Adolescent and Young Adult Cancer Survivors May Be Hesitant About the COVID-19 Vaccine

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More than one third of adults and adolescents who were diagnosed with cancer between ages 15 and 39 were hesitant about receiving the COVID-19 vaccine, despite being an at-risk group.

Adolescent and young adult cancer survivors were hesitant about receiving a COVID-19 vaccination, according to new data in JNCI Cancer Spectrum published by Oxford University Press.

Researchers aimed to determine which sociodemographic and COVID-19 factors may be associated with hesitancy to receive the COVID-19 vaccine among adolescent and young adult cancer survivors.

“Such hesitancy is problematic among cancer survivors, who often have weakened immune systems and are more likely to develop severe respiratory infections,” the authors wrote.

The current recommendation for cancer survivors is to receive the COVID-19 vaccine if they have no contraindications. Cancer survivors on active treatment were considered a priority vaccination group. An additional concern is that adolescents and young adults in the U.S. have the highest incidence of COVID-19 infection of any age group since June 2020.

Participants in the study were eligible if they were 18 years or older, were diagnosed with cancer between the ages of 15 and 39 and received services through an adolescent and young adult program.

Researchers collected data on 342 survivors who completed the survey, who had an average age of 29.5. More than half of the participants had received treatment since March 2020. Of the participants, 62.9% intended to get the vaccine while 37.1% expressed hesitancy about getting it.

Those who expressed hesitancy were more likely to be female (41.6% of female survivors vs. 30.1% of male survivors), Hispanic (52.9% vs 31.6% of White survivors and 20.0% of non-Hispanic other) and have a high school education or less (3.14 times higher odds than college graduate or higher). This may be due to the association of lower health literacy with lower educational attainment, leaving certain survivors more susceptible to misunderstanding messaging surrounding the COVID-19 vaccine, the authors explained. They added that inconsistent messaging from U.S. public health services has also caused confusion about COVID-19 among the general population.

“Targeted education from cancer centers and oncology care teams to encourage equitable COVID-19 vaccination is needed for cancer survivors of all ages,” the authors wrote. “Additionally, oncology care providers should encourage COVID-19 vaccination as such recommendations are the primary facilitator in uptake of other vaccines among (adolescent and young adult) survivors.”

The participants were sampled from across the Mountain West, which means the findings are not generalizable to all regions of the U.S. Additionally, the researchers did not collect any information on political affiliation, and the sample was fairly homogenous which prevented any evaluation of association by race.

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