Adolescent/Young Adult (AYA) Hematology/Oncology Patient and Parent Attitudes toward AYA COVID-19 Vaccination

Abstract

Background: Adolescent/young adult (AYA) patients with hematologic and oncologic conditions are at increased risk for complications of COVID-19 and thus are important targets for vaccine outreach. AYA patients are transitioning from relying upon parental vaccine decision-making to independently making their own decisions. AYA with sickle cell disease (SCD) are of particular concern because a high proportion are African American and experience structural racism in addition to their illness. Further, AYA patients with chronic conditions may consider their past and present illness in their decision-making process.
 Methods: As part of a larger IRB-approved study, we recruited vaccine decision-makers for AYA patients aged 9-21 years attending SCD and oncology survivor clinics, including AYA patients 18-21 years old and parents of AYA patients 9-21 years old. After informed consent, participants completed a short demographic survey and a semi-structured interview regarding their vaccine decision-making process. Questions about the COVID-19 vaccine were incorporated given the ongoing pandemic.
 Results: Forty-nine parents and 21 AYA patients were recruited. The primary barriers reported regarding vaccination were concerns about its short-term side effects (57% AYAs; 37% parents) and potential to have unknown, long-term effects (10% AYAs; 14% parents). There were also concerns voiced about how rapidly the vaccine was developed (14% AYAs; 27% parents) and misconceptions about the vaccine (19% AYAs; 10% parents). Parents and AYA patients described the benefits of vaccination as lowering personal risk (62% AYAs; 35% parents) and several also mentioned the community benefits of preventing the spread of COVID-19 (19% AYAs; 8% parents) and a possible return to “normal” (14% AYAs; 10% parents).
 Potential Impact: The data from this study will further the understanding of how parents and young adults with chronic hematologic and oncologic conditions make decisions about COVID-19 vaccination, a vital tool for protecting medically and socially vulnerable populations during the COVID-19 pandemic.