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

    References
    1.
    United States Centers for Disease Control and Prevention. COVID Data Tracker Weekly Review. Accessed April 29, 2021. https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covidview/index.html
    2.
    Brandt  EJ, Rosenberg  J, Waselewski  ME, Amaro  X, Wasag  J, Chang  T.  National Study of Youth Opinions on Vaccination for COVID-19 in the U.S.   J Adolesc Health. 2021;68(5):869-872. doi:10.1016/j.jadohealth.2021.02.013PubMedGoogle ScholarCrossref
    3.
    United States Centers for Disease Control and Prevention. Guidelines for Mass COVID-19 Vaccination. Accessed April 29, 2021. https://www.cdc.gov/vaccines/covid-19/index.html
    4.
    Mahase  E.  Covid-19: Expedite vaccination or deaths will surge, researchers warn.   BMJ. 2020;371:m4958. doi:10.1136/bmj.m4958PubMedGoogle Scholar
    5.
    DeJonckheere  M, Nichols  LP, Moniz  MH,  et al.  MyVoice National Text Message Survey of Youth Aged 14 to 24 Years: Study Protocol.   JMIR Res Protoc. 2017;6(12):e247. doi:10.2196/resprot.8502PubMedGoogle Scholar
    6.
    The White House COVID-19 Response Team. Comments by Andrew Slavitt, Senior Advisor to the COVID-19 Response Coordinator. Accessed April 29, 2021. https://www.whitehouse.gov/briefing-room/press-briefings/2021/04/19/press-briefing-by-white-house-covid-19-response-team-and-public-health-officials-30/
    ×